I can’t tell you the number of times I’ve had to feign diarrhea to get out of a terrible group study session. You really must be intentional in your approach to group study or else you run the risk of wasting a lot of valuable time. The truth is that group study in medical school can be an effective study tactic when done correctly. The biggest challenge is forming the group and knowing when and how to use it.
Building An Effective Study Group
You can’t choose your family, but you can choose your study group. I am not actually a big fan of study groups in general. Possibly because I did it wrong for most of my life up until medical school. There are some important considerations when trying to establish a study group that operates at a high level. I’m sure your medical school will assign you “group work” in the form of cases and other nonsense. But random luck of the draw is not how I would approach building the team.
Find Your People
You need to find people who can match your level of motivation and dedication towards studying and doing well. If you study with some “good timers” who are content with just getting by or only doing the minimum required to pass, you may discover that the benefit is really one sided and you would be better off just studying by yourself. The flip side to this is if you join up with the “gunner” who is so intense that they bring toxicity or unrealistic expectations to the group then your life gets harder for no reason.
A helpful strategy is to join forces with people who have similar specialty interests as you. Obviously, this isn’t perfect, but even early on in medical school you have a sense of which specialties are more competitive and which ones might require higher than average boards scores. If you join a specialty interest group, you might be able to find people who are similarly motivated to work hard and could benefit from strategic group study.
Force people to take a personality test. Just kidding. But it does help if you actually like the person or people you study with at least a little bit. It can also be helpful to have a diversity of skills and backgrounds in the group. Kevin taught anatomy and was super solid on physiology. I was really good with biochemistry and other basic sciences. Kevin knew how to use Anki and could teach me. I was super neurotic and had a lot of nervous energy. Kevin was grounded and more realistic. We both wanted to attack Step 1 like it had deeply wronged us and our families.
Limit The Size
Forming study groups that were too large was my most common mistake. I also tended to use group study incorrectly, but more on that in a bit. An ideal group in my mind is two likeminded individuals who are capable of good communication and are flexible. I think it is possible to make a group of three function as efficiently as a group of two if you have the right personalities and everyone is motivated. Four people is two groups.
Group size is important because the benefit from group study comes mostly from your ability to participate in verbally rehearsing material, trying to explain it, making connections, and being quizzed about your understanding. In a group of four you end up covering 1/4 of the material in about twice the amount of time it should take. Your mind starts to wander while other people are talking. You don’t get as much out of the experience by passively listening to 3/4 of the material. Don’t check my math on all this.
If you are so popular that you must have multiple study groups, then I think that’s a better scenario than one large group. At least you benefit from repetition and have more chances to solidify your understanding.
Set Ground Rules
This doesn’t have to be super formal, awkward, or aggressive. I think that it is generally a good idea when starting out studying with people to get a consensus on how people want the group study sessions to go. How often would it be beneficial to meet? What type of material should we focus on as a group? Where should the group meet? Do people have issues with music or ambient noise?
If efficiency is your goal, you should make sure you agree to keep off-topic discussion to a minimum while meeting as a group. Save it for the end. Agree to silence notifications if you must. Commit to cover the material on your own before meeting with the group to discuss it. This helps you get more out of the time, and you don’t have to waste time exploring basic concepts. Group study is best when it involves high level discussion and teach-back opportunities, so it’s best to be prepared.
This is important. You should try and study from the same resources as much as possible. It just makes the study sessions run smoothly. If you have an imbalance among group members’ knowledge on certain topics, then it tends to throw off the flow because one person doesn’t know enough about the topic to participate fully. It also helps if your study partners are familiar with the resources you use so they know if you are explaining a topic correctly, because they also studied that same information. It sounds obvious, but it really is key.
Certain outside study resources, like UWorld question banks, allow you to generate specific practice tests that multiple people can take. Everyone has the same questions in the same order. It makes studying as a group and comparing thought processes really slick.
When starting out studying for Step 1, it was super obvious that Kevin had killer retention of topics we had covered earlier in the year because he was using Anki. I was resisting using Anki because it sounded like a lot of work. I eventually joined in the fun because I felt like I was slowing us down. He kept bringing up info I hadn’t seen before. I downloaded Anki, Kevin forwarded the pre-made deck he was using, then, suddenly, we were firing on all cylinders again. We could reference Anki cards both of us had done and we started amassing a solid fund of knowledge. Between the two of us we were like some kind of USMLE supercomputer.
