Method of Loci: Memory Palace
Clinicians often say their medical education felt like trying to sip water from a fire hose. As a student, you may feel you are just trying to keep your head above water. It's all too easy to drown in information. That's where the method of loci - or memory palace - comes in.
What is Method of Loci aka Memory Palace Technique?
Clinicians often say their medical education felt like trying to sip water from a fire hose. As a student, you may feel you are just trying to keep your head above water. It's all too easy to drown in information.
But does traditional medical education have to be so…hard? Boring? Both? Is there is a better way to learn the otherwise fascinating material other than endless study sessions hoping something sticks?
Just like modern medicine has held on to some archaic beliefs, so too has medical education, and educational theory in general. For example, you may have heard that you are either a visual, auditory, or kinesthetic learner.
Many of us even identify with one or more of these styles, but the evidence is less than convincing. We all probably use some degree of each one, and healthcare students may learn better using at least two.
However, there is a method that is almost magical in its ability to improve most folks' memory capacity. This novel technique has been making its rounds through the neuroscience world to help you learn – and retain – more medical education knowledge than ever.
As part of a comprehensive study approach utilizing spaced repetition, high-yield question banks, and the method of loci (aka memory palace) technique, you can beat even the gunnest of the class gunners. Today, we will delve into the powerful method of loci, or memory palace, technique. By the end of this article, you'll be able to apply it to your medical education immediately.
The Neuroscience of Memory (sort of)
They say everything you need to know about neuroscience you learned in kindergarten. Or maybe that's manners. Someone correct me.
Anyway, neuroscience has been studying the intricacies of memory and its formation, storage, and abandonment for centuries. Along the way, someone noticed people retain information in stories better than lists or other forms.
Maybe this is why, for centuries, Learned People passed down knowledge using stories. If it wasn't in somebody's head, it didn't exist. Therefore, scholars, researchers, and other smart folks had to remember everything they learned, or it would disappear. And sure, the total volume of knowledge available was incomprehensibly lower than it is now. However, the amount that individual scholars retained would seem super-human by today's standards.
Then, a radical new invention burst onto the scene and catastrophically disrupted the knowledge economy forever.
Books. Specifically, the written word.
When they were first introduced, old-old-school scholars accused books of “destroying the memories and minds of the younger generation” of the time.
Sound familiar? Cough *smart phones.*
Using Memory Palace/Method of Loci in Medical Education
The reason people of yonder year were able to remember so much more wasn't because of a difference in their brains. It was, in part, because the way they learned was strategically designed to force their brains to remember the most possible.
As with everything else in life, you (hopefully) learned everything you need to know about the neuroscience of memory before getting out of kindergarten.
I'll prove it.
Remember bedtime stories? You probably still enjoy a good story before bed even today. Instead of mom or dad, however, it's George RR Martin comforting us with his stories.
Stories might work so well because of the way information flows into the brain. One theory suggests that in travels bidirectionally along a certain pathway in the hippocampus. That is, one way for encoding and another for recall. First, information makes its way into the the hippocampus for processing. Certain types of information go to certain cortical locations via specialized proteins for further storage, thus creating a full-fledged memory.
That means memory is a physical structure that you could touch if you were small enough. How cool is that! Although, this article was written primarily by a brain, so there may be some bias there.
Click to compare with Netter's. How much has changed?
How to Make a Memory
The information probably travels sequentially through specific tracts during both storage (forward travel) and recall (backward travel). This makes the hippocampus especially useful for episodic or sequential events.
This biological mechanism may be why stories are easier to remember than boring lists or ugly PowerPoint slides. It's also why this type of memory is called ‘episodic memory.'
As an aside, the hippocampus is right next door to your olfactory tracts. Some neuroscientists believe this juxtaposition causes certain smells to occasionally trigger strong memories.
So next time you find yourself studying pituitary macroadenomas, tell yourself a story and be grateful for your anterior hippocampus and its ability to encode stories. If you don't get that, you need to brush up on your neurology.
