 So first of all why are you here? So you see upside down there put it upside down because it's that important for me This is there's not a didactic lecture series. So I'm not going to stand it and give you a lecture now in the beginning In the beginning I might do it because I ask you questions and you don't know the answer I'm going to say one or two things or if no one around the table really knows and I know the answer Which doesn't always happen. I'll tell you the answer, but that's not the point You're not here to be spoon-fed your postgraduate student So when you at your age now someone who's on main campus It's already a postdoctoral student Contributing massively to their field and you're just little kids running around drawing blood filling in forms phoning for beds You know, there's a great discrepancy between what's happening here and what happens in the real world is a very artificial world medicine And really to be in your shoes and still get a lecture with a PowerPoint slide and being told I think that's absolutely ridiculous So that's not going to happen. Yeah, it's not why you hear the second reason why you're not here You'll see there. That's also supposed to be made as you're not yet to pass the exam Now that's not what we're trying to achieve here and I'll get back to that as well. You're here For one reason because you've got to go home and study We're gonna somehow make you do that but not study to pass the exam study to be a doctor proper surgeon or urologist or whatever and That doesn't happen just studying for an exam being able to regurgitate Which you know and by next week you've forgotten that this is the point completely and that's how this world unfortunately is set up But that's just wrong what I want for from this exam is for people to love the idea of knowing stuff learning where you know stuff is to open the books and read and pay attention in the ward and be in the ward and get some work done You know various stuff that you go through But that should not stop the time that the exam is finishing when you pick it up again for the finals When you start studying and something is terribly wrong with that picture that surgeon I don't want anywhere near me or my family when I'm sick and it's urgent. I really don't and to do for it for exams to create that kind of Situation we just trying to study for the exam. That's just wrong. No one will convince me that that's right So one reason for you being here is to also realize that if you want to run 10k race or marathon or 100k sprint, you don't just pitch up on the day you exercise You exercise well the brain your brain is the exact same thing. You're not just gonna You know, no things you've got to you've got to work at it Last perhaps reason why you here is it's easy for you to think about something you see something in the ward We do war downs or you see a patient walk away. You think about it And you might know the answer, but that's quite the different thing from there from vocalizing And that's the training part of the training bit as well. You've got to learn To take the knowledge in your head and vocalize it I can Going to work in walking into the exam and that's the first time you hear your own voice That's just wrong. You are going to stutter and you are going to say bad things and you are it just doesn't work So after this is done You've talked so much. You're so used to talking so used to You know interacting vocally with an examiner that when you walk in there You're fully trained athlete and you're ready for that 10k run or marathon run or whatever. It's only 20 minutes times two So it's not that bad So just the exam, you know, you're gonna do the MCQ Initially people were quite against the MCQs But there's a lot of literature out. There's a type of literature that you won't be reading because you're in to pass your exams I shouldn't say that now to become a good surgeon But the MCQs there's a lot of literature out on there to show that it is if not as good as Better in testing higher cognitive function than a short or medium or long form question The problem with that literature is that literature that research obviously gets done on very properly set questions It's not just pulling You know 200 MCQs out of a hat and making people like that and doing research on that to show if it takes cognitive function or not So those are very select questions You can imagine that when the research is done on these things and that's not the same in this exam This exam is just the college keeps on asking people just to submit questions And it's South African safe questions. It doesn't come from those UK books and all of those. It's local stuff But as we stand out as of now, there is no quality control on those and we know for instance in the last exams You know, it was women with prostate cancer, you know, it was that bad this apparently the spelling mistakes were, you know, the grammar Spelling mistakes. It was horrible. So That's you know, that that's just the worst part of it But second worst part worst part of it probably is that none of us doing these exams Setting up these MCQs have been properly trained how to do it. Well, I think we can man That's part of being a surgeon You think you can do everything because you can do one thing that what the medically means you can do everything else which is just nonsense so Even though it's been shown to test I order cognitive function I'm not convinced in our setting it does and I'm not convinced that a student who passes the MCQs actually knows they work I don't know if it's always indicative of you knowing your work And you know, some people do fail it and I think to myself when I interacted with that person I personally knew what he was doing and then he or she and then they fail the MCQ and that for me is a clear cut You know indication sort of that the MCQ did not properly test that person something else was going on And there's some people who are always quite amazed by the MCQ because I thought they knew nothing So, you know for us extrapolating the research that's out there on our MCQs. I'm not not quite convinced and Furthermore the way and it's