Memorizing is not learning. In PA school that difference will find you fast.

Dr. Adam Rosh created Rosh Review, and this conversation is about how to actually study medicine. His whole approach is built around questions rather than passive review, because answering a question forces you to retrieve information, and retrieval is what makes it stick.

This is why so many PA students live in question banks. It's not because the questions are magic, it's because getting something wrong and then understanding why is the fastest way to learn.

For pre-PAs, start practicing this in your prereqs. Close the book and test yourself instead of rereading highlighted notes. Rereading feels productive and mostly isn't.

What we cover:

• Why memorization fails once the volume gets high
• Studying with questions instead of passive review
• How Rosh Review got started and what it's built for
• Connecting book knowledge to real clinical decisions
• Study habits pre-PAs can build before they're accepted
• Managing the sheer amount of material in PA school

Resources:

Free Application Timeline: https://www.thepaplatform.com/services/free-application-timeline

CASPA GPA Calculator: https://www.thepaplatform.com/pa-school-caspa-gpa-calculator

PA Program Map: https://www.thepaplatform.com/pa-platform-map

Pre-PA Counseling: https://www.thepaplatform.com/services/pre-pa-counseling

Mentioned in this episode:

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For today's episode, we have a very special guest, Dr. Adam Rauch, the creator of Raasch Review.

We're talking about study tips and how to make the most of your study time in PA school.

Welcome to the Pre PA Club Podcast.

If you want to learn how to become a physician assistant, you're in the right place.

I'm your host, Savannah Perry.

Let's get to it.

Welcome to the Prepa Club Podcast.

Thank you so much for joining me.

I'm your host, Savannah Perry, creator of the PA Platform and this podcast.

So I'm so glad you're here and I am so excited about today's guest.

Roche Review, if you don't know is a resource.

It's a QBank for PA school to help with studying for boards.

It was not around when I was in PA school.

We had access to one QBank that was not very helpful.

And I do the best with studying with question and answer, especially with great explanations which Roche Review offers us.

I've kind of helped them with some stuff with their PA Cat resources.

And I was connected with Dr. Rasch, who I met once at a conference and I really wanted him to come on the podcast and and really to share the background of kind of how Rasch was created, why it was created, and thank him for including PAs.

So I think, you know, I think this episode is going to be really helpful.

We'll get into it.

You're going to hear from him and his experience and his story, which I think is really cool.

I have my recertification coming up in a couple years.

I talked about that on last week's episode and I will 100% be using Roche Review Cuban.

I've done them with some of my PA students who rotate and I really love the questions and the answers and explanations.

So we will get into hearing from Dr. Rauch and I hope you guys will join me in a few weeks for the personal statement challenge.

And don't forget, you can always use the code Future PA for a discount on any service or book from the PA platform.com First, I want to just.

Thank all of the listeners for being here and taking the time out to listen to my story and to our conversation.

I want to thank Savannah for all of the amazing work you've done with the PA Platform with the Pre PA Club podcast.

It truly is a privilege and honor to be here today and hopefully by the end of this, we're able to help at least one prepa student or Paul along their journey.

Because one of the reasons why I'M here today has to do with struggles on my own journey.

You know, in high school, things were pretty straight, pretty easy for me.

I got to college at the University of Wisconsin, Madison.

I was a badger.

And things were pretty overwhelming in my life.

I.

What I ended up realizing was I. I never.

No one ever taught me how to learn, right?

They taught me facts, they taught me, you know, the basic arithmetic of learning, but not how to learn.

And sometimes what happens is you have to fail to actually begin to succeed.

And.

And my story is about my struggles and through undergrad, where I turned my attention to learning and education, and that became the focal point of my life.

And I made it through undergrad, ended up doing fine.

In the end, it was a struggle.

At one point, I had a 2.1 GPA, graduated with a 3.0 GPA.

And that was.

I did do an extra year of undergrad to get to that point, which in Madison, that wasn't such a big deal.

That was fun to be there.

But ultimately, I set out on a goal to go to medical school.

I thought it was going to be.

I wanted to set a very high bar for myself, and I wanted to do something that people wouldn't believe that I was capable of doing.

Because what I had recognized early on is that I didn't believe in myself.

And it's really because also people weren't believing in me, and I wanted to change that.

So I remember the day where I said to my roommate in college that I was going to apply for medical school.

He laughed, of course.

And it was, you know, understandable at the time.

