Medical Trainees: How to Learn FASTER as a Busy Doctor

So yeah, I'll just kind of set the scene a little bit in terms of um what we're going to be doing is um you know, so we've got yeah that 30 35 minutes at the moment, the first round and I'll just go through see what I can help you with essentially with learning, what sort of challenges you might have. So I really want you to think about your context, what type of thing do you need to learn? Why do you need to learn it? Where do you need to get to with that knowledge? And what

are the challenges that you come across along the way? Or if you don't think there's any challenges, think about it the other way. If you could just have a magic wand, wave it, and then just poof, you know, this outcome is achieved. What would be that thing that significantly improves your quality of life or the quality of the learning that you're getting out of it? And so whatever problems you have, I'll basically teach you how to solve it. >> Well, I guess I have mana on the top. >> You can go for it. Go for

it, Grace. >> So, I'm preparing for my [clears throat] fellowship exams. I feel like I've been doing well with my learning of new topics and I'm able to use that information very fluidly at work. But I guess the biggest issue is that the level that I need to know it at work and to be even very good at my job is not aligned with what is being examined on. that's like maybe two to three levels more depth as far as more minute information, more granular kind of information. And I'm finding it difficult to test myself

because there's not a lot of specific CAST exam papers or examples of the way the exam is now, especially since it's changed in the last two years and has arguably become more difficult. So I'm in a position where I'm performing really well in tutorials, performing very well in my lectures, but if I'm only comparing myself to other people in my classes, the fail rate of the actual exams has actually increased. So it's like I could be doing better, but am I above that press mark? >> Yeah. So, I'm finding it very difficult to create those

questions for myself to elicit those questions from chat GPT just to figure out how to make sure that I'm not overestimating my performance. >> Okay, I'm going to try to summarize that uh and sort of draw it out and you let me know if I've got I've got it right. So, basically, you have a certain amount of knowledge that you need to gain. So, let's say that that's this bar here. So, this is very high level of in-depth knowledge and this is very low superficial. You're basically saying that the amount that you are getting tested

on and that you are using at work is like here and for here you you're doing well. However, the exam is probably going to be somewhere around here and then there is this gap between what you need versus what you are reliably able to test you on. And so this is the thing that's giving a bit of anxiety and question and uncertainty around you know like is am I good enough at this point? Is that basically it? >> Yes. So it's not the fact that you feel okay I'm definitely missing this. It's that you don't

even you just don't know because you haven't been able to test yourself at this level. One point I think which is important is that you've been trying to use charge key to try to fill this however you're finding it difficult to do it probably because and this is the sentiment I get when I talk to a lot of people that are in like fellowship training is that the level of nuance and the level of expertise and the exact way you need to think about it is just so specific that it's really hard to get a

limb. Have you tried to get Chachi PT to a point where it's able to think in the way that it needs to at that nuance level? >> I've used some pretty complex prompts where I said I need it to not be leading. I needed to examine me not just on base level facts but like multiple abstractions. I've given it examples. I've said look at the question that you created and look at this actual past exam question. Can you see the difference? How would I make a prompt to make you make questions more like this? I've

asked it to use exact textbooks because we have the Robins textbook as our kind of ground truth for path and said I need more indepth questions. It looks like they're asking about jeans and this and this and this. Can you incorporate this? But it's still like not quite right. I've even made 20 questions at a time and then showed it to other traineees who have sat the exam and said, "Is this kind of close? Am I kind of getting into the right area?" And tweaked it based on that. >> Yeah. And still >> really difficult.

