Your plate is full as a student and yet now you have to be a teacher. Bear with me—not only will this help you on your exam, but you’ll also get to practice educating your patients to be a great doctor. When I sought help, I found that what worked for me was teaching the material to someone. You can teach it to anyone willing to listen: friends, family members, or even your cat. Sometimes, our brains have a way of convincing us that we know more than we do. When you verbalize it, you have the opportunity to check your understanding. If I didn’t have a firm grasp, I found that it was difficult to answer questions that were asked or I struggled to expand on certain concepts. It also allowed me to come up with specific questions regarding material I didn’t understand. I can sometimes recognize that I’m lost or confused but not be able to pinpoint the "why" or "what". Teaching it out loud helped me discover those gaps.

I said above that it’s okay to struggle in this class. You’ve heard “it’s okay to not be okay,” before and that goes doubly for this class. You can accept frustration and discomfort. . . within reason. I recommend maintaining whatever routines keep you well (including attending or initiating counseling or psychiatric care). Additionally, when you’re in a real pinch or about to explode, take a break and put an ice pack or bag of frozen veggies on your forehead. Take some deep breaths, particularly with prolonged exhalations. Physiologically, this should help you calm down. At the very least it can make you chuckle at yourself for having frozen veggies on your forehead. It may be cheesy, but it works.

The people teaching you are experts in the field. They know this material inside and out, they have practiced for years, and they’re passionate about it and that is how they will teach it. While it is a privilege to be taught by people who are so invested in you getting the full breadth of cardio knowledge, it can be a double-edged sword especially if you are like me and you want ALL the details. I refused to move on from certain lectures because I was getting too caught up in the weeds of certain concepts. For the second exam, I was very strict with timing myself during review sessions. If I didn’t understand something, I bookmarked it and moved on. If I had time, I could come back to it, but it was more important that I get through what I needed to do for that day. I think being efficient made it to where I did have time to come back and review what I didn’t understand. Cardio especially can be like an impressionist painting; try to get the whole picture before wasting time and frustration focusing on a single brushstroke.

This is not exclusive to Cardio, but a white board can be your best friend. Drawing out the circuitry of the heart and lungs or the graphs for the antiarrhythmics, creating concept maps, tables, and lists will reinforce the material in a new way. Everybody’s brain works differently and often the same brain will even work differently in one course versus the others. Endlessly repeating the same method, instead of trying something new like drawing out concepts, can be like rolling a boulder uphill. I won’t say it’s impossible, but why do it? More passes of the information, in more modalities, will lead to more retention and understanding.

Here is what I will leave you with: medical school is difficult and “failure” (disappointment) can be inevitable at times. Whether it be a numeric score or just an internal feeling. • There are several opportunities to review during class–TAKE FULL ADVANTAGE. • Grow from it. These are all opportunities for you to learn. If you knew everything, you wouldn’t need to go through this process. • Cardio is notoriously one of the most difficult classes of M2 year. It’s part of the Dreaded Three (Respiratory, Renal, and Cardio), and even worse, it’s the third class so you’re already mentally exhausted. • Get help. Don’t try to tough it out. Stress, anxiety, depression, etc. are not conducive to you succeeding, which will cause a positive feedback loop of pain. • Do your practice questions/cases! • You don’t know what you don’t know. Utilize other resources to further solidify concepts. Watch the drug lecture, watch a few Sketchy videos, watch the physiology lecture, watch some Boards & Beyond, and so on, and so on. More passes of the material, with more modalities of teaching, leads to more retention and understanding. • Seek help before you’re drowning. It’s okay to ask for help. You’ve helped others and will help others as a doctor. It’s okay to ask for help now.