Elite Study Tactics: Mastering Spaced Repetition

Medical school can swallow your calendar, your identity, and your relationships if you let it, and plenty of people will tell you that’s just the price of admission. We push back on that idea with Jacob McKuin, a soon-to-be physician, former nurse, and father of three, who shares what it actually looks like to thrive in med school with a family. We talk about the hidden pressure of missing moments you can’t “make up later,” and why having a spouse and kids can be a stabilizing force instead of a distraction. 

Jacob also explains the deeper mission behind his journey: returning to a small community and improving access to care in the Mississippi River Delta. That leads into a practical conversation about osteopathic medicine, holistic healthcare, and the biopsychosocial spiritual model, including why social determinants of health matter when you’re trying to serve real people, not just treat diagnoses. If you’re drawn to rural medicine, community health, or purpose-driven training, you’ll hear a clear framework for making decisions that match the life you want. 

Then we get tactical about learning: why med school is often more about volume than raw difficulty, how stress and sympathetic activation can narrow your focus, and how that can wreck your study efficiency. Jacob shares a concepts-first approach, using spaced repetition tools like Anki or ScholarRx the right way, and adding practice questions early so you stop guessing what you know. You’ll leave with actionable study strategies, better stress management, and a reminder that training is part of life, not all of it. 

If this helps, subscribe, share the episode with a classmate or support person, and leave a quick review, so more students and families can find it.

@Arkansasstatemedianetwork.com.

0:00 - The Med School Trap

1:45 - Balancing Family and White Coat

4:15 - Protecting What Matters Most

6:40 - The Mississippi Delta Mission

9:10 - Demystifying Osteopathic Medicine

11:35 - The Biopsychosocial Spiritual Model

14:20 - Tackling Social Determinants of Health

16:55 - Volume vs. Difficulty in Medical School

19:30 - How Stress Wrecks Study Efficiency

21:45 - Mastering Anki and Spaced Repetition

24:10 - Tactical Practice Questions Early

26:30 - Protect Your Training, Protect Your Life

Transcript

Welcome And Meet Jacob

SPEAKER_01 0:09

Hi, everyone. Thanks so much for coming today to the show. Uh, Student Doc 101, a guide to thriving in medical school. I'm the host, Michael Stonet, and I have Jacob McEwen with me today, and he's going to talk to us specifically about the student perspective of succeeding in med school with a family. So, hi, Jacob, and thanks so much for being here today.

SPEAKER_00 0:31

Hi, it's great to be here. Hello, everybody.

SPEAKER_01 0:33

Yeah, it's so good to see you guys. Jacob is getting ready to graduate. So, woohoo, soon to be Dr. Jacob McEwen. That sounds cool. So, Jacob, the goal of this show is pretty simple, right? We are going to go inside medical school to show people, the listeners, what it looks like to um to just be successful in something so hard. Because, listen, we know med school is hard. The journey to becoming a physician is long, it's arduous, it's loaded with difficulties, obstacles nobody even sees yet. But it is possible with the right strategies, the right processes to flourish. And so that's why I've asked you to be in here today, because I know you can tell us about what that looks like. So thanks again for being here, Jacob. So will you tell us

From Nursing To Medical School

SPEAKER_01 1:20

who are you and what brought you to med school?

SPEAKER_00 1:23

Yeah, so uh my name is Jacob McEwen. I basically am from a small town in southeast Missouri called Fisk. It's a I'm actually from outside of a town of about 300 people. Um, and for me, I I always knew that I loved uh science and I knew that I loved people. And so I was looking for a way, like a path to try to integrate those into my career. Um, I had an uncle actually who was a really good uh role model for me and taught me a lot about how in his generation, science had done a lot to improve like the quality of living for people. And so for me, it actually started off with I was able to do an A plus scholarship in Missouri and get my associate's degree in nursing. So that's how I started in healthcare. Um then I was able to work as a nurse to finish out a bachelor's degree in nursing. Um, and by that time, I basically knew that I had my options were to be a CRNA or a nurse practitioner or a physician. Um, but I did not like the idea of there being treatments that I couldn't prescribe independently if I thought it was what the right thing was to do for the patient. I also knew that I might want to come back to my hometown and set up a clinic maybe once a month or something like that. And I didn't like the idea of having to have a collaborator for that. Um, so that's uh what made me think that I might want to become a physician. Um, and so I just sort of incrementally worked my way up to it. I made sure I could do nursing first, and that piqued my curiosity even further, and then that led to my med school application. So yeah, wow, I love that.

