The Best Laid (Study) Plans

Holy kamoley there's a lot to learn in residency. And not a whole lot of time to study. I start each rotation with all sorts of study aspirations but invariably studying ends up taking a back seat to just about everything else. Not good.

This rotation I've been making more of an effort to study better, and have the beginnings of a system. Here's what I've been doing...

First, I made a schedule for the whole 3-month rotation to figure out when I'd have time to study. It's not really a study schedule, but more a means to keep track of how I'm using my time. Flexibility is key, since my work days are unpredictable; a rigid schedule would get derailed, stress me out, and then be abandoned.

I try to look at this calendar each day and pencil in the thing I'll be focusing on that evening (be it a study topic, data entry, or rounds Powerpoint). It forces me to set a goal each day, rather than default to The Bachelor (but rest assured, haven't had to miss an episode yet).

I've also been making lots of check-box lists and using my planner (the clipboard's still working for me) to get the rest of my life organized. I don't know how I'd get by otherwise!

In terms of studying, what I need to spend the next 18 months doing is getting organized to study, so that in my fifth year I can actually focus on studying. The hardest thing about studying in rad onc is that there's no standardized textbook, so you can't just sit down and start memorizing stuff. The residents generally create their own study notes, based on the practice at their centre, the American (RTOG, ASTRO, NCCN, etc.) guidelines, and studies and contouring protocols.

My study note-making process looks like this:

I have a blank Word template for each cancer site with headings for everything from histology to radiation technique to prognosis, and am chipping away at filling them out. Open on the right of the screen is one of several books I'll go to to search for the info.

Although I do love making study notes on paper, for this process where my notes are continually evolving, computer is the way to go. I try to add to these notes whenever I learn something in clinic, or when I find out the way we actually do something in practice (generally somewhat different from what I've copied down from books and guidelines).

For radiobiology, we do have a textbook (Hall), which I'm hoping to read through this summer and make notes on. Maybe even paper notes!

For physics, I've yet to figure out how to study...

For learning staging of the different cancers, I'm making flashcards, as it's rote memorization. I've tried to make flashcards for the sites I see as I go through my rotations, and keep them in my pocket to refer to in clinic. Unfortunately, the staging system has just been updated (AJCC 8th edition) so it looks like I'll be remaking some of these cards.

This process may seem tedious, but I really don't mind it. Studying in residency is different from studying in med school. You're focused on your area of interest and can see the applications of the things you're learning (for the most part...I'm not sure there's really a clinical need for us to memorize which translocation causes which type of lymphoma, but at the end of the day you've got to pass the exam). Anyhow, we'll see how the study plans pan out!