Here’s the typical (and average) medical student talk
This is a re-creation of a talk that one of our students presented to the team last year. It followed the script for the typical medical student talk (ie the type of talk which we’ve sat through many times):
Introduction: “The subject of my talk is pulmonary embolism.”
Content: unrealistically extensive overview of a massive topic based on major texts
Conclusion: “Well, I guess that’s all I have.”
It’s easy to make that talk significantly more impressive and memorable
Introduction: “Substantial and unacceptable.” Those were the words of Dr. Kenneth Moser, referring to the morbidity and mortality rate of venous thromboembolism ... A major issue in reducing these high rates is enhancing early diagnosis. In my talk today, I’ll review recent advances in diagnostic techniques of pulmonary embolism.”
Content: in-depth review of a focused topic including recent medical literature
Conclusion: “As the recent literature has shown, the diagnosis of pulmonary embolism may clearly be challenging. As in the case of our patient Mr. Smith, however, a combination of diagnostic methods leads to improved sensitivity."
Being asked to give a talk on a rotation, observership, externship, or clerkship
may be anxiety-provoking, but it’s still a
great opportunity
If you're a medical student, resident, observer, or rotator, then at some point during that experience you may be asked to give a medical talk or presentation.
This is a common (yet anxiety-provoking) experience. Having acknowledged that, it’s important to realize that preparing and presenting a talk is a great opportunity to demonstrate your knowledge and grasp of clinical issues. While you can’t control what an attending might ask during rounds, you do have complete control over your talk. With preparation and practice, you’ll be able to deliver an outstanding talk.
In this post, you’ll learn specific recommendations to improve the quality and impact of your talks.
In fact, it’s pretty straightforward to incorporate the 7 key principles of giving a medical talk.
It’s easy to make your medical talk significantly more impressive and memorable. These 7 key principles will show you how
1. Do the important prep work: audience research and topic choice
2. Strong introductions are critical
3. Educate, not overload
4. A strong delivery is vital
5. Practice the right way
6. Strong conclusions are also critical
7. "After the talk" is just as important as "during the talk"
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Principle #1:
Do the important prep work:
audience research, time limits, and
choice of topic
Before you sit down to draft your speech, make sure you do the important prep work.
Do an audience analysis
Know and adhere to all time limits
Choose the right topic: one that is focused, fits into time limits, and is of interest to you and your audience
You can’t give a talk unless you know your audience. Always take their knowledge level into account
If you’re assigned to speak before an unfamiliar audience, ask for this important information beforehand.
Your audience analysis should answer:
How many people will be in the audience?
How familiar is the audience with the subject?
What is the educational background of the audience?
How can I provide information relevant to their specialty?
What would I like the audience to do with the information I present?
If you consider the background of your audience, you’re more likely to deliver a talk that meets the needs of your listeners. In the article “Presenting with precision,” author Brenda Happell wrote that
“It is extremely frustrating to attend a presentation, confident that you are likely to learn something new, only to be exposed to basic information and knowledge that is readily available.”
Choose the correct topic
In some cases, you’ll be assigned a topic. If, however, you get to choose your own topic, we advise that you:
Choose a topic that you have background knowledge of. If you cared for a patient with asthma, address asthma.
Choose a topic that you’re interested in. Equally (perhaps more so), make sure it’s a topic that your audience is interested in.
Know your time limits
Once you know your time limits, make sure that you choose your topic accordingly. Time is a major concern, especially if you’ve been asked to speak about a broad topic such as “lung cancer”. To help you focus, either ask the attending for a specific aspect of that topic, or choose a relevant aspect, such as the therapy of metastatic lung cancer.
Many medical talks are too broadly focused
In a study of medical student talks, Yale students were asked to present a 30-minute talk on a topic of their choice during the Internal Medicine Clerkship. At the orientation, students were informed to avoid overviews or large topics. As an example, rather than talking about pneumonia, students were asked to focus on a particular aspect of pneumonia. Despite this recommendation, faculty evaluations noted that 35% of presentations were too broadly focused.
Clearly describe the objectives of your talk
You need to determine the specific purpose of your talk, also known as your lecture objectives.
What are the needs of your audience? Based on those needs, establish the objectives for your talk. When developing your objectives, be specific.
Consider these two possibilities:
"At the conclusion of this talk, my listeners will know how to manage an acute gout attack."
vs
"At the conclusion of this talk, my listeners will be able to specify at least three types of medications that can be used to manage an acute gout attack."
