How to study during third year: my actual rotation study flow

How is studying different in third year?

You lose the luxury of time. Clinical days take your best hours and some days leave you with very little. That forces two changes:

1. You have to be efficient. I stopped writing my own notes entirely and moved to a board Anki deck.
2. You have to study in more than one mode. In the classroom I'd prioritize high-quality studying over volume. In third year, if you only study when you feel focused, you won't get through the material. You have to push through lower-quality sessions too. See the 5 Study Modes.

Rotations reinforce what you learn. The real mastery still happens in your own study time.

What was my actual study flow?

1. A board Anki deck at the start of each rotation. The deck held the key memorization points for each shelf, so I made it a priority to start every rotation by getting that subject's cards into memory. More in Anki for medical school.

2. The Divine Intervention podcast as a main learning source. The host is a clear teacher who flags what's high-yield, which made my studying more focused. I listened to the topics I needed most.

3. Question banks as the backbone, each with a different job:

I used AMBOSS early because the way it let me take a second attempt before revealing the answer suited the learning phase. Features change, so check how each bank works now. For TrueLearn, I enjoyed pushing my own scores up, which kept the volume sessions from feeling like a chore.

In internal medicine and family medicine, the material was demanding enough that I ended up doing UWorld even in my less productive sessions.

4. NBME shelf practice exams for the final read. I took all the available practice exams for each rotation. They're the closest thing to the real shelf in content and format.

How do I know I'm ready?

By the last week of each rotation, I aimed for 80–85% across all my question banks. Hitting that range on difficult practice questions was a strong sign I'd do well on the shelf.

Two things helped me read my scores honestly:

• Expect low scores early. You're new to the material. Sometimes I kept my banks separate so I could save my best test-taking energy for UWorld, my benchmark.
• Ignore the bank's average. You're only doing one subject's slice of the bank, so the percentile comparison isn't very meaningful. Watch your own trend instead.

Then let the NBME practice exams confirm it. More in shelf exams.

Should I finish the whole question bank for each rotation?

For the big subjects, yes. Family medicine and internal medicine have large question sets, and it's tempting to do only part of one during the rotation. I pushed myself to finish all of it. My first internal medicine rotation was much harder because of it, and it made the rest of the year smoother. Use the questions per day math to see what finishing takes.

When do I fit all this in?

• In the gaps. Instead of your phone between patients, do Anki or read about the condition you just saw.
• In a protected evening block. Set aside uninterrupted time daily for questions.
• On the drive or at the gym. That's podcast time.

Some sessions will be bad. Don't let a bad session talk you out of the next one. Keep a weekend off or an evening with friends in the plan, and get back into a hobby. You have more room for one this year than you might think.