Table 1 Quotes from interview transcripts (IS) and guided reflective journals (JS)

IS12

1

“Instead of setting an objective to pass the exam, I will set a higher objective, like scoring an A or a distinction in the exam. If things did not turn out (as) how I wish, at least I can pass (the exam). Yeah, I will always set my objective higher than (what is) necessary.”

IS9

2

“Knowing what you want to do as in if you want to pass the exam, and then you need to know how to do it.  If you want to pass the exam, then (you should) study. If you know what you want, then you (should) know how to do [obtain] it.”

IS12

3

“Planning is the only way for me to eliminate the feeling of insecurity and nervousness when (it) comes to studies.”

IS4

4

“If I don’t plan, I won’t know if I am behind or ahead (of goals).”

IS3

5

“I feel like I know everything during the study week, I can answer any questions from my friends (and) I don’t need to think further (of it when I answer). When I do past year (questions) and do questions (given by) seniors. I can say [answer] straight away without needing to revise the answers, so I think I can do well (in the exam)”

JS17

6

“Having the kind of thoughts that patients might suffer more if I’m incompetent in my future career has always prompted me to learn as much and as fast as I can and I will feel bad and guilty for not studying”

JS13

7

“I would say that what motivate me (the) most are my own expectations and the desire to make my parents proud. Before every exam, I would set a certain goal and push myself hard to achieve it. As for my parents, I believed that they have given me the best and this is my way to repay them.”

IS8

8

“Because if I have the passion, then I will be disciplined to support my passion. If I don’t have the passion, I will not have the desire to be disciplined since I don’t care what I am doing. So, passion is the source that drives (motivates) other attitudes, such as discipline and hardworking.”

IS2

9

“I realised if I just memorised and didn’t understand it, I wouldn’t be able to explain when a patient came to ask me ‘why this (happened)’ because I just memorised it.  That’s why I need to understand it so (that) I can give a better care (to patients)”

IS1

10

“I read (lecture notes) to know what we are going to study, like (having) a general view of what we are going to study that day. So, I don’t enter the class not [without] knowing what I am going to study that day.”

IS8

11

“If you don’t get enough sleep, you will feel (that) you have a lot of negative emotions the next day, and the negative emotions will make us less efficient and enthusiastic to do (things)”

IS16

12

“Because some doctors will give very good explanations and some explanations are also not easily found in textbooks. For me, when the doctor explains it, it is easier to remember because some of the explanations are very simple and easy to understand.”

IS17

13

“I will read up on the topics in textbooks and make my own notes by compiling the points from lecture notes, textbooks and articles based on the learning objectives given in lecture notes, which I personally think, are quite concise and easy for me to revise before clinical sessions and exams.”

JS8

14

“Since I have learned bit by bit throughout the year, it doesn’t take me much hard work during the study week to cram all the knowledge and when I am consistent, I feel more confident with my ability which creates a virtuous circle for me to work harder and fare better.”

IS16

15

“If you understand the concept, you can explain (it) in detail and relate that topic to another topic.”

JS7

16

“Understanding (the content) will prepare you for a real clinical setting because it [theory and practice] are not the same. With the understanding, you will be able to apply (the knowledge) in order to solve a problem.”

JS11

17

“(By) understanding things and not blindly memorising, (would) keep the information longer in our brain.”

JS12

18

“...I find (that) it is easier for me to understand something when I re-illustrate it in my own words and diagrams, and that is when (a) mind map comes into play. Flow charts are the one(s) that I love when illustrating pathophysiology of a disease, as it shows me the whole process of how a healthy person can eventually fall sick, together with the signs and symptoms presented. Hence, it is clearer [easier] for me to point out the principles behind each investigation and the management that I should prescribe to target either the symptoms or the causes.”

IS4

19

“Sometimes you have to know your priorities, like which one has to go first, which one can hold on.”