The latter statement is clearly more specific and will help you develop a clear, focused, helpful talk.
Principle #2:
Strong introductions are critical
Start your talk with an introduction that leaves your audience eager to hear what else you have to say. You only have one chance to make a strong first impression. And if you fail to grab your audience’s attention, you’ll find it a challenge to capture it later.
For this reason, plan your introduction carefully. Too often, students begin their talk with one of these statements:
I’m talking today about …
The subject of my talk is …
Yes, it’s critical to include the topic and objective of your talk in the introduction. However, rather than using a bland statement, begin with an introduction that inspires interest.
Introduction Ideas: Ask a rhetorical question
We all realize that pulmonary embolism is a major cause of death. Did you know that the diagnosis of pulmonary embolism is missed in approximately 400,000 patients per year? And that's just in the United States ...
Introduction Ideas: Make a bold statement or share a startling statistic
In the United States, 650,000 people are diagnosed with pulmonary embolism every year, with over 200,000 deaths.
Introduction Ideas: Use a historical reference
160 years have passed since Virchow's classic paper on thrombosis and hemostasis was published and we, of course, continue to use the principles of Virchow's triad in the diagnosis and management of patients with pulmonary embolism. From historical reports, Virchow was small in stature but possessed a quick wit. He was known to be sarcastic, particularly when he dealt with incompetence or inattention. Yet he could also be generous and friendly, recognizing those who had made significant contributions. If he were alive today, he would perhaps be impressed with the progress that has been made in the diagnosis and management of pulmonary embolism, but he might also berate us for not making more progress. After all, pulmonary embolism remains a major cause of death in the United States ...
Introduction Ideas: Provide a thought-provoking quote
Substantial and unacceptable.” Those were the words of Dr. Kenneth Moser, referring to the morbidity and mortality rate of venous thromboembolism …
Introduction Ideas: Tell a brief story
If you've ever seen a patient die suddenly of a massive pulmonary embolism, it's not something that you will ever forget ...
Principle #3:
Your goal is to educate, not overload
Before you organize your talk, you have to first select material for your presentation. The real trick is determining what not to use.
Your research will yield more material than you could possibly use. This can actually be a problem: you need to avoid information overload, as there is a limit to what your audience can handle in a finite period of time.
In fact, one of the most common mistakes we see students make is presenting too much information. Remember: every point you make should support your talk's specific purpose. If it does not, cut it out.
Author Brenda Happell writes that “there is a tendency for inexperienced presenters to overdo the content in their presentation. It is easy to feel that every little piece of information is vital, but we know from experience that even the most interesting topic becomes hard to follow when we feel we are bombarded.”
How do you know what to include and what to discard? When you’re not sure, ask yourself if the information supports your specific lecture objectives. Discard any material that doesn’t support those objectives.
Make sure your data is accurate and that your resources reflect the most up-to-date science
During your talk, you’ll present data that supports your ideas. Your data must be accurate and relevant. Review all data several times, since even one inaccurate fact can call into question the accuracy of your entire talk. With statistics, make sure that your information is up-to-date. Presenting statistics that are years old when more recent information is available will damage your credibility. For resources, you should turn to authoritative texts as well as the recent medical literature.
Principle #4:
Delivery is more than just content:
the importance of voice, body language, and note cards
Do not, under any circumstances, read your talk word for word
Some students write out their talk and then proceed to read it word for word. This is another very common error made by students. This almost always leads to a monotonous delivery. It’s also impossible to maintain eye contact with your audience, except for maybe an occasional upward glance, which diminishes credibility. Think about the best speakers at your medical school. How many of them read their talks word for word? Keep in mind the words of Dr. Michael Edwards who wrote that "... natural rhythm of telling a story with its pauses and eye-to-eye contact with the audience is lost when the talk is read."
Feel free to use note cards
Instead of reading your talk, we recommend the use of note cards, with no more than ten words (or so) on each card. These should be a reminder of the most important points. As you’re speaking, you then formulate sentences to express these points.
Practice with these note cards. As you practice, you’ll be able to start developing sentences using just these few words as cues.
As you grow less dependent on your cards, you can then memorize your introduction. Especially with a memorized introduction, you can convey the impression of confident and articulate student right from the start.
On the other hand, when quoting an article or conveying detailed statistics, it’s better to refer to your notes.
