HMI: What led you to start Osmosis?
Shiv and Ryan: We met at the Johns Hopkins School of Medicine as anatomy team-based learning partners. A week after anatomy ended, we were quizzing each other on material that we had known extremely well just a few weeks earlier and were shocked to realize that we had already forgotten much of it.
That did not bode well for the next four years of med school followed by 3-7 years of residency, not to mention a lifetime of practice. We found that our classmates had similar issues with retention. Compounding this problem was that we had an overwhelming number of resources – books, question banks, videos, reference articles, etc. – that were not being organized or presented to us in an easily digestible or optimal way.
Given that both of us had backgrounds in neuroscience and engineering, we did a literature review and found proven cognitive techniques such as spaced repetition and test-enhanced learning that were implemented only in isolation in medical school curricula, if at all. We decided to start building a tool that would essentially help a student “manage medical school.” The idea was to create a virtual tutor that knew exactly what we were learning, could recommended high-yield resources, and would quiz us periodically to ensure we were staying up-to-date. Within a few weeks of releasing this tool – Osmosis - to our classmates at Johns Hopkins we started hearing from friends of friends at Tufts, Northwestern, Columbia, and a few other medical schools who wanted to use it. We decided to keep developing it and almost three years later we now have 35,000 medical students and 16 schools using it to improve the way they learn and teach, respectively.
HMI: Why “Osmosis”? What’s behind the name?
Shiv and Ryan: We chose the name Osmosis for two reasons. First, most people understand the phrase of “learning by Osmosis,” whereby knowledge diffuses into your brain. We wanted to make learning as seamless and enjoyable as possible. For example, the Osmosis platform knows that you had a lecture on sickle cell disease today from 1-2 pm and immediately after your lecture will send you a 10-question quiz on sickle cell. Furthermore, the night before we can prime your brain for tomorrow’s lecture by sending you a video of a patient describing his experience with a vaso-occlusive crisis. We use mobile push notifications, web notifications, emails, and other mediums to deliver bite-sized learning opportunities that are engaging and memorable.
The second reason we chose to name it Osmosis was to capture the idea of social diffusion, also known as peer-to-peer learning. In addition to offering a ton of its own content, Osmosis enables students and faculty to “crowd-source” questions and flashcards to teach each other. To date more than 2,000 contributors have created and shared more than 318,000 flashcards and questions, which they have collectively answered over 6 million times.
HMI: What was it like starting a company while in medical school? What kind of mentorship helped you down this unusual path?
Shiv and Ryan: It was definitely a learning experience. We had to convince a number of people, not least of whom were our parents, that we had a viable idea that would help tens of thousands of future clinicians perform better. They saw how passionate we were about improving medical education and we were fortunate that overall we have received great support. The turning point came when we decided to pursue Osmosis full-time between our second- and third-year of medical school. This journey was made easier by the DreamIt Health tech incubator through which we met many advisors and entrepreneurs who have helped us along the way. Fortunately there are many similarities between being a medical student and an entrepreneur, which we’ve previously written about.
HMI: Tell us about some of the learning techniques used by Osmosis and about the science behind them.
Shiv and Ryan: We’ve written and spoken about many of these cognitive techniques, including having the wonderful opportunity to present at the Harvard Macy Institute Digital Citizen Course where we spoke at the closing dinner. This past fall we wrote an article for Medscape entitled “5 Study Techniques Every Clinical Student Should Know” that described test-enhanced learning, spaced repetition, memory associations, interleaving, and behavior change models. Let’s take spaced repetition as one example. This was first observed by Ebbinghaus in the late 1800s, but only recently has achieved widespread use through programs like SuperMemo, Anki, and Osmosis. Osmosis has modified traditional spaced repetition to reflect two key differences between learning languages (which spaced repetition programs were originally developed for) and learning medicine: medical education is rapidly changing and needs to be contextualized. Unlike French vocabulary, medical education is very dynamic; you don’t necessarily want to retain every fact you learned in medical school because it may be incorrect in the future! Second, spaced repetition systems tend to be self-contained but in medicine should take into account what you’re learning in your classes and on the wards, which is something we’ve incorporated into Osmosis.
Another example are memory anchors. We have built a recommendation engine that crawls a student’s schedule and curricular material and then inserts relevant memory anchors. For example, if you’re learning about Sjogren’s Syndrome, we’ll recommend not only boards-relevant flashcards & questions, but also the Picmonic audiovisual mnemonics and a patient story, in this case that of pro-tennis player Venus Williams who suffers from Sjogren’s. We have hundreds of patient anecdotes, because after all we go to medical school to help patients and these cases make learning more engaging and memorable. We even have a bank of more than 300 board-style questions based on notable figures (e.g. a question on cluster headaches based off of Daniel Radcliffe, or psoriasis based on Kim Kardashian, or even gout based on Ben Franklin).
HMI: What is the one thing you would like the HMI Community, who are mostly health professional school faculty, to know about Osmosis?
HMI: So what are you doing with those extra hours of the day Osmosis promises to give you back?
Shiv and Ryan: We’ve put all those hours back into making Osmosis the best learning platform we can!