SPEAKER_01 2:49

So what a nice stairway, right? Like it uh you just chose like hard thing, harder thing, hardest thing, and just kept going. So, man, that's awesome. Was there anything about osteopathic

Osteopathic Purpose And Rural Service

SPEAKER_01 3:00

medicine in general that drew you to this, or was it just that this was close to your hometown and you thought, yeah, this is perfect?

SPEAKER_00 3:06

I would say uh it evolved over time. So I would say that I am very attracted to the idea of holistic healthcare. I'd had some experiences when I was younger, uh, which I can't really get into, but just essentially I've had experiences where I I felt like the healthcare system didn't interact with individuals, even in my own family, as uh as basically whole human beings prescribing treatment sometimes that they couldn't afford. So not taking into account the social determinants of health and everything. So I'm actually very much drawn to uh the biopsychosocial spiritual model of care that is offered with the osteopathic um philosophy. So I think what got me studying osteopathic medicine specifically started off being that it was closest to my home. And I felt called to serve specific, like I didn't go to medical school just to be a doctor. I specifically went to medical school to be a doctor for this area. That's what I felt like I was called to do. And because that uh school basically served uh served my area and was for the Mississippi River Delta, that's what drew me into it. But I also very much agree with the holistic view of healthcare. And to be honest with you, it didn't start off with any interest in the manipulative part of the osteopathic medicine. Um, but I will say that as I went out into practice, I've learned that sometimes we're able to help people with that. Uh, whereas the allopathic model, uh if you don't need surgery or intra-articular steroids or something like that, like we can do something for a lot of patients that other that allopathic doctors may not be able to offer.

SPEAKER_01 4:33

So man, that's neat. And you talk about the manipulative part of medicine. And so for some people who may not know, he's not talking about manipulating people, right? It's but it's moving the body and finding something within the body to heal what's going on, right? And uh, no, I love that. So, man, you nailed the mission for it's like it's like you and you you were part of the process of developing it or something. NYITCOM at Arkansas State University exists for for putting doctors in the Delta and improving health care in the Mississippi River Delta region. It's uh super our our our health outcomes are abysmal. And so part of that, though, is access to care. And so I love that you're going back home. You know, you're going back to this place that needs access to care. Also, where people probably know you, they know your family, they and they're gonna trust you almost immediately. So that's um, man, what a beautiful, beautiful picture of that. So all right, I got some questions. Are you ready for me to dive into those questions, or is there anything else you just want to say first?

SPEAKER_00 5:33

Yeah, I'm ready.

SPEAKER_01 5:35

Listen, for those of you listening, I've I've gotten to know Jacob over the last few years, and he is just a ridiculous student, like way to go, man. I'm assuming that you're just really driven in all of life, and I'm just so thrilled for uh you and your future patients and stuff. So let me ask these questions so I can put fanboy in a little

Volume Over Difficulty And Finding Joy

SPEAKER_01 5:55

bit. All right. Jacob, what was the biggest surprise for you about medical school?

SPEAKER_00 6:00

Oh man, that's kind of a hard one. I would say uh I I would think that the biggest, the hardest thing about it, honestly, or the biggest surprise about it was honestly, I think that a lot of it's not as conceptually difficult as a lot of people fear that it's going to be when they come in the door. Um it's more the volume of information that can be a problem sometimes for people. I'd say that's probably one of the biggest things that was a surprise for me. Um but yeah, I think that's that that's probably the biggest surprise.

SPEAKER_01 6:33

Yeah, it's almost like you you're like a kid with a bucket, you know, at the beach, and somebody's backing up a dunk truck into your bucket, and it's just like that's too much stuff. It's too much stuff, and uh it's it's really tough. And uh there's probably not a way to be prepared for that. Um, did you find a way to enjoy med school?