So, I got one area to the point where they were like, "Yeah, that looked about right, but it's so hard to get it like to elicit that front end." That's probably at this current stage going to be one of the limitations of the LLM is that its training data is just it probably has so little access to that kind of specific questioning that it's going to be really hard to to fight that algorithmic imprint. Their approach to this is the same as the way that you approach basically assessing any kind of knowledge gap first of

all. Okay? So, we have to be really clear about what the knowledge gap we're trying to test on is. And there's lots of different ways that we can think about this. But the two ways that obviously that I I like to talk about this and this goes for any type of knowledge gap. You know, we're saying that you're here right now and you're comfortable with this and this is the gap, but it could be that you're here and you have uncertainty. It's basically any situation where you have certain level of knowledge you're comfortable with and

there's unknown levels of knowledge that you need to gain competency with and you just don't know how to test on that. So, the approach is going to be the same is that first of all, you're going to figure out what is the nature of the knowledge gap, a higher order knowledge gap or is it going to be a lower order knowledge gap and then we're going to look at that based on is this going to be a procedural knowledge gap or is it going to be a declarative knowledge gap? And then once we're able to

at least characterize it, we can start thinking about different ways that we can test it. Higher order knowledge gap, just to make sure we're all on the same page here, higher order knowledge gap means that the gap is in how we are integrating the knowledge together and how we see how the big picture is formed, how things connect to each other and influence each other. So a higher order knowledge gap might be for example, we're we're talking about an entire topic. I ask you a very detailed question about a very complex scenario that involves many

different factors where I need to know that you are able to see the nuances between each different factor and how they all influence each other to, you know, synthesize a really good response. That would be a higher order challenge. If you have a higher order knowledge gap, you might individually know each concept when it's explained to you and the answer is given to you. You know, okay, yeah, I know each of those individual things. However, I just didn't see how it all connected together in that way. That would be an example of the higher knowledge

gap. the the towns exist but the highways are missing. A lower order knowledge gap would be that you're actually missing the data. Right? So you can have higher order knowledge without the lower order gap. Right? You have a highway leading to nowhere basically really interconnected road network but then when you get there it's just empty. So you know how things are connected together generally speaking but when you really have to articulate it and make it explicit just you just don't know. You don't have the concreteness to it. And that that would be an example of

higher order knowledge being present but the lower order knowledge not being present. And so you would fill each gap differently. And then the procedural versus declarative. Procedural means that the issue is in the way that you execute on something. This is very much more like muscle memory. So if it's just about like answering a question, it's it's pretty much always going to be declarative. You know, there's not a lot of situations where it's going to be procedural. Procedural is, you know, basically whether you are able to execute on what you know you need to do

accurately, right? So if you were a surgeon, you know, it would be like, can you literally like suture something together properly? Can you literally make a straight cut? Or, you know, do you have to think so much about doing it correctly and then you're not able to have consistency and accuracy, right? Something like that. Probably for you, it's going to be declarative, right? >> Lower order declarative. >> Lower order declarative. So let's just sense check that that this is where the issue is. So what that means is that you are given some kind of challenge.

That challenge is going to ask you a very complicated question, a very complicated situation where you have to apply lots of different knowledge in in a way that's all put together. You know how it all fits together. You understand the influences. You see the big picture of what it is. You can map out what the answer should look like with a very high level of accuracy. However, when it comes to actually just going through each individual point, there are a few gaps there. You can't exactly remember what that number is meant to be. You can't

exactly remember what that statistic or the probability of it is. you can't exactly remember what the name of you know whatever dose something needs to be like those specific details are missing is that correct >> absolutely >> okay so if there are lower order issues at a low level of knowledge that's really easy to address because things like chatbt can just tell you here's what where the issue is and you can fill that with a lower order method like just spamming through flash cards that becomes perfectly acceptable for isolated just lower order knowledge the issue

here is that you can't do that because your hit rate of being able to find those lower order gaps becomes very low. So you could sit there and for 3 hours brain dump everything you know about a topic going into meticulous detail very very concretely and after 3 hours you may find one gap and that one gap may not even be assessed for examined. So your hit rate at finding a gap and then your hit rate and then that gap being relevant to you is going to be very low. This is one of the more

complicated um issues to address and there are two ways that you can try to address this. Neither of them are really perfect, but um we'll go through them anyway and then see if there's one you could do a little bit more of. It's calibration, but it's either external calibration or internal calibration. So, I'll start with external cuz external is the easier one to understand. External calibration basically says find someone that knows would know your gap would be able to spot a gap and then get them to assess you to find the gap for you. In

