Medical Mnemonist (from MedSchoolCoach) InsideTheBoards

Chase DiMarco opens up about recent events that lead to personal anxiety and discusses how students can deal with anxiety and depression during COVID.
 
[01:50] Mental Issues Among Medics [03:50] Finding Ways to Deal with Your Anxiety [04:50] Trigger Events [08:52] Seeking Help [12:50] How Stress Can Affect us as Learners [14:10] The Vicious Cycle That is Anxiety and Depression  
The medicine world has often been recognized as a stressful environment that sometimes hurts a medics' performance, physical health, and psychosocial well-being. Throw a global pandemic into the fray, and you'll find that even more medics are falling into a state of either depression or anxiety. Interestingly, medical practitioners are less likely to seek help because of the fear of being stereotyped or judged by their peers. 
With the global suicide stats at an all-time high, it's high time we addressed the mental health issues in a COVID-fatigued society. Although Chase has faced bouts of anxiety since his high school, he has managed them with relative ease. However, a recent trigger event made him feel a little overwhelmed with what was happening around him. This trigger event helped him understand that no matter how small the issue you're facing might be, it has the potential to make you feel anxious or depressed. These triggers can come from anywhere, and it won't matter how insignificant they are; the thing to note is that they affect you, and you need to do something about them.
We unknowingly struggle with mental issues which means some of us seek help when it's too late. These little anxiety triggers are known to build up and eventually blow up, leading to a spike in negative thoughts crisscrossing through a person's mind. The most important step in the healing process is recognizing that you need help. 
While different solutions can work wonders for different people, a couple of resources that worked for Chase might also work for you. With the pandemic restricting people's access to physical help, online platforms such as BetterHelp and TalkSpace are known to offer help via text, chat, or video calls. Chase advises people to try and seek help from neutral parties since close friends and family typically have a bias because of the relationship you have with them. 
Learners have the most to lose when it comes to dealing with mental health issues. The fact that depression and anxiety can play havoc with one's memory makes it difficult for learners to ingest new material or answer a patient's questions. The mental issues will also affect your sleep patterns, and the longer you wait before seeking help, the longer it will take before you come back to a state of normalcy.
Chase's message for you today is that it might not be you who's battling depression and anxiety, but you might know someone who is. Not everybody has the guts to come out and talk about what's eating them. If you notice somebody acting differently from what you associate them with, be the friend and offer a listening ear, you'll be surprised by how big an impact you can have by just being there. You can also share this episode with them to let them know that they are not alone and that there is help. We live in trying times, and the best way to look out for one another is by being there for one another. 
Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! Also, do check out Read This Before Medical School. 
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Discover advanced memory techniques from the experts at Mullen Memory.
Chase DiMarco hosts The Medical Mnemonist podcast episode: Advanced Memory Techniques with Mullen Memory.