not going to change by the time you do your finals is the first world is really moving towards a competency-based Examinations of competency-based team and that's not what we do local No one knows how you can operate by the time you've done No one knows if you're a good doctor if you interact well with patients if you can communicate well if you have the correct the levels of sympathy empathy and Most of all we don't know how you can how you operate because no one ever judges that And especially the finals even the interaction you have with examiner there. That's purely subjective evaluation of your knowledge You know, and that is just I mean that is now being I think in most first world training Institutions has been shunned the way we're doing it. It served us well in the past, but World has moved on from this. Okay, and the reason for me is just to diminish the power that the exam Hold over you. You know, let that go the way that we examine still in this country. It's old-fashioned Useless type of examination. Okay, so rather prepare yourself to be a good surgeon and Buy product of that would be that you pass us these two silly exams. That's the line wait for you Okay, with time I know like you still in Bosch is signing up for can meds can meds is a way of training Which is really being accepted in most you know in many places in the world as a proper training methods and Evaluation methods and we've got a long ways to get there but still in Bosch I know is signing up to the can meds method comes from Canada and it's really Training a 360 degree or full Specialist as opposed to this very Small goal directed way in which we do but so the MCQ you've got a pass As I say and our setting is not always indicative If you know your work or not So if you fail that little hurdle just try the next time it really isn't indicative whether you know your work or not Our role is something different. You know, there's a face-to-face. It's not a piece of paper You're sitting in front of someone who can actually laugh in your face, and that's not that's where the the stress comes in Okay So that's a whole different interaction and that will will will exercise here as if there's no tomorrow You're really when you walk in there You should be so well trained in handling that situation If you didn't attend this and just went in there versus attending this there should be a big big difference So the subject matter what you know, that's on the website And the colleges website what the subject matter is for this people the examiners go way beyond what's on those Webpages, okay, this is a very open in that exam. They can ask you anything and some some examiners go way overboard I think last time people asked about research into pediatric surgery and Some funny thing about that. I think you know kind of exactly with a silly example perhaps there are many more examples of people going way outside of that But that doesn't mean that's incorrect to do that When we sit Beforehand and we get our brief in the morning before we start the goal of that exam is just to identify the candidates Who we feel are safe to carry on to the final exam or they need six more months of experience? That's what we that's the goal of that that exam And that means people might ask stuff that is outside of that But usually if you paid attention while you were in the world, it shouldn't be too much of a problem Even if you didn't meet that get yourself a good textbook So the text stands for you know, any of these big green fields Any of those textbooks obviously the select chapters in that the chapters on trauma the chapters on wound care wound healing, you know, those generic chapters They always form a good basis. There's multiple open educational resources these days go and Metscape Any of these websites even on YouTube search for lectures on on a topic and I'll get to why I want you to do the whole lot in the review articles It is fantastic if a candidate can quote Randomized control trial that was published two months ago an exam, okay, but they just too many of those You know, if you can do that be very Be very sure that you're quoting things correctly because usually they examine a rate that You know, you use it with different eyes than you or she and you might get into trouble So if there's one thing you have I really advise you to do is get some good review articles On each of these subjects textbooks are old they get old quickly in the review is instead of you having to go search for all these Things it's it combines that all in one for you know, nice little article So where do you find these articles that's on PubMed? I've given you a Link there that you can type in that takes you to a YouTube tutorial made by PubMed itself on how to do a proper PubMed search and we have time for some groups who've actually stepped by a computer and she did it this particular training videos on mesh Headings, you know what mesh headings are? medical subject headings It's a much better way of searching specifically for some like review articles if you just type in your search term how many irrelevant things come up and It's usually just a page after you stop that the good one was but you you must have because you didn't go to the next page You're fit up Okay, there's a way around that to get to the good stuff with stuff that you're really interested in that she's using Mesh headings as a short little tutorial on how to use PubMed to get to what you want and with 10 results as opposed to 2483 okay, I Want to just touch on what to wear on the day at UCT We've got a standing tradition now that everyone wears the same thing at the exam It's a beautiful thing to see people know it's that's a thing now speak to people before you So men you're gonna wear a black shoes black trousers and a black blazer so black suit There's a thin metal strap in it. I always don't want to see it. That must be like that I don't care what you have to go by steel ring or whatever you're gonna wear a black suit With that you're gonna wear a white shirt or very nearly white shirt and a very plain tie Okay What's it blue if you're a public and led the food and