a perfect world, chipd will be able to just do it for you. But we've already established that it's really difficult to get it to that point. So this would be an example of find someone who passed the exam. Find a senior who does have that level of knowledge, knows how to assess you, and then just literally block out some time, sit with them, get them to basically test you and and and quiz you to get an idea about where the gaps are. The limitation of this is usually just access to these people and access to

to the time. And it's a precious resource. So if you've got a senior and then you're spending an hour sitting with this person like you you have to use that time very strategically but having some kind of external calibration is going to be important like you need to have external calibration for deep knowledge because you have no awareness of whether your knowledge is deviating away from the truth or not. Internal calibration is about taking an area that you can test yourself on and then assessing whether there's likely a gap there based on your level of

confidence or certainty with answering it. So you could be given a really complex challenge and you're trying to answer it and then as you're trying to answer it you realize you're not certain about a certain part and then so that tells you there is probably a gap there to explore. You don't know what the gap is but you feel a sense of weakness, uncertainty and a lack of confidence. And so that alone means that there is probably a gap in that direction and allows you to focus your search through. You can basically cascade that by

then going deeper and deeper onto that particular point until you see which aspect of this you feel confident on and which aspects more specifically you feel weak on and then that gives you a much more focused direction to figure out where the gaps in your knowledge are and then you can try to test that. Probably what you will need to do in your situation is to do both. So you use the external calibration to get a sense for the level of standard and as you test yourself on it, you're constantly internally calibrating to see which

are the areas based on that person you see as trends of the types of gaps you have >> and then I can take the themes of those gaps and apply it across the different body systems cuz it's like uh it tends to be microbiology uh what type of cells it is what is the genetic marker that we'd be talking about in an MDT situation >> and then I can carry that over from Gani to Abdo. >> Yes. Uh yes and no. So when you do this, what you're going to come across is you're either going

to come across a knowledge gap or a knowledge bias, right? So a knowledge gap means that you simply just don't know this thing. That could be because you literally didn't study it. You just you skipped over the content. You know, you like never were exposed to this idea or that you just never happened to test yourself in that particular way. A knowledge bias is that the way you approach information and the way you tend to collect data systematically means that you are missing something. The most common way that I see a knowledge bias is in

people that know that they have a weakness or just don't enjoy a specific aspect of a topic. So because they know that they don't enjoy something when they're learning through it, they kind of avoid it or they do the bare minimum of it because it's not an enjoyable experience or they just know that this is something that's that's weaker for them. Um I have that. So if you have that that means that that trend you might discover this bias through external calibration you get a series of questions you realize hm I tend to get these

types of things wrong when someone asks me about this type of angle about this type of topic I feel that there's a gap here and you can use this for a higher order thing as well I do this all the time when I'm uh doing planning or strategy where I'll ask certain types of questions to someone based you know on the strategy or the plan that they've created and then I'll get a sense for what angles of thinking do they tend to avoid or or this and then you can see is that actually a one-off

or is that actually a bias and if it's a bias it's it's it's in a way a good thing because you found a transferable gap transferable gap that is then going to you can apply it across mult multiple different subjects your hit rate goes up if it's a gap it's just you know you're lucky that you found the gap but you know it's not going to change your hit rate by too much and this is probably one thing that has to be understood about like the unfortunate truth about ultra high volume examinations and ultra high

volume assessments where the amount you need to know is so high that there's probably no realistic way that you will ever know everything that you need is that you're always going to have a gap. And your solution to winning this is to try to find as many of your bias gaps as possible. Address them early on and then fill as many gaps as you can find knowing that you're never going to find them all. And usually in those situations for these ultra high volume assessments, the pass mark for those doesn't require you to have no

gaps. You'll have brutal examinations and as long as you get 60% 70%. You're actually in the clear. Most of the time you will have to expect that there are gaps. But the issue is that some people feel so anxious about the fact that there are gaps that they ignore the thing that's bigger which is actually the a knowledge bias. But this is the more high yield way of filling it. And and actually most of the time you will spend all of your time just finding knowledge biases and filling those and you won't even have time