Learning Method of Loci for Medical Education
The technique is called the method of loci by the brainiacs who study it, and a ‘memory palace‘ by the rest of us.
I have to give credit to my friend for showing me this. He was entering his pharmacy program when I was about to start my PA training, and he introduced me to the concept. We both used it to crush our respective medical education curricula; me the PANCE and him the NAPLEX.
And he's an even better pharmacist than he was a student.
Creating a Memory Palace with the Method of Loci
The best way to learn the method of loci is to read the book Moonwalking with Einstein by Joshua Foer.
The author writes about his journey to improve his memory by training with the world’s top ‘memory athletes.’ Yes, memory athletes are apparently a thing, and after reading this book, you'll see why, too.
Here’s a quick and dirty example, from my own twisted memory palace.
As a student, you will have to remember a lot of long, boring lists. For example, you'll one day know more about acute bacterial sinusitis than you ever cared to. But to learn everything there is to learn on the first try, put the information into a story in your memory palace.
Example: Acute Bacterial Sinusitis
- Streptococcus pneumoniae
- Haemophilus influenzae
- Moraxella catarrhalis
- 10 or more days of symptoms:
- Persistent, purulent rhinorrhea
- Nasal congestion
- Facial fullness
- 10 or more days of symptoms:
- Amoxicillin-clavulanate
- Use doxycycline in pen-allergic patients if there are no risk factors for resistance
Applying the Method of Loci to Medical Education
Instead of repeating that list until you lose your mind, put all that information into your memory palace. You'll have plenty of chances to lose your mind once you become a licensed clinician. Trust me.
The experts recommend imagining yourself in a familiar place, such as the front of your childhood home. Start somewhere natural, because you'll be ‘walking through' it in your mind's eye.
As you proceed through your house, you begin to ‘fill' it up with your new knowledge. Each location in your mind becomes associated with a piece of information you are trying to remember.
That way, the next time you imagine walking through, everything you've ‘left' there is still in its place.
From the Theory of Method of Loci to a Legitimate Memory Palace
Be sure to assign each fact a remarkable image in your mind's eye. This way it'll be easier to recall when the time comes.
And the more bizarre the scene you create, the better.
In mine, Strep pneumo was always a stripper with a bad cough (strep became strip, pneumoniae reminded me of pneumonia[duh]). H. flu was a human-sized mosquito (no idea why) and M. catarrhalis was some weird, infectious-looking version of Felix the Cat.
Feel free to copy mine, but it works better when it comes from your own head. Once you've done this, congratulations! The front of your house will now remind you of acute bacterial sinusitis for the rest of your life. Have fun visiting around the holidays and trying to seem normal.
As I said, the weirder and more unique each of your scenes are, the easier they will be to recall later. Also, the harder it will be to explain your internet browsing history as you look for inspiration in Google image search to guide you.
When recalling ABS, don't rattle off a list of meaningless words, which is what your medical education probably feels like as a student. Instead, ‘remember’ yourself walking through your house. Take note of all the weirdness you have created, triggering easy recall of the information you want.
Show Me The Science
Method of Loci in Medical Education & Peer-Reviewed Literature
There's more to this technique than memory athletes and a great book.
This study found that medical students who used this method did better than those who underwent ‘traditional lectures’ when tested on the subject of insulin and diabetes. Science.
And that's without spaced repetition or that bomb question bank you've had you eye on. By the way, you should really get it a year before your boards if you really want to crush them.
If, after all that, you are not sure how to use the method of loci to build a memory palace for your medical education, here's a TED talk explaining it further from the author of Moonwalking with Einstein.
References & Video Explanation
Qureshi A, Rizvi F, Syed A, Shahid A, Manzoor H. The method of loci as a mnemonic device to facilitate learning in endocrinology leads to improvement in student performance as measured by assessments. Advances in Physiology Education. 2014;38(2):140-144. doi:10.1152/advan.00092.2013
