Less Is More: How to Keep Your Writing Clear and Concise

Whether we actively think about it or not, an important part of writing is making sure readers understand what we’re saying. So this month’s lesson is a little different than usual. Rather than focusing on a specific punctuation mark, grammar topic, or set of easily swapped words, this lesson tackles ways you can simplify your writing and make it clearer for readers. Think of the topic as “less is more.”

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Let’s start with a straightforward tip: avoid repetition. The quickest way to make me check out is by reading the same words or sentence structure over and over. Repeating words, phrases, or sentence structure has its place—particularly in creative writing and fiction—but we prefer to avoid this when we’re communicating facts or scientific concepts.

She just took the shelf exam. She is tired. She would like a snack. She would also like a nap.

I want to nap just from reading that. Talk about short, stilted sentences that keep repeating “she”! Here’s one way to fix it:

The exhausted med student just took the shelf exam. She’d like a snack—and maybe a nap.

I combined some of the short snippets, did a little rewording, and varied the punctuation. It’s still straightforward and communicating the same information, but it’s no longer repetitive.

It can occur after any fracture, however, the most common fracture is a tibial fracture due to the large amount of swelling in a tight compartment that occurs with these fractures.

Wow…there’s a lot of fracturing going on here. Let’s mend it! (Think of editors as word doctors—we can fix your writing but not your leg.) Here’s one way to make the sentence less repetitive and more concise:

It can occur after any fracture, but the most common is a tibial fracture due to the large amount of swelling that occurs in a tight compartment.

Can you spot the redundancy in this one?

In addition to maintaining current vaccinations, patients with HIV infection also should receive an office visit with laboratory examination of complete metabolic panel and complete blood count every 3–6 months. 

We start with “in addition” and then have “also.” They mean the same thing, and both aren’t necessary for the sentence. Let’s cut one.

In addition to maintaining current vaccinations, patients with HIV infection should receive an office visit with laboratory examination of complete metabolic panel and complete blood count every 3–6 months.

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Now I’ll give you a peek behind the Rosh Review curtain to see some tips we give our question writers.

Up first: how to keep answer explanations concise and avoid repetition (I’ve highlighted the sentences to pay particular attention to):

In patients with hypertrophic cardiomyopathy, a beta-blocker such as metoprolol (B) can be used to treat symptomatic premature beats or symptomatic nonsustained ventricular tachycardia. However, it does not decrease the risk of sudden cardiac death. In patients with hypertrophic cardiomyopathy, radiofrequency catheter ablation (C) is mainly used in the treatment of recurrent ventricular tachycardia in patients with a left ventricular apical aneurysm. In patients with hypertrophic cardiomyopathy, sotalol (D) can be used for symptom control in patients with nonsustained ventricular tachycardia that is refractory to a beta-blocker. However, sotalol does not lessen the risk of sudden cardiac death.

We can assume the reader knows we’re talking about patients with hypertrophic cardiomyopathy and doesn’t need it repeated three times. But how else can we combine the highlighted sentences to make this explanation straightforward and not repetitive?

In patients with hypertrophic cardiomyopathy, a beta-blocker such as metoprolol (B) can be used to treat symptomatic premature beats or symptomatic nonsustained ventricular tachycardia, and sotalol (D) can be used for symptom control in patients with nonsustained ventricular tachycardia that is refractory to a beta-blocker. However, these medications do not decrease the risk of sudden cardiac death. Radiofrequency catheter ablation (C) is mainly used in the treatment of recurrent ventricular tachycardia in patients with a left ventricular apical aneurysm.

Nice and tidy!

And for our last Rosh-specific example: how to minimize formatting to highlight specific information (in our case, bold text).

In our answer explanations, we use bold font to highlight high-yield tips and important information. Here’s what part of an answer explanation may look like:

Mycoplasma pneumoniae is a difficult-to-culture double-stranded DNA bacterium that is commonly responsible for community-acquired atypical pneumonia, particularly among children and young adults. Symptoms of atypical pneumonia may include fever, headache, malaise, and sore throat, with lower respiratory symptoms such as cough and hoarseness developing after a number of days. Cough may linger for up to 4 weeks, and some patients may also have associated wheezing. Examination findings are variable and may be normal or may include wheezing or rales. Likewise, results of chest X-rays in affected patients are also varied and may be nonspecific. Inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein may be elevated, but white blood cell and differential counts are typically within normal range. Gradual onset of pneumonia with prominent cough is clinically suggestive of infection with Mycoplasma pneumoniae. Definitive diagnosis is difficult, but PCR for Mycoplasma DNA is recommended, together with acute and convalescent IgG antibody titers drawn 2 to 4 weeks apart. Macrolides are recommended for treatment. Although they may not eradicate the bacteria, therapy has been shown to reduce the duration of illness.

In this paragraph, we easily pick up 4 things thanks to the bold font: 

1. Mycoplasma pneumoniae is a double-stranded DNA bacterium
2. Cough from atypical pneumonia may linger for up to 4 weeks
3. PCR for Mycoplasma DNA is recommended for diagnosis
4. Macrolides are the recommended treatment

This makes things clear for the reader. If they’re skimming through the paragraph and taking notes, these 4 points are probably important for them to remember.

But what happens when we use bold a little too liberally? This is a portion of a different answer explanation:

Patients primarily complain of heartburn and regurgitation 30–60 minutes after eating and upon reclining. Dyspepsia, dysphagia, belching, chest pain, hoarseness, and a chronic, dry, nighttime cough may also result from gastroesophageal reflux disease. Upper endoscopy is the first-line diagnostic test used to document the extent of tissue damage secondary to reflux and to rule out complications of disease, such as esophageal strictures, Barrett esophagus, and esophageal adenocarcinoma. While patients with typical symptoms do not require diagnostic studies, those with symptoms refractory to empiric acid inhibitory therapy or those with “alarm symptoms” (i.e., troublesome dysphagia, odynophagia, unintentional weight loss, or iron deficiency anemia) require testing. Esophageal pH with or without impedance testing may be utilized to quantify esophageal acidic or nonacidic reflux. Patients should be started on empiric acid suppression therapy using a twice-daily H2-receptor antagonist (ranitidine) or a once-daily proton pump inhibitor (omeprazole) for four to eight weeks. 

If the reader skims through, they can’t easily pull out the key takeaways (bold) because there’s so much of it. They have to comb through the whole paragraph to figure out the main points. This is a great example of where less bolding would be more useful for Rosh Review learners.

While you may not use bold in your writing, this tip is applicable to other formatting choices: excessive italics, overusing em dashes (I’m guilty of that one), Capitalizing Words That Don’t Need It For Emphasis…the list is endless.

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When you write, remember less is more. Whether we’re faced with overwhelming formatting, redundant words, or repetitive sentence structure, our goal is to keep the information easily digestible. We want the reader to come back to us rather than vow never to read our repetitive material again.