Avoid-the-monotone
Students sometimes present an entire talk in the same pitch and pace, leading to the dreaded monotone. This is boring, and it suggests a lack of interest in the topic. As you practice, work to incorporate a more natural pitch and pace throughout your speech.
Limit your use of fillers
Fillers are sounds like “um” and “er” that speakers often use when they’re thinking about what to say next. Most students don't even realize that they use fillers. Make sure you record yourself, and if you find that you’re relying on them too much, practice replacing them with short pauses.
Speak at the proper pace
You need to speak at a speed that allows your audience to follow.
In students who normally speak at a reasonable pace, anxiety can cause them to speed up. The effect is poor enunciation with mumbled words and sentences. "Too many ideas presented too quickly will not be understood, even to the most well-informed and intelligent audience."
You must make a conscious effort to slow down so that your listeners can follow you. Accomplished speakers will also pause periodically to allow their listeners to fully process.
In their article on lecturing, Brown and Manogue wrote that lecturers, to improve clarity, should "speak clearly, use pauses, and don't go too fast ... Whilst these suggestions may seem [to make] common sense, observation of lectures suggest that they are not common practice."
Utilize gestures appropriately and deliver the talk while standing, if at all possible
Only 7% of a speaker's message is felt to be obtained through actual spoken words. 55% is conveyed through nonverbal communication, while 38% is transmitted through vocal tone.
How does this come into play if you’re speaking in a small conference room? Students often remain seated during talks given to a small group, and we’ve found that they generally place their hands underneath the table. This robs them of the ability to gesture. Voice patterns often follow hand movements, which may affect the energy of your presentation.
If at all possible, give your talk while standing. Keep your hands in front of your body with your palms open, and feel free to gesture when appropriate. If you decide to give your talk while seated, lean forward in your chair, a gesture that conveys enthusiasm and confidence.
Avoid gestures that convey anxiety or a lack of confidence
These include:
Keeping your hands in your pockets
Gripping the lectern or audiovisual equipment
Playing with keys or coins in your pocket
Rocking back and forth or from side to side
Rubbing the back of your neck
Playing with your hair
Clenching your fists
Pacing back and forth
Fidgeting with clothes or jewelry
Do you make any of these gestures? Most students have no idea they’re doing any of these. That’s why we recommend that you record yourself.
Eye contact is a critical component of delivery
As you give your talk, make eye contact with your listeners. This keeps audience members interested, and helps you come across as more credible and confident.
One technique is to speak to one audience member, then direct your attention to another audience member. We recognize, however, that looking into people’s eyes while delivering a talk can be difficult for some students. If you find this unnerving, focus on another part of the face such as the forehead, nose, or mouth. Your listeners won’t know the difference.
As you make eye contact, don’t be surprised if someone in your audience isn’t paying attention. You may notice your audience nodding off, as your audience, sadly but expectedly in a medical setting, is often a very tired group. (As a speaker, I can tell you that chances are very high that somebody in your audience will start to nod off.)
Don't be thrown off track if a phone goes off or if audience members are engaging in conversation. (These are very common. Let me repeat that. VERY common.) As distracting as any of these may be, they shouldn’t be allowed to affect your presentation.
Pay attention to audience feedback during your talk
It’s very easy to be overwhelmed by the task of providing great content and ensuring an effective delivery. Most students are single-mindedly focused on giving a great presentation.
However, you need to be alert to audience feedback. During a presentation, this takes the form of nonverbal cues, such as body language cues that indicate total boredom.
While it’s easier to process such feedback when you’re an experienced speaker, such cues should be a warning sign. You may need to work on eye contact, or vary your volume, pitch, or pace of delivery.
Visual aids enhance presentations
Studies on learning styles have clearly identified distinct preferences. Some individuals are visual learners, while others describe themselves as aural learners.
Some learn better by seeing, others by hearing--but a talk that meets the needs of both learning styles will have the most impact. Whenever possible, try to incorporate visual aids.
Obviously, there are situations where this won’t be possible. If the attending has asked you to give a quick 2-minute "blurb" on a topic while standing in the hallway between patient rooms, the short duration and location of the talk clearly preclude the use of visual aids.
For longer talks that take place in an environment more conducive to the use of visual aids, there are compelling reasons to do so. Effective use of audiovisual aids can:
reinforce your statements
help you direct the audience’s attention
help your audience comprehend your ideas
make you appear more credible and professional
lead you to deliver a more memorable talk
Students today most often use PowerPoint or a similar tool. While these are useful, this only holds true when utilized well. Poor visual aids can actually downgrade the effectiveness of your talk.