I know blue of your Who's who I never can you remember? Republican or Democrat anyway? So you're going to wear black suit black business Suitesh kind of thing for you as well with a white blouse. Okay Properly covered up properly professional You know Something that can compare with a with a with a proper suit and it's gonna be all black and you have no choice in the map I will force this issue. I tell you now it's a tradition and it's so nice beforehand and even after it while people's People are waiting or when we come in as examiners. There's a used to people and they all they're all dressed professionally and You know with some regard for what's going on some respect for for the whole process. So there's no negotiation on there There isn't Done. That's what you're gonna wear The body language we will go over these things again, you know And in more detail, but for now the body language is people are so afraid when they walk in What to do and people are so nervous and they just do stupid stupid things The door is going to be open for you and someone's going to invite you and don't walk in before they Okay, don't walk up and try and shake people's hands because that always happens and some people seem to think that that would idea you to And somehow, you know, give you some extra points or make some connection between you and examine This is nonsense. You wait for that person to Get up and Try and shake your hand Otherwise, you don't don't put your hand up because you know me. I don't shake hands to start off with I just look at you and I say sit down and it's like really awkward But it doesn't get you any bonus points neither does smiling or making a little joke or going Or you know doing some funny thing People do the weirdest nonsense when they walk in there It's ridiculous to see and by candidate number 20 that really gets irritating You know and actually doesn't buy you but actually the tax from You know from what you're trying to create there So we'll go over that in quite a bit of detail how to walk in what to do Don't just sit down, you know That sort of indicate towards the seat someone will say sit down, you know, but don't make it awkward It's natural because after all of this exercise, you're gonna walk in there and have a discussion with a with a colleague about a few topics That's the whole idea. You're not gonna walk in there as student and an examiner. That's the strong You're walking with that attitude. It's lost the candidate It's so beautiful to see someone come in there who's relaxed and they have a discussion with you It's very easy to force someone even Seving them to be in a much higher standing than you to force them into a discussion There's a question answer question answer question answer then you've lost Not lost you can still pause okay But to force that kind of discussion issue that is that is a most beautiful thing to see on this side of the table I cannot tell you what an impression that creates Okay, those are the candidates that do well. So that's what we're gonna try and do So how do you fail? So I'm you know if everyone else from other universities watching this sorry for them, but from this university no one fails None of you are allowed to fail It's not allowed either. This is as much as not wearing proper black suit on the day is not allowed failing is not allowed So what happens, you know, how did you get into mate school? Well, at least a my time I think it's still in your time You were you know one of the clever kids in school. Otherwise you didn't get into mate school Okay, the really clever kids of course went to study maths and physics but anyway, the second tier people got into medicine as you put it that way and And you all did well who didn't do well at school. You know somewhere along the line. You didn't get into this, you know to this Career or university study mates and because you were the stupid kid in the class You know and now suddenly, you know from being way up there now suddenly get to this exam You're worried about failing Yeah, what what went wrong? Huh? Why suddenly now you're afraid of failing you were the most of most people First in their class or whatever as people come to study medicine usually Okay, and or even if you weren't the first second third whatever top 10% whatever now suddenly worried about failing What happened between those days and today what changed? You still a top sort of Cognitively speaking still be a top kind of person. So what what's gone wrong? You know where you hammered over your head as a registrar too many times, you know What what do you know? I failed to understand what went from you being a top student now for you to be worried about failing Something's really wrong. Is the word really difficult? For crying out loud studying medicine is easy. Tell me what is difficult about studying medicine? What is difficult about? Hmm if I asked you something moderately difficult, you know, give me a Derivation of the oil a Lagrange equation Takes a bit of thinking takes a bit of brain power Me asking you the cause of something or you know what you would treat this with how the hell is that difficult? Medicine is not difficult. I failed to understand I You can train anyone to be about as really not that difficult Where it becomes difficult is you don't have enough input data to make a proper decision to have a good output a good outcome And you can take exact two same people with that exact same thing do the exact same thing to them And you'll have differing outcomes because we don't understand medicine to a deep enough level yet we still playing around on the surface You're not always going to have a good outcome Okay, and if you're not always going to have a good outcome Then that's what makes this a bit difficult. That's what makes this makes this a bit difficult Okay, but there's nothing difficult about it You've got to memorize a few things facts and somehow make a few connections and we'll talk about those And you just got to spit them out somehow either to the exam. There's nothing difficult about this Really go study physics or something hard and that's difficult. This is nothing I