to work on isolated knowledge gaps because there's so much to learn and there's not enough time. That's basically the the strategy. So that's why I said there's no perfect way cuz you can probably not avoid gaps if you're actually aiming for a 10 out of 10 level of knowledge. So that's going to be common for fellowship examinations um like deep deep deep expertise development. >> I think that definitely explained what my issue was and I was immediately able to write just numerous things that every time I hear about them I'm like and they're definitely biases

cuz I'm like I don't use this dayto-day. I have a sort of a combination I think of different aspects of the same learning problem. So I'm an ED traininee and at the moment I'm studying for my primary exams which is basically foundational sciences in anatomy, physiology, uh pharmarmacology and pathology. The general advice is to just, you know, cram this information in and then and keep on smashing out the questions um and, you know, you'll pass and you should be good. The issue is um I can't sort of just learn things at uh just because it

is. I need to apply it. I need to be able to connect it to a high order level of thinking and ask the question why and most importantly be able to integrate it into my practice and see the relevance of it in my practice. I mean the ideal way is say for example there's a condition and then there's a management of that condition and then okay I'll learn the anatomy and then the pharmacology and then you know there's like this level of knowledge being built here that the foundational sciences level whilst also it's influencing that

at the higher level but just because there's not many people doing it in that way I'm find that I'm on my own with that and also usually I'm always on the race for time but I guess that's that's something that we can't we can't really control a lot factor. But I just I guess if I have a methodology of being able to do the lower level order learning and then integrating it into >> the high order if if that makes sense at all. >> Yeah. What you're describing is super common, right? Um you know the

race against time is sort of the main reason why learning is difficult because if you have an infinite amount of time you can just basically learn anything. This ties back to this idea that people generally on a on a spectrum of processing, right? So if if this is a spectrum of spectrum of processing. So if this is a really high level of processing, it usually means that you're able to develop a really good higher order structure and a schema of knowledge more quickly and more easily than the average person. This is your kind of natural

high performer, right? And then this here is a very low level of processing. So this person really struggles to do that higher order schema and and connecting of information. So it's just the idea like are you able to see how things are related together and create a big picture understanding? If the answer is yes, I find that really easy to do. Usually I've always found that really easy to do. When other people find it difficult, I find it pretty easy. I never really have to spend too much time thinking or learning. It just kind of

happens automatically. You have a naturally higher level of person. You're on that side, right? Whereas if it's always I've always taken more time. It it requires like a lot more for me to be able to do that. Then you're on this side. Now when it happens, it happens. Like when you can form that schema, yes it clicks, you can understand it, but it's about how easy is it for that to happen. So if you have a very high level of processing, which is mostly out of most people's control, that's largely influenced by genetics and early

childhood experiences. If you have a very high level of processing, you don't need really good studying techniques until you're operating at the highest level. You can get away with pretty much anything. This is a phenomenon that called deep process tanking, right? Your deep processing ability is so strong that you can just do anything you want. You can use the you can just the most ineffective studying strategy of all time is probably reading and rereading right all you do is read it and then you just read it again and again and someone with a really high

deep processing they can actually do very well with just that they will reach a ceiling as well obviously and those people if they learn more effective techniques will have huge gains but for their everyday learning they don't need anything more than that. Uh whereas here if that if this person uses that technique it's just a complete waste of time. But the other way to think about this is that this person here has a very low sensitivity for learning efficiency because they don't need efficiency. They can't really detect very easily when the methods they're using are

inefficient. What you have described is that probably based on the fact that you are a doctor, your processing is probably closer to this side than the average person, right? However, there are things that you're saying that tell me that you have a higher sensitivity for when the method that you're learning is not making things click. That's actually a good thing in a way because it means that you have a good radar for when the method that you're using is not cognitively optimum. So, when you say you need to make things click, you can't just have