But I started that journey, and along that journey, I had picked up.

It was like a hypertrophy.

I call it like brain hypertrophy.

How do you.

What are the best techniques for learning?

And how do you.

How do people from all different backgrounds, people who struggle in so many different areas, how do we incrementally help improve their interaction with content so that in the end, they become confident, they succeed and ultimately reach a goal and achieve a dream?

So it was after medical school, I went to Rutgers Medical School in New Jersey.

That's where I'm from.

My family's there.

And then after medical school, I went to nyu, New York University, Bellevue Hospital for Emergency Medicine residency.

And that's where my passion for doing board review started.

I worked for McGraw Hill, and I edited, like, the Pre Test series.

That was my first real official stint.

The books.

Yeah, I used those during PA school.

Yeah.

Not many people know what books are, but they.

Some exist.

Yes.

That's right.

I remember I did like the internal medicine, some of the usmle, like the step one.

And I begged them, I said, can I do one for emergency medicine?

Because it didn't exist at the time and I was only a.

Right.

I was first year medical student.

And that was very unusual at the time.

Well, after about a year of working at McGraw Hill doing this, they gave me the opportunity and I'll always be grateful for them.

And.

And my editor at the time was Katherine Johnson and she believed in me.

Right.

And when someone starts believing you and it opens up doors and allows you to really express yourself and to achieve things.

So I wrote along with, you know, I recruited some other authors to the first edition of pretest emergency Medicine.

And that's where things got kicked up, kicked off.

After residency, I worked at.

I left New York and went to Detroit.

I worked, you know, from one knife and gun club to another from New York to Detroit and was involved in residency program there.

And I really loved teaching and education, but I also love technology.

And at the time, the idea of a QBank, an online QBank, was just really getting started.

And I said to myself, can we do this better?

Can we do it in.

In a way that allows students and learners to interact in the content, kind of put them at the center of this.

I think that was one of the differentiators in approaching education is instead of thinking about always the teacher and what the teacher wants you to do, what does the student want, what does the student need, and how do they learn best?

So ROST Review was born out of a night shift where I was talking to the residents, asking them how are they going to study.

There wasn't a great resource.

The next morning I got home, didn't sleep, and started writing questions.

And today I believe we have close to.

There's like 28 products in the sense of what I call a product that you have to qualify it some way.

We'll do the pants review, rotation exam review, didactic year review and so on.

So there's about 28 different areas.

And every day I wake up and my sole purpose is to help learners, right, who are probably stressed, anxious, get through that and to stand by their side as much as possible in my role at Ross Review.

And it's something I love to do.

That's so awesome.

And I just love hearing what other people are passionate about and how that has kind of impacted where they end up.

But I think with rash so that's what I'm not sure.

There was one QBank from one company that was online and it was clunky and it was very clearly just med school questions.

Like it wasn't tailored to what we needed to know for boards.

Yeah.

And so that was frustrating that, you know, I paid for this and then I'm sitting there going, I don't need to review biochemistry, that.

Like I'm not going to be tested on that.

So why are they asking me this?

And so because I, I am a question answer person.

Like you said, nobody teaches you how to learn.

I fumbled my way through undergrad, got to PA school and realized, oh, you can't just memorize this stuff.

Like you've got to apply, you've got to understand it.

I found doing question and answer was so helpful.

Really the most important part of that was the application and the explanations.

It wasn't just, oh, I got that right, oh, I got it wrong.

It was, why did I get this right?

Why was that wrong?

And kind of figuring that out.

So that's what.

Now I've had some PA students come through who do rotations with us.

And one of my best friends is in PA school now and, and it's really fun getting to kind of study with them essentially and kind of see what I remember since I'm in Durham and I don't remember that much.

So practice together.

I mean, so that sounds really interesting.

And you know, what you just touched on there is we talk about memorization, we talk about how to learn.

And you know, I would say this like there's, we have to.

With all the amount of information that we need to take in, in PA school and medical school, nursing school, all of the health profession schools, they're all the same.

There's an immense amount of information.

Memorization, sometimes that's what you have to do.

And you have to sometimes do it to take an exam, to pass an exam or to score high, fine.

But there's a better way, a more long term type of way to study and to prepare for these things.

And what happens, I find when we look at why students fail.

I spend a lot of time looking at failures, believe it or not, because I feel like if we can understand failures, then we could try and increase the pass rates.