SPEAKER_00 6:55

Uh yes, yeah, I did. I I think that the biggest thing, the source of enjoyment, everybody, I think this happens to everybody at some point. You can forget why you're why you signed up for this thing in the first place, because for the first couple of years, it's a lot, uh, to be honest with you, of sitting alone, studying, watching lectures, reviewing flashcards. For that first two years, you oftentimes don't get that much contact with uh patients. And so when you remember that you went into this in the first place to help people, you didn't go into it to make money, you didn't go into it to be the best, you know, necessarily uh at any artificial metric like the grades, like you went into it to to help people. And when you're able to hold on to that, then it becomes enjoyable. When it becomes about ego or anything other than that, or you forget the purpose that you had for coming into it, then it can become miserable. So my biggest, my biggest thing is yes, any time that I was able to remember why I was doing it, uh it was enjoyable.

SPEAKER_01 7:50

You hit something that probably applies way more to life. So this isn't on my list, but let's just talk, man. Let's just have a conversation. Um, how does how does purpose keep you focused when it's hard?

SPEAKER_00 8:01

You know, I think that I think it just really cognitively kind of reframes everything. Because I I remember having I'm a I'm a very high-strung person, I'm very open about that. Uh, but I think that goes with the drive that you're talking about. I I do naturally have that. And sometimes I feel like if I'm not the best at something, that I'm I'm basically not doing anything important. And at one point in time, I just remember thinking in my first year of medical school, you know, it doesn't matter how long this takes me, it doesn't matter if I fail something, it doesn't matter if I have to can just keep going and going, going. I went in this to help patients, and I feel like if I keep a hold of that, that I'm gonna be able to make it through whatever, whatever kind of gets in my way. And whenever I enter into that kind of mindset, it it really does work out that way. You can when you're doing it to help people and when you're doing it to uh achieve what out you set, like the the core goal of what you set out to do, it really makes it feel like you're happening to the process rather than the process is happening to you, if that makes sense.

SPEAKER_01 9:01

Oh man, how yeah, you're happening to the process. That's neat to think about. Like it's it's something so much bigger than just this test or this score or comparing yourself to your friends who or you or comparing yourself to your peers, or sometimes what who to people who feel like competitors. It's um it can be a challenge. So, okay, so other than just my uh my gratefulness to you and how much you've helped me get better at my job as a learning specialist, I've learned so much from Jacob as what it means to help students and just work with students and the learning challenges. Jacob didn't have some of those things, but helped me understand how to address them student facing. So thanks for that. But the reason that I invited you on the show is I was so impressed with one, your ability to stick to a schedule. I was impressed with your ability to uh have a family and thrive in medical school because um we just hear people say you can't do that. So I want to I want to focus there for

Medical School With Kids And Marriage

SPEAKER_01 10:05

a little bit. This specific episode is about managing uh to thrive in med school with a family. So can you tell us? Maybe we'll address the first one is maybe like, was there a particular challenge to having a family in medical school that if you don't have a family, you don't understand?

SPEAKER_00 10:23

Yeah, I would say so. Um I would say so. For me personally, I've got three kids, um, one of which I have every other weekend, and the rest, the rest of them they're full-time. Now, when I started medical school, I just had one child. So my wife had our second child the second semester of medical school, and the third child was born um uh just last September, so in the third year of medical school. Congrats. Or actually, sorry, that would be the beginning of the fourth year of medical school. So I would say that the biggest challenge was for me personally, it's like I've only got so much time with the kids outside of school or maybe at home on the weekends, and there's a part of their development that is not going to happen again. In other words, if you're not present for starts of that, you know, parts of that, you're not going to get to make it up later. Um, so that extra load of carrying that and maybe not having as much freedom in the schedule related to that responsibility, um, is it is an it is an additional challenge. I would never frame it as if it isn't. I personally think it's worth it, and we'll get into a little bit of that. We'll get into why I think it overall is a net benefit to the process, but it it it definitely was different than some of my other classmates who had no spouse, had no children, so therefore they could structure their entire life around their study schedule, whereas you can't always do that if you have a family.

SPEAKER_01 11:38

Yeah, for sure. And tell me, maybe what was was there a was there a rewarding part about having a family during medical school? Or was there like what was the benefit of having a family for you?

SPEAKER_00 11:51

So I think it ties back to remembering that medical school isn't all of life. So, like the way that I kind of tie this in sort of philosophically is the whole idea is that I went to medical school to increase, you know, the biopsychosocial well-being of my area to help heal disease so that other people could basically have their time enjoying life with their families. So I kind of root all of, you know, all of life's meaning into my faith and into my family. So the whole goal is to increase other people's health so they can enjoy their family. Well, me having my own experience of my family always helped me to remember that and to remember that medical school process was just a part of my life. It was not not all of life. Not to mention having somebody there that is always on your side, that I feel like would be always on my side, whether I was, you know, doing menial, you know, any any other task within the economy. If I was a doctor or not a doctor, they would be there for me. Um, so I feel like having that constant rock that's there for you no matter what's going to happen, um, just is an immense comfort. And it helps to kind of contextualize the difficulty that you're going through.