do not understand the concept of failing this Okay so Other things other way people fail is to say something like that's how we do it Locally, okay, remember we're dealing with a bunch of surgeons here surgeons are not good people may I said it's for the record It's gonna be on YouTube everyone working here this, you know, we're difficult people That's what makes you gives you the ability to do this job Something about your character made you decide this which is different from someone else's character Okay, some way some way there's something going on, but anyway So you might not like what the way other people do it We're very fond of the way that we do things again might be different from what it's done We know examiners from and he might or she might take exception to that because there's some underlying issues going on Okay, so it's a man met up last resort to say we do that locally Who's not to say that the one thing you do locally is eminence based as opposed to evidence based A lot of what we do don't kid yourself is still the eminence based in every institution the people who go straight up against evidence Because in their hands something else is better and they'll stick to that You know and that happens all over the show and it's silly to think it doesn't happen here So so never say but we do it that's not good We answer that question because that is what is stated in the literature that is the proper and Reason behind you deciding on that answer Not because it's done local okay most of what we do obviously we purpose the correct thing But then fall in that trap people sometimes get into arguments with a with a and then and then you know human factors stop playing And that's not between you and the examiner. That's not a good thing Okay, so I never ever say that's what we do locally no matter how right it is That's not an argument for you choosing that answer you read it some way There's some backup for you for having chosen that answer and then you'll see the big letters They what people fail is because they succumb to the pressure of guessing Because you think if you say if you don't know the answer you're going to fail That is not why you fail this exam. You fail this exam because you show the examiner I'm willing to take the risk and guess and hope that I guess correct And I just said to you that we sit beforehand and we decide we let people pass if we feel that they are ready to go on to the Finals if you are willing as a surgeon and training to guess at how to treat the patient you think you're gonna pass So do not ever succumb to trying to get an answer out because you feel you have to otherwise You're gonna fail because under those circumstances you're gonna guess incorrectly and what now all the examiners Season as a person willing to take chances with patients. I'm not comfortable with this student I'm not gonna pass you. That's why people fail. It's the biggest reason for failure so many many many times in this course we're going to Learn I'm gonna drill it into you have five seconds if you cannot come up with something when in five seconds You are going to say I don't know No one has ever failed because they said I don't know it does not Happen you do not fail when you say I don't know and you don't have to say to make those exact same words You've got to play the situation. You might say I don't know the next time I'm you know, I'm up against this this issue, whatever You know, I'll have to check up on that, you know plate Just play the situation But it's gonna come down to the fact that you say I don't know the first thing that happens that examiners starts pushing For that for that until you start guessing and guessing wrong and so then you've lost You look and stay back in the eye who stayed back in there You say I don't know you make them understand that we stop the bus here because it just goes downhill from there Because they won't let it go because now you start answering incorrectly and they go deeper and deeper and deeper and your hole This goes deeper and deeper and deeper Okay, so no one if you don't know you don't know it is not the end of the world It is not an embarrassment embarrassment or some reflection on you No one walks in there knowing everything and the guy who tells me I'm gonna go check up I've got no issue with that guy and That brings me back to why this these exams are such in my view is not a good way of doing things is that if I asked you Just regurgitate for me the 16 causes of this or regurgitate for me the T&M classification of that does that does that make You a good surgeon in any way So unfortunately you are gonna get questions that are not proper questions Okay, if you tell me no, well, I can't remember the classification of that But it's something that's up on a placard up on the wall every time you walk in Why the hell must I ask you about that and why must I fail you if you don't know if you can just look up there Anything that you can quickly look up on an app Why must I ask you to regurgitate that what I want to know from you is do you understand the concept? Can you deal with this situation? That's a proper question Unfortunately, not always going to get proper questions in the exam You know this these are not this is not a structured thing. We're not there yet with a college where these things are done fully assessed full, you know done in a proper fashion and Objective as opposed to subjective. We're still going to do a subjective test. Okay You don't know you don't okay, so tips on learning very quickly These are things that happens to you normally The first time you walked into med school and to anatomy class or whatever you heard something for the very first time Never knew that that existed you can take that for anything in life the first time you hear about something just before that period You were unconsciously incompetent. You didn't even know that you didn't know about this now you hear it for the first time Now you become Consciously incompetent at least you know that you don't know At least you know about it and you go through it a couple of times and then you become consciously competent That's