Edward Tabor
Bethesda, Maryland, United States

 

Some of the sources of medical vocabulary. Photo by author.

Both of my parents were physicians, and their discussions were often medical. One weekend when I was about four years old, I listened to one such conversation at lunch and interrupted to ask, “When I grow up, will I be able to speak the language you speak?” They paused to assure me that I would. In the end, I, too, went to medical school and learned that language.

Learning the vocabulary of medicine is like learning a foreign language. It has been estimated that a medical student learns more than 9,000 new words during the first year¹ and about 55,000 new words during the entire four years of medical school.² However, the way these totals were calculated was not reported. In addition, the number of medical words that are actually needed to become a good doctor has never been determined.

Whatever the actual number of words learned per year by medical students, we do not really know the limits of human memory for anything, let alone for medical terms and definitions. The vast majority of medical terms are derived from Latin, and for many generations teachers and parents have advised pre-medical students to study Latin because it is helpful in learning the vocabulary of medicine. Whether this is true or not, it does reflect the similarity between learning the medical vocabulary and learning a foreign language.

We know from various personal accounts a little about the capacity to learn words in a new language, and this might suggest the limits for memorizing medical words. I know a physician whose advisor at a Chinese university told her to study English by buying an English language newspaper every day, from which she memorized fifty English words per day. Even if this were done only on weekdays, it would have been more than 13,000 words per year.

There are a few published accounts of people who were said to have had a large capacity for memorizing foreign words; it is not possible to confirm them. A teacher from Germany who was working in Boston in the nineteenth century was said to have “had the habit of learning, before breakfast, one hundred words of some foreign language,”³ which would have been more than 36,000 words per year if true. A British intelligence officer in the years leading up to World War II, F.W. Winterbotham, recorded that German press officers who had been selected to work with foreign journalists were required to memorize 100 English words per week,⁴ equal to 5,200 words per year. In the 1980s, a Soviet spy, Oleg Gordievsky, learned thirty English words per day to facilitate his work as a double agent for the UK,⁵ equal to almost 11,000 words per year. These examples, taken together, show that some people have the capacity to learn many thousands of words per year.

Learning the vocabulary of medicine may be somewhat easier than learning an actual foreign language. Medical words are learned within a framework of the structure and function of the body or in relation to a disease. The memorized words are reinforced by the framework, as well as by being encountered over and over again in other classes and on the wards. It is important to try to put the words into sentences, practicing everywhere and upon everybody, to assist with retaining the memory.

Learned medical words are reinforced by the context of medicine in the same way that an actor’s memorized lines are reinforced by the context of a play, or a musician’s memorization of a score is reinforced by the sound of the music. One twenty-year-old concert pianist told an interviewer that “it takes her about two weeks, practicing two to three hours a day, to memorize 100 pages of music.”⁶ She said that she was able to play twenty piano concertos from memory.

For the vocabulary of medicine, case histories provide context that helps with memorizing. Paul Farmer, the founder of the medical philanthropy Partners in Health, known for his encyclopedic medical memory, ascribed it to using case histories as mnemonics. He used the memory of the patient’s face, small quirks, and possessions as a framework for remembering symptoms, pathophysiology, and remedies for thousands of diseases.⁷

Medical students have long used mnemonic phrases to help them memorize finite groups of new words. Generations of medical students have memorized the mnemonic “On Old Olympus’s towering tops…” to remember the cranial nerves, as well as other mnemonics, mostly passed along through generations of medical students outside of the classroom, although lists of these have been published online⁸ and in books in recent years.

There is some evidence that a person can work to increase their memory capacity, but it is not known whether medical students improve their memorization abilities as they progress in their medical studies. Certainly, the required pre-medical college courses have incidentally pre-selected them for the capacity to memorize large numbers of new words. Psychologists have shown that improving memory capacity is possible, and they have been able to train students to learn increasingly long series of numbers⁹; furthermore, participants in timed memory competitions can train themselves to learn increasingly long strings of numbers.¹⁰

Another example of increasing one’s ability to memorize was described by Sanford Greenberg, an inventor and philanthropist who became blind at age twenty and expanded his memory in order to continue his education. In a memoir, he described learning to visualize mental lecture notes: “I memorized virtually every sentence read to me that year, something of which I did not know I was capable. … I had to absorb material in a way I never had before. I still remember much of what I learned then. And I discovered that acquiring knowledge at such an insane pace would be a continuous wonder and joy…”¹¹

Almost 22,000 new students enter US medical schools every year. When they graduate four years later, they will have mastered tens of thousands of new medical words. They will use this medical vocabulary for the rest of their professional lives: to keep records of patient care, to understand medical journals, to participate in continuing medical education, to communicate with colleagues, and to report new medical findings.

 

References

1. Morrison, DA. Different Drummer. Friesen Press, Altona, MB, Canada, 2021, pp. 53, 79.
2. Sobel RK. “MSL – Medicine as a second language.” N Engl J Med 2005;352:1945-1946.
3. Hall, FH. Memories Grave and Gay. Harper, New York, 1918, p. 78.
4. Winterbotham, FW. The Nazi Connection, Dell, New York, 1978, pp. 169-170.
5. Macintyre, B. The Spy and the Traitor. Crown, New York, 2018, p. 102.
6. McLaughlin, ME. “One hundred pages of music, no problem.” The Washington Post, January 9, 2008, p. C14.
7. Kidder T. Mountains Beyond Mountains. Random House, New York, 2009, p. 113.
8. “List of anatomy mnemonics.” Wikipedia, 2023; viewed at https://en.wikipedia.org/wiki/List_of_anatomy_mnemonics; last viewed January 24, 2023.
9. Hagerty, JR. “Professor studied how elite performers reach the top.” Obituary of Anders Ericsson. Wall Street Journal, June 27-28, 2020.
10. Foer, J. “Forget me not: How to win the U.S. memory championship.” Slate, posted March 16, 2005; viewed at http://slate.com/id/2114925/; last viewed January 24, 2023.
11. Greenberg, SD. Hello Darkness, My Old Friend. Post Hill Press, Brentwood, TN, 2020, p. 117.

 

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EDWARD TABOR, M.D. has worked at the US Food and Drug Administration, the National Cancer Institute (NIH), and Fresenius Kabi. He has published widely on viral hepatitis, liver cancer, and pharmaceutical regulatory affairs.

 

Winter 2023  |  Sections  |  Education