SPEAKER_01 12:55

Yeah, I think there's something about having kind of like your support person, right? Like having having your person that you can talk to, you can go to, you can know that they're with you. Um, because I think a lot of med students, well, the people in general, uh, they don't have like a safe person. And um, man, when you're in the grind, right? And you're you're cognitively stressed, you're you got a test coming up, and everything's weighing on you, like to be like there's got to be some value there in having somebody that you can just decompress with, somebody that you can just be with, right? And just be Jacob, not the med student, but just be Jacob the human, right? Was there something there?

SPEAKER_00 13:35

Yeah, 100%. Yeah, that's exactly what I mean. Just somebody that, independent of whether I was to become a physician or not, would still be there for me. Uh, another area of my life that is sometimes not about medical school, something to take your mind off of things, like, you know, like at least giving yourself like that. We can get into general medical school advice in a minute. But one of the things that I recommend to people is at least having a certain amount of time a day that you give yourself vast majority of the time, so like the 80-20 rule basically, um giving yourself a set amount of time that is a deal that you have with yourself, um, a deal to basically give yourself a little bit of time separated from that stress. So, like if I do my studying like I'm supposed to during the day, then I at least have this two or three hours or however it works out for you as an individual that's separate from medical school. And helping and having your family during that time, it just kind of helps to take your mind off of all the stress.

SPEAKER_01 14:27

Man, that's good stuff. That's good stuff. What a what

Relationships During Training And Life Design

SPEAKER_01 14:30

a benefit. Um, all right. So, true story. All right, back in December, um, doing an accepted student day presentation or whatever. I'm basically the guy talking to the support people, parents, spouses, partners, whatever. And I have one of them, I'm going to assume it was a mom. Uh, she said, How can she convince her daughter to not be in a relationship during medical school? And then she asked me if I would tell her daughter to not be in a relationship till medical school. And I was like, I'm not gonna do that. Like, uh, I know a lot of people who are successful in relationships, maybe because of the relationship. Uh, distractions are uh a plenty. You can be distracted by whatever you want. So would you say, like, to people who are listening to this episode, and maybe they're hearing that noise? They're hearing, hey, you should wait till you finish. You should, you should get all of the stuff, get your career in order first so that you're not distracted by a relationship. Is there what's your advice for fighting through that noise?

SPEAKER_00 15:35

Yeah, so I would just say, you know, I don't believe in just standardized advice across the board that truly works for everybody. And I think that what a person should do is they should have a holistic approach to their assessment of whether or not they're ready for a relationship. I don't think that they should put uh relationships on hold just for medical school. For one thing, whenever you get into a relationship and see how that's gonna be, I mean, presumably for most of these people, they're ultimately gonna want to get into a relationship anyway, and it might change their outlook on what's important. So maybe you were going to go into a certain uh, you know, specialty and set up your life a certain way, but maybe your vision of that was not realistic. Like maybe you hadn't actually taken into account the value of family or something like that. Like, I think that you should always be open-minded for when that right person comes along and that you grow so much as an individual from that that it's really not good advice just to hold off on medical school to get your career because there's always going to be something else. It's gonna be medical school, then it's gonna be residency, then it's gonna be I gotta get my practice, you know, and the next thing you know, you're you're deep into your 30s or even 40s. And I'm not saying that that's not okay for some people if that's what they choose, but I just don't think that should be the advice across the board. Like I said, for me, it was definitely a net benefit. It it gave me an enhanced sense of meaning, it gave me comfort. You know, and I'm glad that I took into consideration what it was like to have a family before I it became time to pick my medical specialty or decide how I'm gonna ultimately practice. So yeah, no, that's great.

