Time away from "medicine" during PhD

[IonClaws]

So given the way most MD/PhD programs are set up (after the first 2 years of med school and Step 1 you do 3-4 years PhD then do 2 years clinical), you would spend considerable time away from the "medical" part.

I put "medicine" in quotations because the first two years of medical school are not really medicine because you are not seeing patients, for the most part.

I am planning to practice the limited clinical skills we go over the first two years in a volunteer clinic once per month throughout the PhD since I see that as being directly useful.
However, I guess my question is, how important is the didactic knowledge in the first two years for the actual clinical (3rd/4th) years (beyond Step 1)?

---

Members don't see this ad.

 

[gutonc]

So given the way most MD/PhD programs are set up (after the first 2 years of med school and Step 1 you do 3-4 years PhD then do 2 years clinical), you would spend considerable time away from the "medical" part.

I put "medicine" in quotations because the first two years of medical school are not really medicine because you are not seeing patients, for the most part.

I am planning to practice the limited clinical skills we go over the first two years in a volunteer clinic once per month throughout the PhD since I see that as being directly useful.
However, I guess my question is, how important is the didactic knowledge in the first two years for the actual clinical (3rd/4th) years (beyond Step 1)?

Others will probably disagree with me but it's somewhere between "barely" and "not even remotely". You will gain virtually no clinical skills in the first 2 years of med school so you will have absolutely nothing to lose. Do your volunteer clinic if it makes you feel better about yourself as a human being, but please don't pretend it will keep you "sharp" clinically.

I would argue that the transition between 4th year (where you've just spent 2 solid years doing "clinical" "medicine") and internship is a much bigger kick in the jimmies than the transition from M2 --> M3 or from Grad3-7-->M3 will ever be.

 

[IonClaws]

Others will probably disagree with me but it's somewhere between "barely" and "not even remotely". You will gain virtually no clinical skills in the first 2 years of med school so you will have absolutely nothing to lose. Do your volunteer clinic if it makes you feel better about yourself as a human being, but please don't pretend it will keep you "sharp" clinically.

I would argue that the transition between 4th year (where you've just spent 2 solid years doing "clinical" "medicine") and internship is a much bigger kick in the jimmies than the transition from M2 --> M3 or from Grad3-7-->M3 will ever be.

Thanks for your input. That's what my impression was as a lowly rising M2.
I've been thinking lately that med school is basically all pretending and more of another hoop to jump through, and I see that my thinking is correct.

 

[Neuronix]

Thanks for your input. That's what my impression was as a lowly rising M2.
I've been thinking lately that med school is basically all pretending and more of another hoop to jump through, and I see that my thinking is correct.

I agree with gutonc. Though you're taking the wrong impression. You need the funamentals of MS1 and MS2 to understand the observations and science behind the practical things you will be learning and evaluating for the rest of your life. But, you are useless in the clinic until you learn some of those practical things yourself in MS3 and MS4. This is why a lot of programs are going to 3-6 months of clinical rotations before the PhD, which has its own pros and cons.

I personally found grad school to MS3 the most painful time in my training to this point. But that's because MS3 is really important. If you're not a failure of an intern and resident, you will probably move on to whatever you're trying to move on to. If you're not a strong medical student, forget about radiation oncology.

 

[IonClaws]

I agree with gutonc. Though you're taking the wrong impression. You need the funamentals of MS1 and MS2 to understand the observations and science behind the practical things you will be learning and evaluating for the rest of your life. But, you are useless in the clinic until you learn some of those practical things yourself in MS3 and MS4. This is why a lot of programs are going to 3-6 months of clinical rotations before the PhD, which has its own pros and cons.

I personally found grad school to MS3 the most painful time in my training to this point. But that's because MS3 is really important. If you're not a failure of an intern and resident, you will probably move on to whatever you're trying to move on to. If you're not a strong medical student, forget about radiation oncology.

Thanks for your input as well.
I see what you mean - even though the knowledge isn't directly useful, it is necessary to go through it so that we aren't just mindlessly copying what the doctors do, know why certain treatments are used, etc.

 

[gutonc]

Thanks for your input as well.
I see what you mean - even though the knowledge isn't directly useful, it is necessary to go through it so that we aren't just mindlessly copying what the doctors do, know why certain treatments are used, etc.

You can do this if you like though. It's called NP school.

 

[IonClaws]

You can do this if you like though. It's called NP school.

I think I'll pass.

 

[gbwillner]

The first 2 years, more than anything, are to learn the language of medicine. The science of it, if you don't already know that. The approaches to patient care. The ethics involved. The physiology. This makes up the fund of knowledge that will guide many of your clinical decisions. It may not seem important in MS3 and MS4, but all your thinking will ultimately be grounded in what you learned those years.

 

[mercaptovizadeh]

Agreed that as stupid as it sounds, the MS1/2 years - and the huge clinical volume we see in residency - are basically what distinguishes us from midlevel providers like NPs and PAs. Pattern recognition can and must be picked up by anyone working in a clinical context, but it's dealing with the unusual presentations of common problems, and the zebras, that often requires some understanding of basic principles of (patho)physiology that you learn in MS1/2. Things you learn in MS1/2 will come back - perhaps in a different form - in your shelf exams and step 2 CK.