it. That's actually that's the same for everyone. In order for you to have memory that sticks, you need to be able to connect it together in some kind of higher order structure. The only difference is does it happen for you automatically and very easily or does it happen for you only in certain conditions and with active effort. Understanding that is important because you can actually control that. When we talk about relevance, whether an idea is relevant or not, anything that is relevant is easier to learn obviously, right? But relevance is just saying that it's more

connected to what we already know or that we can see a pattern that we can apply to this information. When that happens, we say that it's relevant. So the reason that you feel that it's easier to learn something when you can see you know a condition and a management plan and exactly how it all fits through. The reason that you're able to do that is because you have a pattern that exists. You have an existing schema of how to think about a certain condition. So when it fits that pattern you say yes this is relevant

because I can see how it connects. But you don't want to be in a position where you need it to fit the pattern for you to find relevance. So the skill that you want to gain is how to create a pattern out of this that is meaningful to you even if it doesn't exist in the first place. So I'll give you an example with uh surgery. So a lot of people are learning their anatomy and they feel that it's you know kind of an endless wave of tedious monotony right and it's just like why do

I need to care that the nerve passes through here and 30% of patients but then you not children or whatever it is. Why do you need to know that information? There's you're not you know doing anything with that knowledge. It seems incredibly random. And so for surgeons, one of the frameworks that I recommend is the first surgeon perspective. Imagine you're the first person to ever perform surgery on this area. And the reason you're reading through this anatomy textbook is because you need to figure out how to perform the surgery. Your surgical technique is going to

be defined by what you understand. You're deriving from this data what your procedure is going to look like. So this is this is something I call the first surgeon perspective. Obviously, when it comes to surgery, it's really obvious because you're literally going to be operating on the area. But you can apply this sort of first doctor perspective to lots of things or you can like first operate a perspective. Imagine you're the first person to ever use this information for something. How does that change the way that you think about this? It makes you much more

active in thinking what is the implication of this? You know, interesting thing is like I I distinctly remember in my second year of medical school learning about all the the hand anatomy and I I I hated it. I absolutely hated it. You know what? I bet no one likes it. I bet everyone hates it. It's so complicated and there's so many little things and I just had no idea why I needed to learn it. And then ED is when I realized, okay, this matters because a lot of people come in with wrist lacerations. A lot

of people come in with lacerations and actually there's a lot of different tests for testing each individual specific nerve and each individual tendon and that is the only reason why I was able to learn my hand and wrist anatomy. But the thing is I didn't learn any new knowledge. All I gained is a new perspective through to see that knowledge. And I didn't actually need to wait two years, do an ED run, have someone show me a hand laceration and say, "Hey, this is the reason why you need to learn it. Now go learn it."

I could have at that time 2 years ago just looked for that perspective actively to find a way to make it relevant. That's basically the recommendation is anytime you feel that it's irrelevant, that's a good thing because that's your brain telling you, hey, the way that you're approaching this, the perspective that you're looking at it from is not going to last in your memory. Keep adjusting that perspective until you can find a way where it does become relevant. And then when you do that more and more, that mental flexibility translates through and then you'll find

that it's easier and easier to find ways to make things relevant. >> Yeah. >> Yeah. I just had a thought. Um, how would you word a prompt? Say I come across a piece of knowledge that I'm not sure how to, you know, apply the first surgeon's perspective to this. How would you design a prompt that I would put into charging be to say, how do I need to think about it to be for it to be relevant? You know, that's an interesting question and I'm a little on the fence as to whether you should >>

when I'm on nights and I see a new type of injury particularly. I'll do my report and I describe what I find, but then as like a last point, I'll say, "Chad GBT, what does the Sojan care about? what would change management? So like with the orbital fracture if it hurts the medial canthal ligament it's something I wouldn't think about normally and you think oh who cares about these ligaments on the eye and it's like that actually is one of the things that would change their management and then it makes it stay in my mind.

