Studying medicine in Italy, in English, has some unique implications for note-taking. Here is a system I have devised.
Unlike at many US medical schools, we are required to go to classes — at least, to 75% of them. This is, I believe, decreed by European Union standards. If you do not pass out of certain classes because of prior academic experience — which, is, actually the case for a handful of us at the IMS Milan — this means that you may have to be in lecture from hours as long as 8:30 AM to 5:30 PM, with a break for lunch. (This is, however, not nearly the case every day.) It is beneficial, therefore, to take advantage of classtime as much as possible, maximizing your learning, so you can have as much free time outside of class as possible, among other reasons, so you can do what you enjoy.
The professors at IMS Milan sometimes base their excellent lectures around the curricula designed for Italian-language medical education. Other times, the professors have created innovative, original courses for IMS. Our textbooks, however, are in English, and have pretty much all originated in the English-speaking world. This means that typically, lectures do not follow textbooks in sequence, nor do we students know much about how lectures might correspond to textbook chapters. Nonetheless, we are required to learn the material in the textbooks, and can, indeed, be tested on things that professors did not mention in class.
So, one of the first things you may wish to do at the beginning of a semester is determine which sections of which texts match each lecture. You sit down with your textbooks, and with a copy of the very helpful IMS Student Guide, which lists lectures topic by topic. Then, you notate which lecture corresponds to which textbook content. For example, in my Student Guide to the right, “MBC4 Ch. 15”, next to Lecture 3, indicates that the textbook Molecular Biology of the Cell Edition 4 Chapter 15 covers signal transduction, the topic of the lecture.
Then, the night before each lecture, you skim the chapter on the material it covers. Just skim — you do not need to go in depth. The key here is to familiarize yourself generally with the material, and, crucially, the vocabulary. This way, you are not sitting in class lost, as if you are listening to the Klingon language. For the majority of the students in our school, for whom English is not a mother tongue, this pre-lecture preparation is particularly useful, because the professor may use English technical scientific terminology that they may have not yet heard.
I always print the lecture slides — whenever the professor makes them available — before lecture. (If you don’t have a printer, it is worth the investment. They are pretty inexpensive — you can cover the cost with your student loan or scholarship — and it allows you to print in comfort at home, rather than always going to the university computer lab.) A lot of medicine is diagram and graph-oriented. I simply do not have the ability to quickly copy down drawings in class, so it is more efficient for me to take notes directly on the slides. Furthermore, from time to time slide content will be in Italian — which is a good thing, by the way, because eventually we will be practicing medicine in Italian — so it would slow down the process even more to try to translate diagrams on the fly. When I am notating slides in class, I tend to use highlighters at random to color concepts that stand out, or to distinguish parts of pictures that do not resolve well on my black-and-white printer. Unlike some med students, I do not have a particular system of which color I use, when and where. It is more of an art.
The next part of studying involves reviewing material. The trick here is to create a study schedule which is comprehensive, and ensures you will be ready for the exams at the end of the semester, without exhausting yourself. Pacing is key. I, personally, can handle roughly one textbook chapter a day; this is about as much information as I can ingest before I need a good night’s sleep. So what I have done is set up a review schedule of about one chapter a day. There are a few days with more than one chapter, and a few rather easy days as well. I only do textbook study on days when I have at least a two-hour block free during the day — that is, there is no class or lab — and I do not plan anything for weekends. This leaves a lot of buffer-time — weekends and evenings — if I need to catch up, although hopefully, I can use some of that time to socialize and relax.
My review schedule, to the right, lists: the day, date, chapter, and corresponding module (“CMG” — biology, “HB” — histology, embryology, and anatomy, and “FBS” — biochemistry and biophysics). I put a star next to the chapters which cover material in classes I plan to miss for my plane flights back and forth to New York over the holidays: I have to be extra-thorough with that content, because I will not have the advantage of lecture to help solidify my understanding of the material. My review schedule is about three weeks behind our lecture schedule, because I spent the first three weeks at the IMS just getting oriented and used to the program.
When I actually sit down to review my daily chapter, I use a modified version of the popular Cornell note-taking system. At the top of the page are the date of the notes, the chapter, the module, and which textbook pages exactly it corresponds to. In the main area of the page, I write down everything from the textbook that I do not know, and which we may reasonably be tested on. There are two columns on the right. The larger one is the “prompt area”. The purpose of this area is for later review. When I am preparing for the exam and going back through my notes, I use the prompt area to put down phrases or keywords that trigger me to remember the information in the main area. The small column is a check box area, meant to be ✓’ed when I have mastered a prompt. Also important — and easy to forget! — is the page number of this particular page of notes, bottom right, of invaluable help when a staple comes undone and your papers are lying all over the floor.
A daily chapter study session is complete when: I have notated everything in the chapter that I do not already know; I have gone back through the lecture slides and notes, and added anything that the professor mentioned that is not in the book; and I have tried reasonably to solve the book practice problems, which I have just put in italics because this is absolutely key to mastering material and doing well on exams. Practice problems integrate, conceptually, what you are learning. I have not yet gotten my hands on books with a standardized exam question bank, like First Aid USMLE. I hope to buy them when I get back to New York next month. When I do, I will attempt to incorporate their daily use into my review schedule. The review notes get stapled to the lecture notes (which go in back), and everything is sorted, in order by lecture, in a big red binder, one for each module, ready for review at exam time.
Erik Campano is a graduate student in Umeå, Sweden, studying the ethics of artificial intelligence in medicine. He formerly was an academic consultant to the English-language medical school of the University of Turin. Erik completed his Bachelor’s of science in Symbolic Systems (cognitive science) at Stanford University, and then he worked for about eight years as a radio news anchor, before moving to biomedical scientific study and research at the University of Paris and Columbia University. Erik grew up in Connecticut, is a citizen of the United States and Germany, and his family is a mix of Filipino, Italian, and German.
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