IS16

20

“...Because if I delayed it to next week, I might have forgotten what the doctors said during lectures as I said some (points) I might not have taken it (them) right. There are a few (points) that might not (be) important but just refreshing my memory. And if I were to postpone it to next week, it would delay my schedule for the next week as well.”

IS21

21

“...you need to make yourself think that me [I am] being appreciated by myself...If you keep studying without giving yourself any rest, then you will feel burned out at the end. You will (wonder) why I am suffering so much, why I am doing this? So, rewarding yourself is very important.”

IS21

22

“...I look back and realise I have spent too much time on this topic and   missed other topics, then I just go back to (read) the lecture note that hasn't been ticked by me. After I finish (a topic), then I will put a tick, it is effective for me because it will guide you whether you miss a lot of lectures or you cover all the lectures...”

IS20

23

“…sometimes they want to talk to me (but) I will say ‘later, after class’”

JS19

24

“Every weekend, we usually plan to try (out food at) a new restaurant. We also spend one of the days playing bowling and badminton. These have helped me to relieve stress and be able (to) carry out a healthy lifestyle at the same time.”

IS1

25

“Because it is better to ask the lecturers than remembering something in a wrong way and not understanding what I am learning. For me, it’s important to understand what I am studying. So, I usually email to further understand or confirm that I am remembering it in the right way.”

IS4

26

“Because I feel I cannot do it on my own, sometimes it is very saturated or very difficult. Sometimes they [my friends] might not have remembered whatever I remember, so I can just help them, sometimes whatever they remembered I don’t. So, when we discuss we get the best of both worlds.”

IS3

27

“[Muslim]... I trust in His power and the power of ‘dua’ [prayer of supplication]. There are miracles and everything because when we pray it’s like a new spirit to open your heart. It’s a new vibe if we pray, there is (a) positive vibe for me and easy for me to concentrate...”

IS2

28

“[Sikh]...I always believe that two things will lead me to succeed in life which are prayers and hard work. Nothing beats those two.”

JS12

29

“[Christian]...If you believe in God or guarding angels, then it would be easier for you when dealing with problems…they know what I am experiencing, listen to all my wishes, and ‘help’ me when things become complicated, and that is what I call it as miracle.”

IS1

30

“Do the weekly questions…and sometimes do the USMLE questions for that block…For me that helps me determine what I know and what I don’t. It helps me see how much I know…I do those questions to help me apply my knowledge better and know where I stand in my knowledge, like how much knowledge I have on that block.”

IS15

31

“I did some sample questions…it was from there that I found out which topic that I wasn’t strong [good] at, and I would study more on that topic.”

IS4

32

“...if you score well in your midterm assessment, that means you understand your foundation (module) properly.”

IS2

33

“As transitioning from module 1 to module 2, I was trying to adapt to find a study method that will suit me...and when I saw my study methods are working based on the post-midterm assessment results...I was quite comfortable for the rest of my Year 1.”

IS5

34

“…I only studied during weekends…no need to do daily study… It was because of the wrong method. One week before the midterm assessment, I wasn’t able to cover everything and I broke down, I felt like I couldn’t do it…I changed and started studying every day and from 8 to 10 and 10 to 12 (midnight), then weekends and try to cover as much I can.”

IS2

35

“I had a problem of coping at first due to the transition…I coped with the overload by being more organised and systematic in planning what I would study for that particular day and how long I would take to cover it.”

IS4

36

“Because (when) I feel it is not working, why (do I have to) waste my time? So, I try to find another method with the hope that it will increase my productivity. If I don’t try it, then I am not going to get anything; if I try, there is a chance that I might be better. So, I will take that chance.”

IS12

37

“...part of it comes from doctors’ and your friends’ compliments...I feel satisfied when I can explain something to them and solve their problems when they are asking questions to me and I can answer their questions...it’s that satisfaction that pushes me all along the way. When you did something well then (and) receive compliments from others, it builds up your confidence and you feel that you want to have that satisfaction all the time, so you will keep performing.”