PowerPoint Do’s and Don'ts
Don't read the text.
Do use a font color that contrasts with the background color.
Do use the same background color throughout the presentation (medium blue is popular).
Do maintain consistency by using the same symbols and typefaces.
Don't use full sentences. A good rule is to keep each line no more than 6-7 words.
Don't place too many points on each slide (less is more).
Do use at least 18-font size (be sure that people in the back row can read the information).
Make sure you avoid fancy fonts. Instead, choose a standard font like Arial or Times New Roman.
Don't capitalize entire words unless necessary.
Do proofread your text for spelling, repeated words, and grammatical errors.
Make sure you avoid overly complex tables, charts, graphs, or diagrams.
If possible and the topic lends itself to this, provide a short handout
Should you provide your audience with a handout? In many cases, yes. Handouts can help the audience follow your train of thought.
Most listeners appreciate written material that they can refer to later. The fact that you produced a handout will also give your audience some idea of the effort you put into the talk.
As you prepare the handout, pay careful attention to its presentation. Its appearance is a reflection of you. If it appears unprofessional, your listeners may form a negative impression, even before you’ve opened your mouth. As always, proofread your work to avoid misspelled words and grammatical errors.
You can provide the audience with the handout either before or after your talk. The disadvantage of handing it out at the start is that your listeners may pay more attention to the handout than to you. With complex subjects, however, you may find it preferable to have the audience follow your thought process.
Principle #5:
There is actually a right and a wrong way to practice
When practicing, strive to simulate the actual experience as closely as you can. Whenever possible, practice in the room in which you’ll actually be speaking.
If this isn’t possible, pick a room that closely resembles the real location of your talk. Doing so allows you the opportunity to become comfortable with the environment.
As you practice, don’t just go over your talk in your head. There is a difference between thinking and speaking.
Do this instead:
1. Stand in the proper spot of where you will be presenting
2. Imagine an audience in front of you
3. Rehearse your talk.
4. Use your notes exactly as you plan to during the actual talk. If you’ll be using audiovisual equipment, practice with the equipment.
5. As you rehearse your talk, time yourself to ensure that your presentation fits within the allotted time. If you run over, delete material instead of just speeding up.
You can learn a lot by videotaping yourself
This is a valuable yet underutilized way of improving performance. Play it back so that you can see and hear yourself the way that your audience will.
We’ve found that students are often surprised by what they learn from a videotape of their performance.
Utilize the techniques of professional speakers to handle anxiety
Some surveys have demonstrated that public speaking is the number one fear, ranked ahead of the fear of death. Anxiety affects everyone, but the best speakers are able to channel that nervous energy into a better performance.
If you do experience anxiety, you may find it reassuring that studies have shown that speakers generally report a higher level of anxiety than what an audience can perceive.13 In other words, audiences aren’t very accurate in detecting a speaker’s level of anxiety.
Before the presentation:
1. Take several deep breaths
2. Stand tall
3. Make eye contact with your audience
4. Smile
Ways to relieve anxiety before giving a talk
Adjust your attitude
Students who view their talk as a task to avoid may develop greater anxiety than those who see it as an opportunity to improve skills in communication.
Ensure adequate preparation and practice
The best way to lessen speech anxiety is to give yourself sufficient time to prepare and practice the talk.
Don’t overestimate the talk’s importance
A talk typically accounts for only a small percentage of the clerkship grade.
Use positive self-talk
“I know my topic, have prepared well for the presentation, and am confident that it will go well.”
Visualize success
Athletes and actors, as well as public speakers, use the techniques of visualization. Visualize yourself, with full detail, delivering a well-received presentation
Principle #6:
Strong conclusions are also critical
Some students conclude their talk with “I guess that’s about all I have,” or “I think I’ve gone over everything.” These statements completely lack impact.
Some of my students have even closed with an apology. “I’m sorry I wasn’t able to find more,” “I’m sorry I couldn’t get the projector to work,” or “I’m sorry the talk went so long”.
In ending your talk, do not mumble and do not ever apologize. The conclusion is also no place for bringing up new points or rambling on and on. Students who don’t take the time to think about their conclusion end up closing with a whimper rather than a bang.
