exams and understanding

Summary : thoughts on exams


If you want to build a ship, don’t drum up the men to gather wood, divide the work, and give orders. Instead, teach them to yearn for the vast and endless sea” Antoine de Saint-Exupéry

Approaching half way through third year of medical school, I’ve had a decent exposure to examinations to say the least. Medical school is a strange place in that you see people on a wide spectrum- those who are absolutely dependent on external validation from exams, and those that say that exams are completely worthless. Both are a cause for concern, and believing in extremes is never a good starting point.

In one way both tend to sacrifice understanding. The overly obsessed, anxious student aiming only for a good ranking can sacrifice understanding preferring to ‘rote learn’ topics. In fact this was the approach my parents had to undertake in the Indian medical school system in the late 1900’s – and they both unequivocally agree that the approach is flawed.

On the other end of the spectrum, the student can become so dejected by the notion of exams that they fail to put in any effort. So what is the solution?

can you explain it to a 5 year old?

I recently came across the ‘Feynman technique’ for learning. The premise is that

  • You choose a concept/topic you want to understand
  • Proceed to explain the idea to yourself as you write- as if explaining to a new student / layman/ toddler / 5 year old- or whoever you want.
  • The crucial part is that you vocalise the process and use easy to understand terminology.

if you can explain it simply then you understand it deeply

Now is it perfect? Depends on your yardstick of measurement. If your measure is exams, then no, it isn’t perfect. You will miss marks on those inane questions that demand you to memorise pointless facts. But will you gain an understanding of a topic for years and years to come that? Yes

Learning in medical school does of course involve memorising certain facts – for example drugs. But even then, I think that due to technology and storage of information, this shouldn’t be the highest priority.

In fact modern day hospitals are run mainly bureaucratically though guidelines on exactly ‘what’ drug to prescribe and how much, so the whether or not the doctor knows a certain drug doesn’t matter- what does matter is that he understands the reasoning behind it. Things have changed a lot since my parents were in medical school.

learn out of curiosity

Merely to acquire information or knowledge is not to learn. Learning implies the love of understanding and the love of doing a thing for itself. Learning is possible only when there is no coercion of any kind” Jiddu Krishnamurti

Ultimately exams are a necessary evil- but should you put your mental wellbeing on the line to achieve the highest grade possible? I guess that is a personal question that I can’t answer for individuals but atleast I can shed some light on my own experience.

What is more important I feel is not to become dejected by the learning process through examinations. I’ve had periods where I (feeling both internally and externally inadequate) worked intensely hard for exams with idea of‘do or die’ and I’ve had periods where I was so demoralised by the process that I stopped.

It is crucial to remember that learning is life long, knowledge is not an end, but a process. Always ask questions. Always be open to learning. In our 20’s, ego tends to flair up for many where with growing knowledge and pressure of performing and success we pretend we understand more than we do (‘scientia infla: knowledge puffs up).

Instead as Bruce Lee advocates- ’empty your mind’. Be receptive and admit when you don’t understand topics.

To conclude, take it step by step: iteration is crucial in any form of long term endeavour. Only by understanding simple concepts can you build on those to grasp more complex ones. Enjoy the process and don’t become fixated on outcomes, (especially those as trivial as examinations).