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How to Succeed in Physiology: The Course, Step 1, and Beyond

Physiology is different! If you’re in the midst of learning physiology, either in a traditional or systems course, you’ve noticed that it feels different from biochemistry and anatomy. There are several reasons. First, the stakes are high, as physiology is inextricably the basis for medicine; learning physiology has long-lasting, downstream consequences for understanding pathophysiology and clinical medicine. And physiology is the underpinning for Step 1, so learning it well in your courses is essential. Second, physiology cannot be memorized (and you’re good memorizers!). Physiology must be understood, and understanding can’t be rushed. You’re learning concepts and principles, rather than isolated facts, and you’re challenged by the hierarchy of concepts, interconnections, and recurring themes. Last and oh so important, you must make peace with graphs, equations, and calculations, since they are the language of physiology. Rather than concede up front that “I don’t do graphs,” it’s best to find a system for translating the mathematical side of physiology into something intuitive that speaks to you!

Learning physiology – best practices. Here is a time-honored cycle that works!
1. Pre-read
2. Attend class
3. Review
4. Do practice questions
5. RepeatThe night before class, pre-read the topic, preferably in a didactic textbook like Physiology; you’ll warm the circuits, appreciate key concepts, and identify sticking points. Because you’ve pre-read, time spent in class will be productive learning time, rather than glazed-over “I’m completely lost” time. After class, review the material, using a mix of class notes and the didactic text. Then start doing practice questions. Physiology practice questions are best used as learning tools, not as assessment tools; you’ll diagnose problem areas and start applying the material right away. Do questions early and often, learn from the right and wrong answers, and strengthen your test-taking strategies and confidence.
To book or not to book? You may be debating whether you need a physiology textbook, since your hands are full with handouts, Powerpoints, and lecture recordings. The decision is individual, but these are the “pros” to consider. Books tell the same story in a different voice. It’s all about finding a voice that speaks to you – and finding that voice before the course blows past you. A didactic physiology book can help you see that hierarchy of concepts; provide cohesion; translate graphs, equations and calculations into words; fill in gaps; provide spot help for difficult topics; and be a source of extra practice questions. If, ultimately, you will need the support a book offers, make your decision early in the physiology course to gain maximum benefit.
“I need to write in order to learn. What can I write for physiology?” First, what not to write! Do not copy the notes!! Copying may be a holdover from undergraduate school, but it is a passive, mindless crutch that would waste valuable physiology learning time. Kick the copying habit and don’t look back! You can write, but it needs to be active and useful. The first rule is to wait to write until you know something about the topic; resist the temptation to write too early just to feel like you’re “doing something.” Make your writing topic-specific. Ask yourself: for this topic, what would be useful? That might mean creating a visual such as a list of factors, comparisons, charts, or a sequence of events. It might mean compiling information on a topic from multiple angles, such as major points about fetal lung physiology or all major points about adrenal cortical hormones. You can write for drill in physiology, where you practice a sequence from memory, practice redrawing a critical graph (while talking yourself through it), or write out equations from memory. And, of course, physiology practice questions involve writing.
Smart physiology test-taking. Whether on course exams or Step 1, physiology questions require understanding and application, and often are couched in clinical vignettes. What works for recall questions won’t work for physiology. So what are the best practices?
•Sleep the night before. No, seriously!
•Read the question stem carefully and underline or highlight critical words. The most common test-taking problem in physiology is not answering the question asked.
•Clearly identify the topic of the question and find that topic in your brain.
•Cover the answers, whenever possible.
•Work slowly enough to think through the steps correctly and write your main thinking steps in the margin or on scrap paper (if provided). One time slowly through a question is better than twice fast.
•Match your thinking with the answer choices and select the best answer. Don’t be distracted by the distractors (fancy name for wrong answers), don’t overthink, and don’t change answers impulsively. Good luck!