Right.

For people.

And a lot of time the failure, it's not a knowledge issue.

Right.

You've made it through this far, you've gotten to school, you've passed, you know, you've done well in school, you've passed other standardized exams.

It's a test taking issue.

But the key finding is this idea of an illusion of knowing, right?

So people trick themselves.

They don't realize, so they think they understand a topic, but when that topic is taken out of context, they don't understand.

They get it wrong in an exam.

So a lot of what I try and help students who are struggling on exams, it's to identify why do they have this illusion of knowing.

Because a lot of times they'll say, I felt good for the exam.

I don't know what happened, right?

I got to an answer choice and I just whittled it down to two answer choices and I guess I picked the wrong one.

So the exercises that we do, you know, a QBANK is a tool.

That's all it is.

And there are many of them out there.

There are textbooks out there.

There's no one right way to study, but there are many right systems to study.

And I always encourage people using a QBANK is critical because we know through spaced repetition versus the testing effect or retrieval practice.

Those are two learning theories that have shown to help people understand and retain information.

So I believe a QBANK should be used always as a supplement really to your core learning.

Now define core learning.

This is what it's not necessarily textbook learning.

I think the best learning is in the hospital or in the clinic or at the bedside.

So that's only possible during clinical years.

So as a pre pa, that's not going to be the case.

You're studying more of the basic sciences for those types of students.

You may want to listen to a lecture, read a chapter, and then do questions on it and then go back to those questions in a few days.

Because the way to learning is actually by forgetting.

I'll repeat that.

The way to learning is actually by forgetting.

And I think people could relate if.

If I just kind of shed a little more light on that.

Ever have you ever.

There's like something in your memory, you know, it's at the tip of your tongue.

Someone asks you a question, your answer's at the tip of your tongue.

You're like, I can't remember it.

And you just kind of step away from it, stop thinking about it.

And then it comes to you.

Yes, all the time.

And then you always remember that thing, that item.

And that's because the way memory works, or the way we at least believe it works right now is it's like a neuron connection.

Right.

It's like, think about that myelin.

You know, every time you take information and data and put it into your brain, that connection between nerves that store that piece of memory gets stronger and stronger.

So when you forget and you have to dig back into that memory, it's there somewhere.

You're forging through everything.

When you do finally remember it and you may get a cue from something, that connection becomes stronger and stronger.

It's like if you work out every single day, you'll actually plateau and you won't get stronger.

You need to give your muscles time for recovery.

That's the exact.

Well, it's an analogous to how we learn.

So hopefully those ideas on the surface are helpful and useful.

Yeah.

And I think it's something you can get better at, too.

I like that you highlighted having a system.

And I think what happens in PA school is that you get thrown in so quickly and it's so overwhelming that you have all of these resources that you could use, and you get overwhelmed by figuring out what system is going to work for you.

And you may see something working for somebody else and think you need to do that, but it may not be what works best for you.

So it takes that kind of trial and error, I think.

It took me the first two semesters to figure out my system, which was kind of like you were saying, like going through lectures, trying to before class, trying to after class, kind of pulling out the key information and then applying it by practicing questions, figuring out what areas I was weakest in, going back, revisiting those, and kind of going back and forth with my topics to make sure I was covering everything.

But it's just so much one thing that I feel like my classmates struggled with.

I'm just interested to see if you notice this at all in working with students is in the, I guess, question types.

And you may have insights of how you all develop these questions too.

You know, I. I think some people get hung up on.

It's just interesting.

Like, you know, you'll think a question's going one direction, and you're like, oh, I know what this is talking about.

It's definitely talking about this diagnosis.

And then it asks for a treatment or a contraindication, like it asks for something else that really makes, you know, that information.

And I think that trips a lot of people up and.

And at least PA school level learning, because they've never been challenged like that to really put it all together.

So what goes into developing these questions to really Highlight and make sure that people are making the connections and applying and learning things in a way that will apply to the test and patient care.

Does that make sense?

Yeah.

There's so much to unpack in that question.

And, and I could tell you the approach we use at Roster review is based on that.

We're an education company.

We're not a credentialing body.

And that's a big difference.

As a credentialing body, you need to differentiate scores.

So you need to ask questions that are going to differentiate people's knowledge levels.

Okay, Roche review.

We're educating everyone.

So our questions, some of them may seem super easy, some of them may seem super hard, but that's okay because for us, it's not about making, seeing if the learners get it right or wrong.