Dr. Michael Cosimini discusses gamification and games for clinical education. Dr. Cosimini is an Assistant Professor of Pediatrics at the Keck School of Medicine at USC, and the author of Empiric, a card game for learning guidelines-based antibiotic selection.
[02:08] Challenges of Creating Games for a Clinical Setting [02:56] Gamification Versus Serious Games [07:22] How to Balance Between Entertainment and Education [08:09] Tabletop Games Versus Video Games [12:23] How Medical Students Can Apply Games to Their Learning [13:49] How Empiric Works [20:21] How to Find Out More About Michael & Empiric Gamification Versus Serious Games Many medical instructors already gamify their educational content, for example, by transforming a PowerPoint slide into a game of Jeopardy, giving out stickers for accomplishments, and having a leaderboard in class. An example of gamification in the literature is when surgical residents performing laparoscopic procedures were split into competing groups. The randomly selected students who trained in this gamified setting trained longer and performed better.
Dr. Cosimini does support gamification, but he more strongly promotes “serious games” which go beyond gamifying existing educational content, to creating a game for the purpose of education, rather than pure entertainment. For example, the game GridlockED, which resembles Clue, trains players to handle emergency room throughput. Michael’s card game, Empiric for learning antibiotic selection is also a serious game.
How to Balance Entertainment and Education in Games To help find the appropriate balance between entertainment and education, Dr. Cosimini emphasizes the importance of testing the outcome of a game, to see what students have actually learnt. As a rule of thumb, be respectful of the player’s time. Do not have a game that is long, unless there is evidence that shows that this contributes to the learning process.
Tabletop Games Versus Video Games Dr. Cosimini promotes tabletop games over digital or video games for medical education. He cites a study by Mary Flanagan of Tiltfactor, a game design company. The study compared the iPad and tabletop version of Pox: Save the People, a game about disease spread. With the tabletop version, people tended to interact and work together more, which is important for the social aspect of learning.
How Medical Students Can Apply Games to Their Education Creating their own card games might be too involved, and too time-consuming for a medical student. Students can instead use off-the-shelf card games from resources such as East Midlands Emergency Medicine Educational Media, #EM3, which provides games for learning about pediatric EKGs, pediatric dermatology, and pediatric and adult orthopedics. For instructors, Michael recommends MedEd. He of course also recommends his own game Empiric, for learning about antibiotic selection, and his upcoming game about emergency medicine. These games are more helpful for clinical education i.e. for medical students on their clinical rotations, or for residents, and less helpful for first and second year medical students.
How Empiric Works Empiric is based on the American Academy of Pediatrics (AAP) Red Book, 2018-2021. Dr. Cosimini includes visual cues — such as color coding — for facts such as the mechanism of delivery and the spectrum of activity, to enable students to memorize facts more quickly. It can be difficult to keep up with the changing facts around antibiotic resistance, and other antibiotic research. Currently, Dr. Cosimini does this by updating the printable card decks online, after the research is updated.
Check out Empiric’s Twitter, Instagram, Facebook, and website. The website includes a list of medical and non-medical card games.
Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can

Alex Mullen & Cathy Chen of Mullen Memory discuss memory palaces.
Chase DiMarco hosts The Medical Mnemonist podcast episode: Memory Palaces basics with Mullen Memory’s Alex Mullen & Cathy Chen.
Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor!
You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School.
 

Rhett Thomson discusses the importance of understanding material vs rote memorization, the story method, and pre-made versus self-made mnemonics.
[00:43] Physeo’s Philosophy of Learning [05:29] PowerPoints Versus Physeo’s Content [12:05] Pre-Made and Self-Made Mnemonics [23:30] Questions to Ask When Studying or Learning [28:44] Rhett’s Thoughts on Step 1 Becoming Pass/Fail [32:10] Patterns of Learning Used By High-Scoring Step 1 Exam Participants [35:54] How to Find Out More About Physeo and Step 1 Success Stories Chase DiMarco talks to Rhett Thompson, a student at the University of Utah Medical School and Cofounder of Physeo, a learning resource which helps medical students to prepare for the USMLE board exams. They discuss the importance of understanding versus only memorizing, the story method, and pre-made versus self-made mnemonics.
Physeo’s Philosophy of Learning
Physeo was born when Rhett and his friends were approaching their USMLE Step 1 Exam. They realized that they had relied on memorizing facts, without sufficiently understanding how these facts fit into deep and meaningful conceptual frameworks. The original intention was to build a conceptual framework around physiology, which is foundational to medicine. But at the moment, Physeo comprises not only 72 videos on physiology, but 79 videos in total covering other Step 1 topics as well.
PowerPoints have been the standard method of information dissemination, within medicine but also more broadly. There are several benefits to PowerPoints — they enable a student to follow along with a lecturer, and they enable notes to be accessible to students after the lecture, reducing anxiety around notetaking. However, PowerPoints are insufficient with regards to helping students to understand and lock in the information that they are given.
Physeo focuses on creating a large framework which makes learning and memorization intuitive and effortless. The core of Physeo’s philosophy is that understanding is key. Physeo’s videos walk students through complicated topics tested in the USMLE Step 1 Exam, reimagining them as stories, and using mnemonic devices which are logically coherent and intuitive, rather than a bunch of facts thrown together.
Pre-Made and Self-Made Medical Mnemonics Medical students can use various pre-made mnemonics provided by companies like Physeo. However, some argue that self-made mnemonic devices are more effective than those created by someone else. While Rhett agrees that self-made medical mnemonics may stick better, it is difficult to create stories as complex, and yet intuitive as the pre-made ones created by Physeo if you do not have a team of people doing thorough research and refining the mnemonics together. Medicine involves many complex topics, and a mnemonic that is roughly thrown together by an individual person may not stick.
Questions to Ask When Learning Although the quality and breadth of Physeo’s visual mnemonics are not achievable by an individual, Rhett provides key questions that students can ask in their own study time, as an effective learning technique. Firstly, ask why or how. To illustrate, in acute inflammation, prostaglandins can cause swelling. Instead of just memorizing this, ask yourself why/how prostaglandins cause swelling. You can then make a connection that is more logical. For example, prostaglandins cause postcapillary venules to become more permeable. This permeability can cause leaking of fluid, which results in edema in the interstitial tissue.
You have made a bit of a framework by making this logical connection — taking us to the next question: how does this fit into a bigger framework? Having studied prostaglandins, you might relate this to the larger framework of acute inflammation. So you have connected prostaglandins to swelling and acute inflammation.
Taking this further, in a clinical

