High-yield and protected time: A medical student’s take

Learning in medical school often feels like learning a completely new language. There are numerous acronyms (OPQRST, CAGE) and molecules (IL-1, TGF-beta) and more. But most striking to me are two particularly ubiquitous buzzwords: “high-yield” and “protected time.”

I feel like I heard both these terms — and particularly the former — thrown around every single week of this past school year. High-yield has been used to refer to, as you might guess, the material that yields the highest amount of gain — for us students, it’s the material that’s going to show up on our tests. This term pervades not only conversations among classmates but also study materials. First Aid — one of the main step 1 book resources — takes pains to highlight “high-yield” concepts, and Pathoma — another Step 1 resource — goes even further, identifying ideas that are not just high-yield but also “highest-yield.”

This idea of focusing on high-yield concepts bothered me at first and continues to bother me a little bit today, largely because my classmates and I often determine for ourselves what is high-yield and what is low-yield, dedicating our study time to the former and ignoring the latter. The worst part is that we may be ignoring information that may be low-yield in the context of exams but actually high-yield in the context of patient care. The flip side of this is that we only have a certain number of hours in the day; perhaps it makes sense for us to be judicious about what we focus our attention on?

Another phrase that has been widespread in medical school is the term, “protected time.” I started hearing this during the very first week of medical school, when we had part of our afternoon off for protected study time. Later in the year, I attended a panel featuring five pediatricians. The question of work-life balance came up, and one of the doctors mentioned that she carved out protected time to be with her 2-year-old daughter every evening between 5 and 7 p.m. This statement was met with general appreciation but also minor panic. There are so many aspects of our life that deserve protected time: family, friends, time for creativity, and more — and yet, again, there are only 24 hours in a day. Where does protected time start and end? And what does it include? And is it really reasonable to expect protected time when there are so many patient care demands for physicians to navigate?

As I’m about to enter my second year of medical school, some of my questions remain unanswered. How can my classmates and I make sure to learn medicine well enough and thoroughly enough that we can both meet and exceed expectations in patient care? Is identifying high-yield material an ineffective, shortsighted approach? And how do we identify what falls under protected time? Here’s hoping I figure out this tentative balance during this upcoming year,

Hamsika Chandrasekar is a medical student who blogs at Scope, where this article originally appeared.

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