So I'll say what would change management because you're very similar in ED like radiology we work with all the specialties. That's a good way because it's it's being specific and saying like what would whatever specialization think about or like what would make a difference to whether I discharge this person or or admit them into the hospital. As long as you're not trying to avoid the process of changing your perspective and looking for that that angle of relevance, you know, if what you're trying to do is like find a shortcut so you don't have to think

about it, then you know what Grace is talking about here is it makes a difference for work. It's it's you there's functional utility there. It's important to be able to do that. What you're talking about is studying. You have to have that knowledge. You need to have that ability to recall that knowledge and use it. So even if at the time of studying you were like, "Okay, tell me how I can think about this to make it relevant." If you didn't do enough of that cognitive heavy lifting, you might it might not be retained in

your memory anyway. But it is kind of a gray area. In fact, it's gray enough that I would say that you you might actually try to give it a go. See if you can just prompt GPT to say like, "Hey, this is what I'm studying. What's a frame that makes it more relevant for me to understand as an ED doc?" and then see if that actually one to two weeks later persists in your memory or if it becomes one of those things that when you're studying it you're like a it makes so much sense but

then two weeks later you just forgotten all of it because if that's the case it means that using chach to offload it wasn't beneficial for you cognitive heavy lifting that's >> yeah don't avoid the cognitive heavy lifting >> hey it's future Justin here just letting you know that if this coaching session has been insightful there's been new perspectives that have been valuable for you and if becoming a better learner is a priority for you, then I also have a free weekly newsletter that you could sign up to where I basically distill these types of insights

and perspectives. It's kind of like a learning skills course delivered through email. So, if you're interested in that, I'll leave a link for you to sign up to that in the description below, but otherwise, we'll get back into this. >> I had two two questions. So, one question was how to utilize fragments of time. I don't have any set routine. So some some weeks I have many days free, some some weeks I'll have very little days free and so often there's a big big gaps between learning sessions. >> How long are the gaps? >> Honestly,

it can be if if I'm you know disciplined it's sort of a week but that week can become two weeks sometimes if that makes sense. >> How long are the fragments of time you have available? The shortest time would be half an hour to one hour >> and uh you know then some sometimes it would be um >> few hours, half a day, >> a whole day, two days. >> Okay, we can shorten that time. We can shorten the fra the usable fragment of time. Let's think about like this. Let's say that we have an

axis here. On the x axis is time and on the y axis is let's just call it flow. When we first start learning something, our brain has to do a lot of things to get into a good band. So let's say that this is a this is a good good level to reach. So we want to be sort of above this line of flow. So this means that your brain is really working efficiently. It's connecting the dots. It's really, you know, making full use of that time. It's like really meaningful learning is happening when you're

above this line. So in order for us to get from not being in flow, which is down here, uh this is zero. So zero essentially represents default mode network. This is basically mind wandering just your everyday life. It has to generate context and that gen that context generation so this is context generation the context generation time can vary significantly. So for some people the context generation it could take like 30 40 minutes to generate enough context to enter into flow. For some people they're so bad at generating context they get so distracted along the way

that they just they drop context generate drop regenerate drop give up. So they never enter into flow pretty much ever. So the trick here is that what you're saying is that you need about 30 minutes. So that's saying within 30 minutes there is an idea that you're able to generate enough context to get meaningful learning out of that time within 30 minutes. Let's say that you're generating context here for the first uh 7 minutes. That's 7 minutes. And then you're in a good state right here and then you get a little distracted and then you

kind of come back to into it right and so there's a little bit of a context uh switching penalty here and then you're back into flow and then that's your 30-minut session. So this is 30 minutes right and then there was a little bit of time here that wasn't very meaningful. Let's just say that that was 5 minutes. So you're saying within the 30 minute of time in this example 12 minutes is kind of not really providing meaningful learning and then the the rest of the time is so say like roughly 50% of the time

being used really effectively above this line when you're in flow when you're doing this stuff there are certain processes that you can do that make it more effective like really effective active learning strategies you know which we you know covered before and I'm not going to kind of go into again so you should definitely do that to make the most out of this time but in your situation where you've got limited time the first thing that you can do is try to reduce the context generation time so your functional unit smallest unit of available time

