How much of what we're learning during M1/M2 is relevant in rotations and beyond?

[surfguy84]

I'm seriously questioning how I can remember so many of these small details we have to cram into our brains during these first two years. How often, and in how much detail, do physicians in practice (or M3-4 on rotations for that matter) need to recall the details taught in M1/M2?

Will I be a bad physician if I find myself forgetting a lot of this stuff after boards are over?

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[group_theory]

The problem is that at this stage in the game, you don't know what will be relevant or not. What is relevant for a neurosurgeon is different from a PCP, which is different from an intensivist, which is different from an orthopedic surgeon.

If you're interested in developmental pediatrics, or NICU, then embryology and all those metabolic pathways will be important. But they're not important if you are going to be a general surgeon. Knowing fetal anatomy is important if you want to become a pediatric surgeon (or NICU, or PICU, or even general pediatrician) but not important if you are going into dermatology or psychiatry.

 

[MightBeACylon439]

My position on this: who cares.

Sometimes you have to go along to get along, this is one of those times. You probably won't remember that C3bBb(P) acts as C3 convertase and that is not gonna make you a bad physician, but you have to know it now whether you like it or not so it will be best for your sanity if you just accept this and just put in the work.

 

[costales]

Just open wide, swallow, and let God sort them out.

 

[GlowInTheDark]

Some is. But you will have forgotten it by the time it's important again.

 

[surfguy84]

Some is. But you will have forgotten it by the time it's important again.

I guess that's what I was kind of concerned about....I'm seriously doubting how much long term retention I'm going to have for a lot of these details unless I constantly review everything all the time...

 

[surfguy84]

Just open wide, swallow, and let God sort them out.

My gag reflex has gotten exponentially better over the last couple of months.

 

[deleted564680]

I always disliked when students asked "why do we have to learn this," "when will we ever use this." Basically, they should just be honest and say, "I want to learn less and this be easy."

 

[yanks26dmb]

I always disliked when students asked "why do we have to learn this," "when will we ever use this." Basically, they should just be honest and say, "I want to learn less and this be easy."

Wanting to know the application and reason for learning what one is learning seems pretty normal, and something that should be encouraged.

 

[Drrrrrr. Celty]

I always disliked when students asked "why do we have to learn this," "when will we ever use this." Basically, they should just be honest and say, "I want to learn less and this be easy."

There's nothing wrong with want to simplify your life and wanting to cut back down on random courses or things done for the purpose of tradition. I mean legitimately, cadavear lab could be spent actually learning structures instead of peeling away fascia which is and never was fun.

 

[Goro]

A lot of what my students learn in the Basic Sciences is not only for Boards, but also for Wards. Like it or not, you're going to get pimped by your preceptors.

For example: "Mr surfguy, can you tell me what are some of the non-alcoholic causes of cirrhosis? "

I'm seriously questioning how I can remember so many of these small details we have to cram into our brains during these first two years. How often, and in how much detail, do physicians in practice (or M3-4 on rotations for that matter) need to recall the details taught in M1/M2?

Will I be a bad physician if I find myself forgetting a lot of this stuff after boards are over?

 

[Drrrrrr. Celty]

A lot of what my students learn in the Basic Sciences is not only for Boards, but also for Wards. Like it or not, you're going to get pimped by your preceptors.

For example: "Mr surfguy, can you tell me what are some of the non-alcoholic causes of cirrhosis? "

Dr. Goro please krebs cycle the patient, if you cannot remember the 5th metabolic product he's going to crash and we're going to need 15 likes on facebook to resuscitate him....


..... anatomy has destroyed my sense of humor.

 

[dozitgetchahi]

Actually, guys, I'm surprised every day by just how much of what I learned in the preclinical years is relevant and important.

Every day I come across more and more of this supposedly 'inessential' material - on the wards, in tests, in random questions asked by patients and pimping sessions from attendings.

The more of this stuff you guys can remember, the better. Don't goof off.

(And yes, you will forget a lot of it. Then you'll be rudely surprised when you realize much of residency is relearning the random stuff from medical school you forgot and adding an entirely new dimension to it. Medical practice is actually more than what you learn the first two years of medical school - but it includes most of it as well. It's not just 'learn and dump' for medical school and start over fresh for residency. Medicine really is everything.)

 

[Goro]

My young colleague is 1000% correct.

All that M1/2 learning provides the building blocks for what you use later on.

And remember that it's not just memorizing, but applying that counts.

Actually, guys, I'm surprised every day by just how much of what I learned in the preclinical years is relevant and important.

Every day I come across more and more of this supposedly 'inessential' material - on the wards, in tests, in random questions asked by patients and pimping sessions from attendings.

The more of this stuff you guys can remember, the better. Don't goof off.

(And yes, you will forget a lot of it. Then you'll be rudely surprised when you realize much of residency is relearning the random stuff from medical school you forgot and adding an entirely new dimension to it. Medical practice is actually more than what you learn the first two years of medical school - but it includes most of it as well. It's not just 'learn and dump' for medical school and start over fresh for residency. Medicine really is everything.)

 

[group_theory]

Actually, guys, I'm surprised every day by just how much of what I learned in the preclinical years is relevant and important.

Every day I come across more and more of this supposedly 'inessential' material - on the wards, in tests, in random questions asked by patients and pimping sessions from attendings.

The more of this stuff you guys can remember, the better. Don't goof off.

(And yes, you will forget a lot of it. Then you'll be rudely surprised when you realize much of residency is relearning the random stuff from medical school you forgot and adding an entirely new dimension to it. Medical practice is actually more than what you learn the first two years of medical school - but it includes most of it as well. It's not just 'learn and dump' for medical school and start over fresh for residency. Medicine really is everything.)

Agreed. Even if you have forgotten, it is easier (and quicker) to relearn. You may not remember calculus, but if you have the opportunity to review it, it will come back to you more quickly than if you were learning calculus for the first time.

As a practical example, I occasionally have premeds shadow me when I round. Despite their basic science background, it takes a lot longer (and more confused look) when I explain the concept of anion gap. And for them, it's more of a "ok, cool". If a 4th year Sub-I (in the ICU) is on the team, then I can spent more time discussing the finer details of analyzing the anion gap (and what we should do about it) - from recognizing it in the first place, to discussing differential and causes, and how to fix.

If you don't have a background in physiology, then explaining cardiac output, pre-load, afterload, SVR, etc would take longer since you're learning it for the first time - and explaining why certain vasopressors work better in certain situations than others (based on their targets, etc) would be harder if you are learning cardiovascular physiology for the first time (information overload).

The clinical years is when you get exposed to the practical side of medicine, and residency is when you learn how to use your knowledge. But before you can begin to compose an essay in a foreign language, you must learn the words and grammar first.