usually the level of these exams You have to think about it and recall it from memory and and then you do it for many many years and become second nature Like the first time you bought your new phone and you had to learn that new operating system now You don't even think about it your fingers this goes to the now you're unconsciously competent And that's why it's so easy for consultants to do or dance and ask all sorts of things and ever But I've seen it 10 million times as part of their being they are unconsciously competent Okay, it's good if you can get to that kind of level for the exam But most of the time you're gonna get stuck by conscious competence. So how you're gonna get there? So that little thing you see there most of you might have heard about it something maybe you are Unconsciously incompetent and I'm going to make you consciously incompetent. What is that? Blue sticks on him of learning starts at the bottom first you see something and you're trying to record it. That's the remembering Once you've remembered a lot of stuff You can start integrating a little bit and you can understand it somehow From there you start applying it you see patients and that knowledge that you have you can apply to you know How to treat this you know what stuff to write up, you know what dose to do that You know what I need to start you apply this knowledge and then Eventually you get to this you can create new things You're not just working on something someone told you but you know in a new situation Which you've never seen before but you can you can integrate and create a new solution Or you can evaluate what someone has told you and you can tear it apart a button analyze it and think why? Why is it so I don't agree? I think you know you're at a much higher level So how do we go through all of that the first thing you have to do is you learn something? I don't know if you know how your memory works. We'll give you a short physiology Lecture here, so it's those two never make the land hippocampus Did you know you know how you how you record stuff into memory that we tell you quickly because it's important It'll help you study so where's the amygdala system front of the hippocampus and hippocampus is in the middle between the two so your recording device is Like a video recorder like on your phone that can record video audio, but it can do more It can record smell touch and also the thing is the video recorder can't that sits in the hippocampus But it's got to be switched on so the amygdala sits there And it's like in a fight-to-flight mode all the time and then it says who something important is coming and it wakes up The hippocampus and says start recording otherwise things just goes through how many times have you done stuff? You can't remember that you did it because the hippocampus was never recording from the hippocampus It then goes wherever it needs to go to be stored. Okay, so the make the lot tells the hippocampus a start recording and What does the hippocampus require for you to take in what is happening there and convert that to memory and that recording? It requires focus in other words You can't look at your phone you can't sit in the class and then your mate shows you something or You watching TV while studying, you know There's very good evidence to suggest that multi-tasking even though females think they can no one can multi-task your hippocampus Can as a single stream that it takes it cannot take two streams? Okay So focus is important. So who knows how long your hippocampus can actually record While focusing in tense we've got 15 minutes on the table. How long is a normal lecture in class? No, so what we've got 15 minutes on the table. Do I have another do I have another 20 minutes to have another? 30 minutes Okay, we've got a little buggy there, but 20 minutes you cannot record for longer than 20 minutes. That's it glucose up cellular structures up nothing gone Okay, that doesn't mean you can't sit for in a lecture for an hour But the lecture proper lecture will not go beyond the 20 minutes and somehow break In some form of fashion changing the discussion laughing a bit making a joke taking people somewhere else Just giving that odd few moments and then starting the recording again And remember in a lecture usually you're not constant focusing for 20 minutes. That's pure focus that the world doesn't exist for you Okay, if you go beyond 20 minutes, you will not convert that There's no cellular mechanisms left to make you record for longer than 20 minutes So if you really intensely just break 20 minutes that doesn't even get up go to the shops Do something at this means you will not record and from that it goes to memory. Okay, so you learn first But now so it's gone through that recorder now. It's got to go into memory and there's good research to show how that works as well So what is memory? It's just neuronal pathways with interconnects. So the electricity goes to do to do to do to do to do Between all those connections a bunch of chemical reactions and that's that chemicals moving across or sodium potassium moving across a membrane There's nothing more than that Let's not go into all sorts of other other things. That's how your memory works your pure, you know chemical machine Let's stick to that And when you form these connection pathways, there's also good evidence to suggest those neurons actually get thicker and thicker They become well insulated easy for like too much easy for electricity passed down there So you can change your you can change your whole being you react to certain stuff Just because those pathways are well well-willed and those neurons are quite thick and now you believe you have a certain character And you respond to certain things certain ways nonsense man, you can change it It's difficult to form that new pathway, but you can through for habit formation It's this new pathways that gets but this is what you must do here So how do you do that? How do you make those connections? How do you make those neurons go go thicker? First of all think about learning there's some stuff that you know right now You know that you studied some way