To conclude in a way that leaves the audience with a lasting, powerful impression, begin with a phrase that tells your audience that you are wrapping up your talk.
Examples include:
In concluding, I want to …
Let me leave you with …
As a final thought …
To wrap up my talk ...
Since most of your talks will be informative presentations, close by briefly summarizing your main points.
After doing so, end your speech with an interesting closer, perhaps a quote or rhetorical question.
Since a talk is often assigned when a team member raises an issue pertaining to a patient, one effective way to conclude is to apply your information to that specific issue.
“As the recent literature has shown, the diagnosis of pulmonary embolism may clearly be challenging. As in the case of Mr. Smith, however, a combination of diagnostic methods leads to improved sensitivity."
One final note: to leave your audience with a strong, final impression, avoid reading your conclusion. Instead, know it well enough that you can deliver the conclusion with few, if any, notes.
Principle #7:
After the talk is just as important as during the talk:
prepare for audience questions and seek audience feedback
Don’t be afraid to say “I don’t know.”
At the conclusion of your talk, you should invite questions from your listeners. While few students end their talk with such a statement, it is important to do so. I’ve found that many students would rather avoid questions, because they fear they won't know the answer. This is natural, and is certainly a concern for experienced speakers as well.
However, experienced speakers will prepare for the question and answer period by anticipating questions. They then proceed to develop responses to these questions, providing for more polished replies. You can do the same.
You can begin the question and answer period of your talk by simply asking the audience, “Do you have any questions?” When asked a question in front of a large group, you should rephrase the question before answering it.
“Can you clarify the research methods used in the study on statins and inflammation?” “Certainly. The question refers to the research methods used in the study on statins and inflammation. In this particular study…”
This technique ensures that everyone has heard the question and also provides additional time to formulate an answer.
While you are expected to be well read about the subject of your talk, you are not expected to have all the answers. If you’re asked a question and you don’t have an answer, you can simply say “I don’t know, but I will find out.”
Another option is to defer the question to your attending. “Dr. Chen, in your experience with pulmonary embolism, how would you handle this situation?” Avoid at all costs an attempt to bluff or to provide inaccurate information.
Tips for answering questions at the end of a talk:
Let your listeners know early in the talk when you plan to answer questions
Encourage questions by asking "Do you have any questions?"
Listen carefully to the question to make sure you understand it
Make eye contact with the questioner while the question is being asked.
Repeat the question, especially in a large group, to make sure that it’s been heard.
Make eye contact with the audience as you answer
If you don't know the answer, don't bluff or lie. You also don’t need to apologize.
Consider deferring the question to an expert, if one is in the room
Feedback, feedback, feedback
Hopefully, team members will offer you specific feedback after your talk. However, most feedback tends to be vague and short on the specifics that you need to improve your performance during future talks. To make the most of this experience, you must solicit specific feedback.
Examples of questions you might ask (and only at the appropriate time and if it seems appropriate to ask that individual):
Was the introduction interesting?
Was the topic and purpose of my talk clear?
Did you feel that I made eye contact throughout the talk?
Was I able to maintain your interest?
Was the talk well-organized
Do you have any other suggestions for improvement?
Take team members’ suggestions seriously, and determine how you will use this information to improve future talks.
The corollary to these 7 key principles:
Be the first to volunteer to give the talk
During attending rounds, sometimes an attending will turn to the team and ask “Who wants to give us a talk about this subject?”
If you’ve ever been in this situation, you know what usually happens next. Team members try to avoid the attending's gaze, and silence falls. Although this is a common reaction, it’s certainly not ideal.
Instead, if the attending asks, be the first person to volunteer. This is an opportunity to stand out and demonstrate your enthusiasm and initiative.
The bottom line: Yes, it can be nerve-wracking to just think about giving a medical talk. But with the right tactics and practice, you can absolutely excel.
Dr. Rajani Katta is the creator of Medical School Interviewing 101, the course that teaches students how to ace their interviews. She is also the author of the best-selling books The Medical School Interview: Winning Strategies from Admissions Faculty and the Multiple Mini Interview (MMI). She served as Professor of Dermatology at the Baylor College of Medicine for over 17 years.
Dr. Samir Desai is the creator of The Residency Interview 101 and the author of 21 books, including The Successful Match: Rules to Succeed in the Residency Match. He has served on the medical school admissions and residency selection committees at the Baylor College of Medicine and Northwestern University Feinberg School of Medicine.