becomes smaller. So technically right now you're saying that even if you locked off this part of the session probably even this becomes worthwhile but it's hard to use because in in order to get to this 10 15 minute block of really good energy you need 7 minutes to generate the context. But if you could just generate that context within let's say 30 seconds right then now you can use a 15-minute block. So the amount of available time during the day has actually gone up a lot and actually if you don't even need the full 15

minutes let's say even 10 minutes of really good focus time is actually meaningful for you then you can use 10 minutes at a time and that goes on like if you can generate meaningful learning in just 3 to four minutes then that means 3 to four minutes becomes useful and that unlocks an entire new avenue of opportunity because now you can do effective learning waiting for your coffee. You can do it when you are waiting for people to fill into a meeting room. You can do it when you're walking from one ward to another ward.

you're an ED, you don't walk towards uh you know you can do it when you know whatever it is waiting for a bus you know waiting for the microwave to finish you know there are lots more pockets of time that become available and so there are a few different strategies that we can cut down the context generation by a lot uh and there's two ones that I'll focus on right now the first one is in terms of really really good layering of your learning number one the first strategy is really good layering and the second

one is just using loweffort active learning the first one in terms of layering So what this means is that you accept the idea that you are not going to go from knowing nothing about a topic to knowing everything about a topic in a single study session. Even if you've got the entire day, you're not going to, you know, get through it. Even if you get through the content, you're not going to get to mastery and full retention of that content within that same day. Usually, we accept that. So we we already know that if we

have three or four hours to study, we're not going to be able to cover everything. But what if we have 1 hour to study? Well, we yeah, we're not going to cover everything, but we'd still say it's meaningful. We're making a meaningful dent in this, right? Why could we not make a meaningful de dent within 30 seconds of thinking about it? Usually the reason is partly because the context generation takes so long. But the bigger reason is that the way that we're building our knowledge is not set up to allow that to happen. So normally

the way that we go about learning something is we take this huge body of knowledge, we go through it, try to like understand how it is and we do this big consolidation process and as we're consolidating and thinking really deeply about it, that's where the learning is is being extracted from. Imagine now just splitting that process up. So you spend 30 seconds just generating out like the main things that you need to learn and then you stop. And the next time you take that list of things that you needed to learn, you pick just two

of those things and you figure out basically what the definition of it is. And the next time you pick it up, you spend 45 seconds just seeing how are these two things connected in a way that could be meaningful. And then you split it up and then, you know, like 45 minutes later, you spend another minute, you look at this map that's now looking like two two points connected together and you say, hm, another one could maybe fit in there. I don't know. I've got a question about that. Does that actually make sense? Write down

a few different questions you have about that. Next time you're sitting on the toilet, look up the answer to those questions. See how whether it makes sense or not. Next time you have a time available, fill it out. And so in doing it this way throughout an entire day, you can actually start building on knowledge because you are completely expecting that you're not going to finish it in the session. So you just take one step and you prep yourself for the next learning. You put yourself in a position where you're ready for a deeper level

of thought. So you start with just man, what am I even learning today? Let's learn about this. Cool. That's one session. What are the topics in this? These are the main topics. One session. Next session. Okay. What are the main ideas in this? It could be this one and this one, but maybe not this one. Next session. Okay. If these are the two main ideas, how might they be connected together? It could be like this. Maybe it could be, you know, like this instead. Next session. Okay. Well, does this make sense? What are the questions

that I have? Write down a few questions. Answer that question. Answer the other question. You know, regenerate that so it looks a little bit more like this. Add another keyword into there. Build it out. So by the end of the day you can actually develop pretty robust knowledge and the context switching is very low because every single step is just the preparation for the next step. This is a form of microlearning that I teach competitive athletes actually a lot of trainers use this as well. Um and that's because you know it's it's very hard to