SPEAKER_01 17:01

I think you nailed it, and it's it's I knew you would be uh good at this, is uh there's no standard rule that everybody should follow this rule. But I think your your suggestion, consider the life you want, and then work from that, right? Like, do you want a life partner? You know, do you want a family? And if you do, then consider like when do you want those and like just just work from that life you want. But there's something you mentioned is so true too. Like, man, if you're gonna be in a family, if you're gonna do the family thing, like there are certain like decisions that you may make differently once you decide that's what you want. Yep. And that's that's super uh super important because ultimately, if you don't want a family but get one, then the family becomes an obstacle to the life you wanted. But if you wanted a family and don't get one, then like either way. So yeah, I like it. Start with the life you want and then work from there.

SPEAKER_00 18:06

And make sure that you're making that decision because it is what you really want and what you really think to be best, not because that's what everybody else is doing, not because that's what your parents have told you to do, not because of anything else. Like, really sit with that and decide what it is that you think is the best for you.

SPEAKER_01 18:20

Yeah, yeah.

SPEAKER_00 18:21

And for your community, yeah.

SPEAKER_01 18:23

Boy, boy, boy. So, so for the parents listening to this, the the support people listening to this, I guess we would say like stop pressuring your kids to have kids so you can have grandkids. Right? Like, like just let them have their lives, right? Do their thing. And uh I I feel that sometimes for people, and um we don't have to let other people's expectations or other people's desires dictate what we do, right? Yeah, that's that's pretty good. All right, let's jump

Big Picture Learning And Staying Calm

SPEAKER_01 18:55

into some um some med school tips if you're ready. Are you ready for that part?

SPEAKER_00 19:00

Yeah, absolutely.

SPEAKER_01 19:01

I feel like you talked to us a lot about how to have a family. You did it. I know others who are doing it. So just I guess to be fair, you would say med school was hard, right?

SPEAKER_00 19:13

Yes, yeah. Uh especially, I'd say the first two years are the hardest part, more so than the clinical years, personally, even though you're having to balance in the clinical years your family and personal responsibility, uh, the clinical practice component and continuing to learn, you're daily connecting with the reason that you went to medical school, uh, I hope, which is to serve patients. So, like, yes, you have more responsibilities that are competing, but at that point, uh, to be honest with you, um the standard for passing, you you want to thrive in your third and fourth years, but the standard for passing, it's almost like some of the pressure is actually taken off for your comats and things like that. Like it's they want you to be competent. It actually is not as hard to get over the bar to pass those. The first two years when you're learning to balance OMM, if you're in an osteopathic school, anatomy, uh, you know, learning to be a medical student, especially those first two years are the hardest part.

SPEAKER_01 20:09

Yeah, especially because most of that's like not material that you're well aware of. Like for most students, it's pretty new material at that depth. And um, even for you who had some background with the terminology and experience with patients as an RN, like there was still some challenge there. So knowing that med school is going to be hard, because I think everybody knows that, but I think some people have this idea that it won't be that hard for them. So when you get the Mike Tyson effect, right? Like when you get punched in the face and your plan changes, how would you say students can grow through the struggle rather than shrink because of the struggle or give up? Like what would you say? Like this is how you grow.

