PAO! Study for your next test with professional memory techniques

I’ve unknowingly used the term “mnemonic” incorrectly my entire life. I equated it with any acronym that helps you remember stuff, which is correct except for the entire part about it being an acronym. Mnemonics, really, are anything that helps you remember something–they’re not limited to cheesy acronyms like “RTDCB = Randy Travis Drinks Cold Beer.” And a mnemonist, a word I had never encountered, is someone who practices advanced memory skills. While the power of memory is always an integral element of success in professional school, I was unaware of just how poorly I understood the art of remembering things until I read Joshua Foer’s chronicle of the history and practice of memory, Moonwalking with Einstein.

Now, critical book reviews are not really my weapon of choice–there are hundreds of worthy book critics and millions of readers happy to share their opinion on any given title–so I won’t review the book here, other than to say that it was an enlightened read that challenged my perception of how I define intelligence, and gave me a few tricks that I subsequently employed in real-life feats of memory, like the USMLE Step 2 exam. While the techniques weren’t created by Foer himself, his descriptions of them were sufficient for me to apply them without any additional resources.

First, the commonly held perception of intelligence: in medicine and dentistry, and perhaps the written test-riddled US science education system in general, memory has replaced intellect as the hallmark of intelligence. The most impressive students, those who excel in the most economical (and therefore most widely used) testing system, are those who can recall something they saw, heard, or read only fleetingly. For example, we’re all taught to memorize the Kreb’s cycle, the classifications and notable features of microbes, the side effects of medications, and the myriad manifestations of hundreds of disease entities. Those who can store and access that information most efficiently thrive, even more so if they can recall such facts months or years later on rounds or in discussion. And that’s not a bad thing: exquisite memories engender marvelous clinicians and impressive scientists. What I was wrong about is that I believed this recall was a talent, not a skill. I believed smart people had great memories and average people had average memories. This simply isn’t true. As Foer demonstrates in Moonwalking, recall and memory are teachable and trainable. In fact, there are hundreds of people, most of them with what they would call average memories, who perform feats of memorization that would blow me and every intelligent professional student I know out of the water.

The “mental athletes” who compete in national and international memory contests have spent years, or in Foer’s case, months, dedicating themselves to feats of memory–from parlor tricks like memorizing the order of a deck of cards in 90 seconds to the monumental task of reciting entire works of literature. There are more memory skills with varying applicability to the real world, but what is really striking about this world of mental athletes is that most of them believe that their biological memories are average. They increase their capacity using tools established and refined through hundreds of years of oral tradition–skills that existed, by necessity, before the written word was even a thing. Joshua Foer’s book offers an inside perspective on the memory competition circuit. Foer, a journalist by trade, stumbled upon the Olympics of memory competition for a story. Intrigued by what he saw, he committed to learning the trade himself. With the help of a handful of the field’s vanguard, Foer became skilled enough to win the US Memory Championship only a year later.

There are three innate concepts, common to the wiring of almost everyone’s brain, that mnemonists use to their advantage. They relate to how the brain processes information; namely, how it decides what to store and what to dispose of. Unfortunately, almost everything falls into the latter category: information that the brain doesn’t want to use the energy to save goes in one ear and out the other, and we don’t really have a say in it. These three characteristics increase the chances of something worming its way through our spacious inner lobes and sticking.

1. Strong emotional connection, or memory associated with multiple senses: Many people with natural high-capacity memories do this unconsciously: they associate a piece of information with a person they remember, a sound, a smell, or an image. The more “tags” something has, the more retrievable it is. It is difficult to train yourself to do this, especially for vanilla concepts like a step in a biochemical pathway, but it can be done in combination with the subsequent characteristics.

2. Lewd, strange, fantastical, or perverse memories: this sounds almost wrong, but we evolved to retain information that clashes with our perception of the world. This new information justifies remembrance because adaptability equals survival. Similarly, we create multiple strong associations with things that are sexual (If I need to explain why that is, it’s also closely tied to future survival), or humorous. Professional mnemonists use this by tagging the fact or information with a scene that is hard to forget. I’ll explain below.

3. Places. The posterior temporal and parietal lobes we all learned about at least a dozen times are powerful for creating mind maps. Why? Because nothing is more important for survival than understanding where you are, where resources are, where danger is, and how to get back to the familiar. The mind’s capacity for remembering places is virtually limitless. Think about how many locations you have unconsciously built in your mind, just so you would know your way the next time you’re there. Think of the house you grew up in, a parent’s house, your current house, the supermarket, your place of work, the airport, etc. The list goes on. The art of memory refers to these as memory palaces, and their use is key to unlocking the mind’s power for memory.


Taken together, these characteristics suggest a relatively accessible method for remembering almost anything, called the method of loci. Essentially, a mnemonist associates the information with something easy to remember in a place that they already know. The easiest way I found to try this was to start simple. I imagine walking up to my house from the street. The base of the driveway is my first locus; I can put a person or object there that I associate with whatever I’m trying to remember. The next is the stairs leading up to the porch, and the third is on the porch itself. When I walk in the door, there are several loci in the first room (the living room): the closet, a buffet table, a chair and a table by the window, etc. It is virtually impossible for me to forget these places. It’s probably the same for you if you imagine approaching and walking through your house or apartment. The next step is to place what you want to remember in each location, with something notable to make it stick, and do a mental walk through when you need to retrieve the information.

Before Step 2, I used the method of loci to develop a memory palace of my house to remember the genetic metabolic disorders and glycogen storage diseases–if anything is hard to memorize, it’s the name of diseases and the faulty biochemical step that causes them. For the sake of brevity, I’ll illustrate my first couple of stops. At the base of the driveway is a bottle of Aunt Jemima’s maple syrup the size of my car that a baby named Liv (leucine, isoleucine, valine) is beating with a branched stick (branched keto acids), while occasionally having vomiting and diarrhea. It’s hard to mistake that for anything but maple syrup urine disease, especially whne I layer on the smell in the image. On the stairs to the porch is a boy named Lesch Nyan who is biting himself with one hand and using an HP computer to read about respiratory therapy (HPRT= the defective enzyme in X-linked Lesch-Nyan disease). I continued on through the house with similar scenes all relating to a different disease entity, 22 in all, taking me from the driveway to the backyard shed.  Did it work? Yes; I remembered all of the diseases, multiple manifestations, and their underlying pathology. Of course, it was a lot of preparation, and I only got two questions about it on the exam.

So…after reading about these methods and employing them, albeit briefly…does the method of loci merit application to the real world of higher education? Not for everyone, or only in specific situations, would be my answer. Yes, you can memorize a virtually limitless amount of information with it, and yes, common sense dictates that it would become easier and less time-consuming with practice, but it is too laborious to create extravagant images and mental maps for small amounts of information. I believe it has potential application in the tedium of memorizing massive quantities of information for classes such as biochemistry, pharmacology, microbiology, and pathology. I should note that the increasingly popular Sketchy Micro series uses many of these concepts for its purpose, and many students swear by it for preparing for step exams. It’s abundant creativity is hamstringed by the fact that it asks users to memorize a “place”–the sketch–that is entirely new to them. It would be incredibly more powerful to use their phrases and imagery in a mental map that you already know. That is why some of their videos, such as the urease positive organisms found in a bathroom stall, are nearly impossible to forget while those that take place in less relevant spheres, like jungles and factories, are later difficult to recall.



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