Whenever a lecturer would say something technically incorrect, according to the gospel of First Aid, we would look at each other and slowly shake our heads. We actually got called out on this at the end of the preclinical years by an attending. He made us stand in front of the med school class and faculty and answer pimping questions because we had shaken his confidence. We crushed it. (It was all in good fun).
You must have a specific goal in mind with each of your study sessions. You could be reviewing a practice test, covering items from the study guide for an upcoming exam, reviewing every metabolic pathway in First Aid, or standing over a cadaver before a pin test. If you decide to get together and “just review” then you may spend half your time figuring out what you should study.
Check in during the study sessions and see if what you are doing is actually working. If you don’t feel like the game plan is working, you should make course corrections. Some material is harder to talk through and you’d be better off drawing it on a whiteboard.
Don’t just go through the motions. Try and challenge each other to prove that you are learning the material. Make connections to things you have studied during other sessions. This makes for some high-quality group study.
When Does It Work?
Okay, so we’ve covered how you set up a solid study group. When is studying in a group beneficial?
After Extensive Self-Study
I mentioned this before, but it bears repeating. You should meet as a group after you have all studied independently on the topics you want to cover. If everyone is ready to rock and roll it means you have someone who is knowledgeable about the topic quizzing you on high yield information. You have the opportunity to practice active recall of everything you have memorized and strengthen those neuron pathways. You can fill the gaps on topics you don’t quite have down because your study partner knows the material as well.
Another part of this is that you can strategically place your study session at the end of a long day or week of studying when your motivation is gone. This is how we would reach the 12–14 hour mark during our dedicated Step 1 studying days. Meeting with a study partner provides enough variety and change of pace to squeeze in another hour or two of high-quality study that helps solidify the information you just covered instead of watching Netflix and eating Cheetos off your bare chest. Like an animal.
Before Big Stressful Tests
Enormous, future deciding tests produce a ton of stress and it absolutely helps to have another person or a small group of people to share that experience with. They provide moral support and can commiserate about how awful it is. Not only will it help you perform better on the actual exam, but it prevents you from burning out during the study process.
The shared trauma will also make you remember your Step 1 (or Step 2) study partners forever. Similar things happen during your intern year.
Longitudinal Study Goals
It can be difficult to stay motivated to study for things that are months or even years in the future. If you have someone else to be accountable to, then you tend to stick with the program a bit better. It also really helps to have someone to bounce ideas off when organizing complex study plans that span months of time. Our plans were always way overzealous, so it was nice to talk things through to be able to form more realistic strategies.
Over time the quality of study gets better as well. This means that you not only get smarter, but you get more efficient at learning, and you start benefiting from synergy that is not possible on your own. When we were getting towards the end of Step 1 studying, we were cruising through UWorld questions and NBME practice exams like it was nothing. We should have been exhausted and burnt out, but we were getting so good at studying and taking the tests that we honestly enjoyed it. We even moved our test dates up because of how well we were doing.
You also benefit from the other person’s preparation during prolonged study periods. For example, I didn’t have time to finish up the entire Neuro Anki deck. Kevin got through it and had a good handle on it so he could help me identify the highest yield information to focus on by myself before taking Step 1.
What Should You Actually Do During Group Study?
I’ve hinted throughout this post about what “high-quality” group study looks like, but I’ll state it explicitly here before I finish up.
Like I said before, when you show up to study as a group you should already be confident enough with the subject matter to be able to talk through it. That’s how group study benefits you. You can talk through difficult concepts with people who theoretically know what you are talking about and make sure you have command of the material.
Whether it’s a study guide, sections of First Aid, or a practice test you should take turns teaching each other the important points for each topic. While one person is talking, the other should have their study resources open and be following along to make sure all the information is accurate. If the presenter misses something or there is additional info on the topic, the rest of the group should prompt them to see if they know it by asking a question. If there are high-yield connections between topics, then those should be explored as well. Then switch roles.
I could write a whole separate post about the process for reviewing question banks. Maybe I will. But the goal in group study is to work through each person’s incorrect questions together and identify why the question was missed (knowledge gap vs misread the question stem vs problem with pacing). Figure out what knowledge was required to answer the question, identify the key information in the stem, call out the distracting information, and be able to explain why the wrong answers are wrong. You can also compare technical approaches to questions to learn from each other’s process.
And that is it! Feel free to use that diarrhea trick the next time you find yourself in a terrible study group.