SPEAKER_00 21:04

Yeah, so I would go back to the framing of things happening to you or you happening to things. Um, a lot of that has to do, my understanding of the psychology of that has to do with how you conceptualize things. If you think about it as being, you know, beyond your but basically what you have to do is you have to pick progressively harder challenges and challenge those challenges and see that you can overcome them, and then your self-concept will grow and you'll feel like like I think the biggest thing for me, I think a good way to illustrate this in a practical sense is that when you're sympathetically activated, when you are worried, when you're just starting medical school, what happens when you become sympathetically activated is your perceptual field narrows. So you can't take in broad concepts, you're just looking at right what is right in front of your face in space and time. And I think that's what happens, I what I've seen happen to some people whenever they enter into medical school is they have. That approach to lectures. They watch the lecture very, very slowly. They take notes on every single aspect of the lecture. If they don't understand something, they worry about it and worry about it until they get it. And they then become to worry about that. They're worried that they're not going to pass the test. They're worried that they're not going to do well. And so their perceptual field just narrows and narrows and narrows and narrows. And I've seen that happen to so many people. They struggle to get through all the lectures. They end up getting exhausted because they're hanging on every single thing that the instructor basically says. And that is not my strategy in dealing with it. How I would deal with it is have people watch the lectures maybe at one and a half times speed, get through them all, have a set schedule. I would always try to get through them about a week early. So I would do them at a fairly high rate of speed because a lot of times what happened is you will be hanging on a fact that you don't get, but you're not seeing that individual fact because you're not taking in the whole picture. You're not understanding the concepts that would make that individual fact click for you. And a lot of times the answer uh for how you're going to understand it is going to be in the next lecture. You know, it's not in that lecture. So, like you basically have to, I think what happens to so many people is they start one way of studying, which is just overly focusing on every single detail, and then maybe they don't do good on the first test. So then they build this self-model that I can't do this, which causes them to then create a negative association with studying, which then forces them even more to feel like they got to hang on to every detail and they have a negative association with studying, and then it becomes something they don't want to do. Whereas if you remember why you're doing it, like I said before, that it's not about your ego, that it's about helping patients, you try to bring yourself to relax, you try to get through the material at a fairly decent rate and then go back in and look at it again and fill in the concepts. That was my general strategy. So I remember in our conversation, I think what happens to a lot of people is they try to use like, say, space repetition or something to learn the individual facts without building the tree of the concepts of knowledge that those facts are supposed to stick to. And then it becomes just brute memorization, which takes way more time, way more effort, and creates a negative association with studying. Whereas if you focus to both learn the concepts and learn the facts, and you take it one day at a time and you realize that you can do it, then you become more and more confident, which causes you to relax, which causes you to retain the information better, if that makes any sense. I think that what happens so many times is a positive feedback loop, either for the good or for the negative when people start. So just realizing that you can do this, the vast majority of the people who start this and have started this before you have finished it, it is doable. Remembering to like face the evils of the day as they come and just being diligent to stay on top of it and stay present. And then each each time you overcome a test, you become more and more confident. You begin you build a positive like self-model, a mental representation of yourself. And then that is what causes you to grow. I know for myself personally, my ability to deal with stress has grown. And you need to think about medical school as yes, it is a stressor. You've got the financial responsibility, you've got the life responsibility, but you're gonna have even more. It's probably not what people want to hear, but you're gonna have even more whenever you become a doctor, and you're responsible for taking care of other people's lives. And I honestly, in the moment, did experience a lot of stress and anxiety over medical school. But now I'm looking back at the end of four years and realizing that it made me into somebody who's capable of going out and being a doctor. Because it it helped me learn to deal with stress, to incorporate it, to overcome it, and to grow and be bigger as a person.

SPEAKER_01 25:42

Yeah, that's um so much. Man, we could chop that up. That's gonna be a lot of work right there, man. That's good stuff. Because uh, yeah, you talked about being sympathetically activated, right? So when you start to get stress and your heart rate increases and anxiety increases, and blood flow constricts, your learning decreases, and and we don't see all the impacts that that makes. So I love that you talked about that and how we I think you called your perceptual field narrows. Yeah. And you start to see the the struggle, you start to see the challenge, you start to see the problem instead of the potential if you just keep going. I was thinking about it like this. Um, are you familiar with the phrase long-term potentiation? Yeah. I think students have this idea of short-term gain. So let me watch this lecture, and then I should know this thing. And I should be able to take a test on that thing because I watched that lecture. And they disconnect, like, well, what do you do in between to reinforce that thing? And long-term potentiation, it's yeah, it's just the idea that your brain cells are connecting to make memory happen. And then you have to practice that, which is something you did. You have to practice that over and over again to strengthen that connection for long term. So you have the potential for long-term memory. And I was thinking about it like this is the first time you walk through a big overgrown grassy field, if you turn around and look immediately, you'll see where you walked, right? Because the grass is blah, blah, blah. But if I come back in four days, I might not have any idea where I walked. But if I do it all four days, then I'll see it. And then if I do it for like the next four weeks, eventually I'm wearing a path out. And here's what's really cool is the longer that I do that, the longer that path lasts when I quit. And it's the same concept, I think, with learning and building long-term memory, is if I practice it over and over and over again, then once I get really, really good at it, I can go a little while longer without having to practice it. It stays like right now, you probably have a really good grasp of some of the uh like pulmonary issues or cardiac issues. You could talk about those things in a year from now, if even if you don't see them. Because you built long-term memory. And so I think that's so good because you didn't let that struggle, you didn't let that sympathetic uh activation cause you to run away. Instead, you reframed and you found flourishing, but you also, and you said this, and this is so good, you connected it back to your purpose. Um I'm here for my patience. So that's good, man. Um, would you say, I actually, I don't want to make you do any more work. Let me ask you this. So we're getting ready. Is there anything else you want to say before I ask you my final question?