It's about what do you do after the question.

Right.

It's about.

The question is simply a primer.

It's the spark.

Right.

And the real education comes with the explanation and tying in everything.

But I would say this.

You know, when you read an ECG and ekg, when you're learning about ekg, this is how we think about questions and how we create questions.

An EKG has 12 leads in it.

You're looking at the same heart, but it has 12 leads.

It has the Precordial leads v1 through v6.

And if you think about those, those are just in the plane, kind of this plane that goes right around the heart.

Those are all the precordial leads.

It slices the heart in half.

Then you have the limb leads.

The limb leads are like the diagonals that cut the heart in this way.

Ultimately, if you just looked at one lead, you could be missing such an important part.

If we only looked at V6, we're not going to see anything in the anterior portion of the heart.

When we create questions based on the topic, we think of the topic as the heart and we think of all the questions as the different leads we may have.

Now, it's not 12 questions per topic, but maybe there's four or five.

One question may focus on diagnosis, one may focus on treatment, one may focus on pathophysiology, risk factors.

But by putting that all together, we start creating a picture that now creates a pattern that creates understanding, that links everything.

Just like a 12 lead EKG gives you the full insight of a heart.

Right.

And that's the approach that we take.

And I think if you're just studying off a limited QBank one question on a topic, you're not going to truly grasp the connections that that one topic has.

And so I think it's the same approach when you're studying, you know, think about it from different angles.

Here's.

Here's a technique that.

That I used when.

When I was going through school that I thought was very helpful.

It's not an official technique.

It's an Adam Rasch technique.

Okay.

It was.

It was called layering.

Layering.

And this is the way this worked was really.

You know, this was in residency that I really use this.

So for the pre PA students out there, you could think about this, keep it in the back of your minds.

And when you get into PA school, this is something to really apply.

If I saw a patient who had a shoulder dislocation, I would, first of all, make notes on a little notebook.

I used to walk around with one of those server notebooks when I used to waiter, and I would have that notebook, and I would record every patient and my thoughts and what happened to every patient.

I'd go home and I'd use that as the guide for what I would read and study.

So I'd only focus on patients that I saw in my clinic that day or ER in the ER that day.

So if we had a shoulder dislocation, I would go home and I would just open up the standard emergency medicine textbook.

In my day, it was called Rosens or Tintinelli.

And I'd read about shoulder dislocation, an overview of it.

Then what I would do is I'd go to a second textbook called Emergency Radiology by David Schwartz, and I would read about the radiological diagnosis of shoulder dislocations, which I already got a little insight from.

But now I go deeper.

I layer on the radiology part of this.

So now I become knowledgeable of how to interpret the X ray, what do I look for?

And, oh, why do I have.

Why does the patient present the way that he or she presents clinically?

And now I get to see it radiologically.

And then I would put that book aside, and then I'd open up the Robertson Hedges procedures book, and I'd read in depth about how do you manage or treat anterior or any shoulder dislocation?

In this case, an anterior shoulder dislocation, how do I treat that?

And I'd go in depth, and I'd understand that concept of it.

And then I would put that aside and open up Moore's Anatomy, which I know many pre PA students have used.

It's a great book.

And then I'd read about the anatomy, right?

I'd say, okay, what muscles Are, what are the connections?

What nerves are at risk?

What, what arteries at risk?

Here I put that aside.

Then I'd open up things like Bates's history and physical exam, which I'm sure many prepa students are going to use.

And then you take what you learned in the anatomy book and then you understand how you're doing your physical exam.

Well, I need to test the deltoid because there's a risk for axillary nerve injury.

Right.

So you start layering all of these different aspects of that one condition.

And when you're done with that, you now have a full view of anterior shoulder dislocation.

And I will know everything there is to know about it at the time that I think, right.

And then the next time you see that case, you're like, oh, this is how I reduce it from my Robertson Hedges reading.

This is how I do the HMP from my Bates AS reading.

So the layering effect is, you know, I think a very effective way to not to move away from memorization and move closer towards understanding of conditions.

And it's a great technique for learning.

And having those patients in those clinical experiences to me is what helped things stick so much because there was a, there's a difference about doing that in class and you know, you learn something, then you learn about the pharmacology and all that.

But then in clinic, like as you're talking about that, I was like, I remember that 16 year old boy with a shoulder dislocation.