you heard some way and you remember naturally and try and think about how did that come about? What was the situation? What was happening at that time that made me? Remember this and that's why one of the things that this pertains to is how you study will study differently Some people like late at night some people like getting up early some people like all sorts of Situations that plays to this Think about when you were successful before and remembering stuff think about and trying to recreate that Don't try a new way now study if you're starting studying now a way to fit in with your Schedule of doing woodlands and being on call bugger that try and remember when last you were successful when last It was easy for you to remember something and recreate sort of trying to recreate that scenario That helps The other is think about the for instance things like when you had aha moments You know when something clicked for you when something clicked for you those neuronal pathways connected And try and when you read some stuff try and make you know create those aha moments in some way Okay, for instance, I was asked that and what other day why I saw a patient You know, that's not oh now I read it. Yeah. Oh, that's an aha moment You know you remember that stuff much better than just reading through and highlighting Okay Another point is it's been well shown now that if you write notes It helps in your memory much more than typing notes. So this computer in the classroom typing is not as good as it's actually physically Right, okay, it adds to a muscle memory and all of that. I can't remember. I heard it Little it's some way, you know, it's much better than typing. Anyway And also build on prior knowledge when you bought your new phone You had an older phone so you really knew something so you just added a little bit You didn't learn the new phone all over and before that there was a push button phone in your house And if you know as old as I am there was a phone that you actually had to Turn the little wheel on and before my time There was a thing that you have to turn and then someone answered and you told them what you wanted But this is one knowledge building on the next knowledge. Okay, you've already got a substantial amount of knowledge try and hook stuff Onto what you know before so these are all just little tricks And then the last and probably most important one is it's also been shown You must take in the same knowledge in different ways and that's why I said where do you get all the stuff that you have to study So if you read it you heard it from some way and you watch the video on it or you read three different papers on it Three seems to be the minimum that you've got to get the same Subject into your head in three from three different sources At least three different sources It also makes it much easier to to form from that upper campus into long-term Okay, so try not just Get knowledge on ventilation from one book and one lecture or what I tried to same subject different different ways of getting it in Okay, so Some more tips and tricks social social learning and we're social beings If you discuss something with a mate or a situation like this You heard someone else say something something happened there We laughed about it or whatever you walk into that exam you remember that moment Okay, social learning is much more important than all is probably more important than this sitting on your own You've got to do it on your own But discussing this even you know outside of this room But especially in this room you have a lot of social interaction that really helps Then there's lots of evidence on the music We all learn different music. I'm funny. You know all know I love physics and medicine I teach that as well and I'm quite involved with with that at university as well So if I do physics I've got to listen to classical music and a very specific kind of classical music if I do maths on the other hand It has got to be pumping dubstep acid You know, it's really gonna You know, it's got to be a heavy Beat to it music and that's weird, but music you know music has been shown Then there's got to be some fun aspect to this because to do this against your will and this just becomes a ball in a chore It's not gonna work You know, so it's got to be some fun aspect to it and even here we're gonna have a few laughs Light competition is quite important and that's a very important for being here because you're all gonna see You're gonna see how he does he's gonna see how she does and that's competition and I want you to push each other because Some way from around the stable. I want look after the exam. We sit there in each candidate gets discussed in the exam We sit in the room and we wait for the marks to get put on a computer. They bring it in put it on the screen Like it will be in the big room there because exam is here We go to each and each in every candidate and we can see who did the best so it's got to be one of you That will not be from another university Okay, and each of you've got a push, you know to be better than the other one as well specifically. Yeah I want to see you trying to compete with you trying to compete with you. Please I want to see who's the best and I want to see who's the worst so don't come sit here and be the worst Please I'm gonna I'm gonna it's gonna be clear who's the worst so bit of company and like competition Then everything one seems to think that you've got to repeat stuff. That's what builds memory. That's not what bulls me man It's it's a retrieval So when you read it the second time try not just reread it again Try and retrieve it from memory from the previous time. So it's not repetition. It's Retrieval and re-retrieval and After three times you get a drop in your return on investment So to go through it for the fourth time and fifth time and sixth time is not as good But it's not just pure reading that sentence over again. It's trying the second time and the third time to retrieve it from memory so it's a retrieval aspect and There's also good evidence to show that Between two episodes and I mean you read it now and you're gonna read it