SPEAKER_00 28:50

I would just I would just reiterate that, you know, whatever different people do things different ways. But I really want to reiterate that if you're coming into medical school, it's good to use those space represent repetition tools. I use ScholarRx. That was my backbone. A lot of people use Anki, but make sure that you are the big I'm gonna mess this up because I'm not an art guy, but the biggest thing that sunk into me in medical school that never had occurred to me in all of undergrad or anything else, is somebody said it's almost like an impressionist painting. You've got to look at the whole thing and let it reveal itself to you over time. And that's the way that you should approach learning in medical school. You should try to get the tree trunk and the branches of understanding the basic concepts. You should not hang on every single detail of every single lecture the first time that you're through it and feel like you've got to understand it 100% before you move on. I would I would from the very beginning go through the lectures at, depending on the content, but typically one and a half speed, increase you know, the rate at which you're going through them, try to understand the big picture, and then go back in and use the space repetition to put the leaves on the tree. And the second thing that I would do differently than what I began medical school is I actually didn't start incorporating questions uh other than the last week of every study block until I was in the second year. And you have got to understand that not only do you have to have space repetition, but you have to have a self-testing component to see where the holes are at. I feel like I could have got through the school with even like less effort than I did and done even better if I had incorporated the uh doing questions early, because you don't know what you don't know. And there's only so many ways they can ask a question about an individual topic. So I would do do questions early and often. I would get through the material fairly quickly without hanging over every detail and try to get the big picture. Then I would then, if you get through it a week ahead of time, then you have time to go back and do even more questions and reinforce the material. I would look at it over and over again, like you said, and I would try to look at the big picture, not get anxious. And what I meant about the nearing of the perceptual field is even what when that happens and you're not relaxed at all, and you're doing it from a fight-of-flight, and you're not doing it from purpose, then you're just gonna see a bunch of unrelated facts. And physicians, even in practice, oftentimes forget the facts, maybe the dose of a medication they don't prescribe. You can look that stuff up. You cannot in a moment look up the concepts. It's important to get the concepts, and the concepts will make the facts stick. It's not gonna be just nobody looks through this stuff the first time. Don't let them fool you. Nobody looks through this stuff the first time and then just remembers all the facts. That's not a reality. So connect it to your purpose, revisit it every day, and that is what will make it stick long term.

SPEAKER_01 31:40

Man, I love it. Um, man, I don't know. Maybe I can speak this into existence, but are you gonna go into academic medicine so you can like teach other people some of these things, man? Dag gum.

SPEAKER_00 31:51

So I feel like my biggest thing is uh my calling is to improve the well-being of my community. I think that I may not go into maybe being affiliated with the college directly, but I definitely see myself taking medical students in residence when I get further in my career.

SPEAKER_01 32:08

Yeah, awesome. Well, we'll we'll line up for that. Uh well, I was gonna ask what's one sentence you would leave our listeners with, but you just gave so many great sentences. I'm not gonna make you repeat that because that's so good. Um, so my final question for you is not med school related, okay?

Gardening, Video Games, And Closing

SPEAKER_01 32:25

I ask every guest, what is your binge? Like, what's the thing you do when you have your time? Like some me time, is it? Do you have a TV show, a book, a coffee shop, a food? What's the binge for you?

SPEAKER_00 32:37

Uh, I've got two if I'm if I'll be so loud. So one of them is like gardening with my children every summer. That's one thing I actually manage to keep alive even during medical school. Um, is I I I like I plant tomatoes, cucumbers. Every year I try to expand my garden a little bit uh and do that to spend time with family. And then the second one is uh video games. You know, it's my generation's big thing for uh stress relief. I find that video games, unlike a show, you have to interact with it. And what that does is it causes you to attend to it. You can't be really thinking about other things when you're playing a video game, especially a hard one. And then that kind of like resets the default mode network. So that's what I one of my big things that I do.

SPEAKER_01 33:20

I love it, man. I love it. We'll keep doing the things you're doing, Jacob, because you've been crushing it and flourishing. I'm so excited for you and the graduation and residency, and then going on to see you practice. Uh, keep me in the loop if you ever need anything, okay, man? Yeah. Same thing. Thanks so much.