And I like, I remember talking about with my preceptor looking it up like I remember all of those things.

And so then you have that experience to kind of connect with that as well and kind of make it all to me like sink in.

There's no question, you know, when you're pre PA or when you're, when you're applying to school and you're in the basic sciences, it's hard to make that come alive.

But for everyone listening, who's in that, who is on your journey to PA school or whatever health profession school it may be, the best advice that I could give is people worrying about studying.

They're like, I don't have the time to study.

When you're at the patient's bedside, that's when you're studying.

And then you take that home and if you could just spend 15, 20, 30 minutes reading about the patients that you saw, that's it.

That is all you will need to study.

You will never have to open up a book again for an exam.

Yeah.

And that's the cool thing about PA school is that most pre PA students do have to get some patient care experience.

As you guys are working as a CNA or a medical assistant or ER tech, you're seeing a lot of really cool stuff and you can definitely do what Dr. Rasch is talking about.

I encourage my medical assistants in Derm.

When they first start, I say go to the sample closet, just go there, take a picture.

When you have downtime, go there, look up medications, see what they're for, come talk to me about them.

That's the way you're going to learn about these things and have a better understanding than just when you're in the room with me.

And I say, I want a medication for a certain condition.

If you have taken the time to really try to learn about it, it'll make your life easier and you'll understand what I'm doing more.

And so that's something I always encourage them to do.

And I think anyone in any, you know, little pre health job, even if it's a CNA at a rehab hospital, you know, see what medications your patients are on and do what Dr. Rasch said, see what they're taking them for and then figure out why they're taking them for that and then build on that knowledge.

Yeah, because that's why you're there, is to learn about medicine and taking care of people.

So that's great, great advice for a way that they can kind of go ahead and start working on that.

What to you has been most fulfilling from creating Roche Review?

It's always the learner, right?

It's seeing the results of learners.

We get 10, 20 emails a day hearing about, I mean, almost all success stories, but we also hear about the struggles as well.

And of course, from time to time people tell us how terrible we're doing and that's fine.

We like those too because it gives us an opportunity to improve and it gives us a second chance and we'll always take that.

The team that works at Ross Review, we are a culture driven organization and we believe that the same privilege we have as clinicians to care for patients, that intimate, privileged relationships that we have, caring for another human is the same relationship that we want to establish with our learners and with our colleagues and with everyone that we surround ourselves with.

So knowing that, you know, in the er, I had opportunities every day to change someone's day, change someone's life, to literally at times bring them back from the dead.

And in education, metaphorically that is true as well.

We have the ability to boost confidence to provide tools and skills and knowledge so that people who were struggling have resources and have a path forward.

And seeing those experiences is the greatest for me because it's a reflection and a memory of my struggles and the people who ended up standing by me, I will always remember.

So it's truly a privilege whether I'm in the hospital or whether I'm on the other side of a computer interacting with our learners, interacting with people who are out there trying to.

Right.

They're dedicating themselves to other people, to making society better.

And when that's the outcome that they're seeking, I'm all in to help them.

I love that.

And I just From a pa, especially one who's going to retake boards in a year and a half, I appreciate that there is PA specific resources through Roche Review and how y' all have really supported our profession and PAs in general.

And it's just so evident that everyone at Roche loves what they're doing and is so passionate about making sure that students and PAs and other professionals get what they need from education.

So I personally appreciate that and a lot of people have echoed those same sentiments about you guys and wanted you to hear that, too.

So we appreciate y'.

All.

That's super.

Yeah, that is wonderful to hear.

We don't take that for granted.

Every single interaction, every person, it's really meaningful.

Keeps us driven, keeps us doing what we're doing, and we're really grateful to have that opportunity to do it.

Yes, y' all are awesome.

Well, thank you so much for taking the time to come on the podcast and make sure.

Links to all.

All of the amazing Roche Review stuff is in the description of the episode and everything, but we appreciate you.

And I like that people are getting to hear straight from the source about what goes into all of this.

Well, you bet.

I think maybe everyone should start at the PA platform and then perhaps they'll end up at Rash Review.

But thank you, Savannah, for all of the hard work you're doing and you are having an impact.

So thank you for having me.

Thank you for all the listeners who have taken their time, taken time out of their busy day and spent some time with us today.

Thank you.

Thank you.

Thanks for listening.

Head to the PA platform.com for all the resources you need to become a page.