Dr. Jill Wener discusses systemic racism, anti-racism, the Black Lives Matter movement, and the concept of reverse racism. Dr. Wener is the host of the Conscious Anti-Racism podcast.
 
[01:48] Dr. Wener’s Journey into Anti-racism [08:39] White Supremacy Culture and Systemic Racism [15:27] Racism in Medicine [19:26] Why Reverse Racism Cannot Exist [27:40] Why Black Lives Matter exists [31:16] Internal Versus External Work to Combat Racism [37:19] Resources on Anti-racism  
Dr. Jill Wener is the host of the Conscious Anti-Racism podcast and creator of a curriculum with the same name.
But I am Not Racist! Dr. Wener began leaning into her discomfort around race after a friend admonished her on the racially privileged perspective of her blog post on the 2016 election. Initially defensive, she knew that if she did implicitly have harmful views on race, she needed to correct them.
Just like Dr. Wener, many white people are sometimes defensive about race, and reluctant to agree that they are racist and that they benefit from white supremacy and white privilege. They often cite the hard work that they have invested to achieve success, and how they never use their racial privilege. However, Dr. Wener describes the systemic racism in the US as a “toxic fume soup” in which we are all immersed. White people inevitably benefit from their race, even if they do not intend to do so.
To illustrate one of the many ways in which white people unintentionally benefit from the color of their skin, Dr. Wener shares her story of being ticketed for using her cell phone in the car. She describes exiting her vehicle to stretch while waiting, and trying to explain to the officer that she had only taken out her phone to take a picture of an advertisement for a farmer’s market. Once the officer gauged that she was a doctor, he explained that he would not have ticketed her. At the time, Dr. Wener did not count this as an incident of her white privilege. But in hindsight, she knows that if she had acted similarly as a black person, she would have been shot or arrested. She knows a black friend who drives with a stethoscope and his medical ID hanging on his rearview mirror to protect himself from harm. White people can go through life without considering their race very much, whilst black people must always be aware and take precautions to protect themselves.
Why Reverse Racism Cannot Exist Young adult author Kimberly Jones, encourages us to consider a game of Monopoly where the game has been fixed against some players i.e. black people. For four hundred rounds, black people have been working for no pay under slavery, not being able to own land or anything. Then, for another fifty rounds, money that black people earned was taken from them (consider Tulsa). Now, imagine that after four hundred and fifty rounds, suddenly, black people are told to just start playing the game as “equals.” The hundreds of rounds of damage has not been undone. Therefore, when special spaces are created for black people, or when special opportunities are given to them, it cannot be considered racism on white people, rather, it is taking the first steps towards equality.
Racism is the systemic oppression of the weak by the powerful. Systemically, white people have the power, therefore they cannot be the victims of racism. Relatedly, Black Lives Matter does not imply that other lives do not matter. Rather, the name demonstrates that previously, black lives have not been treated as if they matter, and now we acknowledge that they matter just as much as white lives.
Racism in Medicine The boards of most hospitals and the dean’s office of schools, in other words people in power, often lack representation from people of color. In patient care, research has demonstrated that med students think that black people feel less pain. Differential diagnosis methods, whi