find meaningful long pockets of time. The really interesting thing and this the research from microlearning supports this is that when you have sessions that are very short less than 10 minutes long and I'm not really sure why this happens but it's been shown in the research that when you have these smaller microlearning sessions your brain actually operates more effectively more quickly. >> It actually explains why we're more likely to have a lot of random knowledge about many things because we usually gain that knowledge in a burst of curiosity and >> Yeah, it could be. Yeah,

that burst of curiosity is kind of your brain saying like I'm really ready to learn a lot of these things. Like I really wonder, it's ready to connect things together. We can use that and it's actually great because the microlarning prevents you from entering into fatigue and it also means that you have these open loops constantly. So as a loop is open, your brain is still roaring away in the background trying to close those open curiosity loops. You know, if you've got questions here like hm wonder if that makes sense or not. Sometimes I've done

this where I've done a microllearning like I've done periods of microllearning. Literally I'm waiting for people to join a meeting and I'll just pick up my notebook that's always on my desk and be learning something and I'll be having a few thoughts and I'll just think of one more question and I have the meeting and then by the end of the day I'm like hm actually I've got some more questions and then that can actually open up into a whole new section of learning that I that I then explore for the next one or two

weeks. And so it means that there's very there's very very low level of engagement or effort that I need but that time is being used really effectively. And even if you're not a again, even if you're not able to get to it, it means that when you do have that 3 hour, 4 hour, 5 hour block where you can sit down and really focus, you've got a great foundation to start off, right? Your brain is so much more prepped for it. There's so much less inertia because you've already been chipping away at it for so

long. You're just finishing what you already started and that can reduce the context as well. So that's that's the first thing that's really layering it, you know, really really layering it. Finally, the second thing is just using loweffort active learning. So loweffort active learning doesn't mean that the active learning is easy. Your brain is still engaged. That's why it's active. So you it's still thinking but the low effort means that it's really easy to spin up. It's really easy to deploy this learning. So flash cards is actually one of the best examples of this because

to do a flash card requires very little effort. It requires a lot of thinking to actively recall the answer if you don't know it. But the act of doing it is very low friction and very low effort. You can do this with lots of other things like you can have a series of test questions that you generate for yourself. So instead of flash cards you're sort of answering test questions. You can do like a fill in the blanks of the mind map. You can do it as part of your layering. We can just look for

different relevance contexts. So you're saying, "Okay, well, I'm learning this thing and I don't know why any of this is important." So right now, all I'm going to do is find five reasons why this might actually be relevant for me. So anything that's very low effort, low friction to start doing. You don't need a desk. You don't need to be sitting down. You don't need to write notes. It's purely just a mental exercise or something that you can pull out on your phone using an app. These are things that you want to just pepper throughout

the day as well. a lot of um like clinicians, you know, people that spend a lot of the time being very busy throughout the day and then they're at the same time using that knowledge that they're learning throughout the day as well. They they get benefit from this because as they layer it and as they're kind of sporadically learning things throughout the day during the day, opportunities arise for that to be sort of naturally consolidated and and um these little micro loops of retrieval start forming as well. I wouldn't recommend studying for an entire fellowship

exam using just the strategy. probably it's not enough time but it can you know ease the burden of you know a lot. I think we're probably we're probably at time on the session but um yeah thanks so much for the questions um thanks for the engagement. >> Thank you so much. >> No my pleasure. Thanks guys. >> Really uh much appreciated. >> Awesome. Thanks for coming along. >> Hey guys, I hope you liked that coaching session. It's a new kind of format. So if you liked it or if you didn't like it, uh let me

know in the comments below. Would love your feedback. If you did find it helpful and you're wanting something similar, I actually ran a workshop very similar to this but with business owners and CEOs instead of doctors. So, if you want to check that out, you can click this link right here or not. But if you're interested, you should just you should just click it and you should just watch it because if I mean, especially if you like this one, you're probably going to like that, too. You don't have to watch. You could just wait here

if you wanted to. I don't know what you'll be waiting for. There's not really any more content coming up after this, so you should just click it. You know, the most important tip for learning