the second time or trying to retrieve it The second time you've got to have a spirit of sleep in between the two that has been shown to be much better than doing it This morning and this afternoon There's something that happens doing the sleep doing your sleep between your hippocampus and then in your own pathways which trying to to connect that source things out for you. Okay, and It's being studied to such a level now that it's also now knowing that that happens in the last hour of sleep Not doing the whole night of sleep and that is why setting your alarm and waking up by alarm clock in the morning is not good Okay, because you don't get that natural last hour. So how do you get that natural last hour? You don't watch TV until 12 o'clock at night. You got a bed early Okay Now in our lifestyle and medicine specifically surgery. This is a difficult thing but I mean it has been shown to be so that But it's best if you have that natural last hour of sleep Okay, so you're gonna have to go through things at least three times before now in the exam It's not just pure repetition try and do the retrieval thing and try and get sleep in between So don't try and study the one thing especially when it gets close to the end They're trying to go through stuff so many times. There's no return on that investment. I can tell you now There's evidence for that Okay, and then this little actions for you know, what you've got to do from here on and as this developed little habits As I said think back to when it was successful for your all past your primary Before that obviously as I said you did well at school something happened there for you to be successful at the most memory game You know so, you know try and stick to those but do this a bit surely because it this whole thing that Depending upon small little steps, you know Don't get to a stage where this whole thing becomes too overwhelming And you feel like you haven't got enough time left then not a postponing the night the next time And don't fall into the same you know make the same mistake You've got a long time now from now to the exam do a do a little bit every day being you know You've got to you've got to Do some work here. Okay, and you don't have to do three hours a day If you do a little bit each day Suddenly you look back and you look what I've been through. You know, you've done a hell of a lot Okay, but that is some habit that you form and some Ritual that you have that you just do at least a little bit every day Don't let a day go by that you haven't done and it doesn't mean. Oh, well, it's too late in the day And I have to put in at least three hours. Therefore. I will do nothing You know if there's ten minutes left Then you ought to do that ten minutes because you feel better after that ten minutes Then you will feel after they're doing nothing And if you do nothing and nothing and nothing and nothing the feel bad about that nothing and nothing and nothing compounds it doesn't just Cumin it compounds and then after this whole thing becomes so ridiculous and so and such a negative experience You know and that you know, you're not gonna get the best out of yourself So the whole thing about this is you know each have an ability know what that ability is It's just to get that maximum out. Don't leave lots in the back in the tank Why would you leave some reserve in the tank? You know just just do the best that you can here You know, don't leave something don't leave unplayed cards on the table. Just do it or why not try? You know, why not let's move away from just trying to pass this exam to see how good How well can I do? Let's push this to the max. Just do it once in your life Even if you don't do it for the final just do it for this exam prove to yourself how good you are and let's leave this Oh, I'm gonna pass. I'm gonna fail me. Let's just leave that alone. It's not gonna happen. Okay, and you've got to reward yourself There's got to be some oxytocin release after even if it was just that ten minutes because that's all you had today But hopefully a bigger session in this thing But have some release after that if you release oxytocin by some form of happy happy feeling reward Okay, I mean some of these sessions is quite tough. You'll see now You're gonna walk out. You're not gonna feel good because I'm not gonna be I'm not here to make you feel good after this I'm really gonna you know, I push it, you know And then you've got to do something when you walk out of here and we'll do some joke We'll go do something or you go do something. You know something you've got to have that bit of release or reward For that and then again lastly make me proud first of all because my head's on the block and it's been now As I said, you weren't here. I've been going at this for more of four or three years now I mean those guys are that we started without doing their finals There's quite some time and it's been successful. So you're not gonna let me down Number one say secondly, don't get yourself Okay, it's actually the other way. Don't get yourself down. This is a don't leave cards on the table You know why why why do you want to why do you want to do a half past? Attempt at this thing whatever form then there's something then there's something wrong You know You're still young and you still enjoy surgery Grab it by both hands, you know and see how much you can get into your head It's not about getting into your head and and using it in the exam. It's actually it's a nice It is empowering to have knowledge. It's empowering to be faced with a problem or do water and the consultant are something something And you actually know it as a stain as opposed to standing there making a little joke smiling You know trying to get the tension off of you. That's ridiculous. You know, why why must it be like that rather know the answer that's It's enjoyable to know the answer. There's an enjoyment to knowing stuff It's empowering to know which feel good So study in that light not for this Old-fashioned exam that you have to go to unfortunately you have to go through it. So but let it be a side effect of You know this little side issue of the rest, okay