Again, I have to reiterate that a teaching style most conducive to learning is highly specific to each individual's circumstances. Sorry if my statements came out as too negative towards PBL 😳
Also, I hope you understand that each applicant will eventually have to compare schools, and that the pros/cons may be different depending on which schools offered interview invitations.
This is not directed towards you, poopy, but more of a generalization about PBL concerns...
I think the problem is that it's very easy for people to get intimidated by PBL because it is so different. I also think it's difficult to get a feel for the "system" from sitting in on a PBL session for a day, since that's really very little of what we do. It's important, don't get me wrong, but the real work happens later.
It's been a while since we've really detailed PBL and the other concerns on here, so I'll go ahead a give yet another quick synopsis of a typical week:
Monday: Start a new case. We get page 1, which says something like "60yo WM presents to the ED with crushing, substernal CP." We then discuss possible differential diagnoses (this one's seemingly pretty easy, and not a real case, but sometimes they can throw you a big curveball on page 2). Next someone volunteers to be the "patient" and someone else the "doctor" and you do a mock interview. The patient has a script, the doctor does not. Being the doctor is a great chance to practice your interview with your peers and facilitator there to give you feedback. After the interview, we get a typed up history (basically what you would write in the chart after the interview), and then the physical exam page. We then discuss items found on those pages, and what various things (words, values, exam findings, etc) mean. If that all went quickly, we might get another page with a lab test or X-ray on it, but for now it didn't (since it's our first day, we were slow). Group decides on topics to read by Wed morning. In this case, we picked: Heart anatomy, 3 of the 5 heart physiology chapters, and the pharm chapter on HTN meds (he said he takes Lisinopril during the history). Go home and read for PBL, but not too seriously since we don't know where the case is going. Instead study some for upcoming OMM test next week.
Tuesday: No PBL. Instead, we have Clinical Exam lecture (1 hour), followed by OMM lecture (1 hour). Some weeks there might be an additional "Dean's Hour" before the other two lectures where the school admins discuss some issue like poor test scores, or good test scores, or upcoming events, or rule breaking, or something. Go home and read for PBL, more than yesterday since you don't want to look like a ***** in front of your gunner group mates.
Wednesday: PBL Day 2. Someone in the group presents the case, up to where we left off the other day. "This patient is a 60yo WM who presented to the ED with crushing substernal CP x 2 hours that began while he was walking the dog. He has a hx of HTN x 20 years and takes Lisinopril...etc etc..." Now we have to ask for lab tests. From here, the pages are numbered, but we can get them out of order depending on which labs we ask for. We'll ask for tests, then discuss each result and what it means. So, we ask for cardiac enzymes. They're all jacked up. We talk a bit about the differences between CPK and Troponin (I vs. T, etc) and what each one means. Ask for CXR, CBC, Chem panel, etc etc etc...that takes up most of the day and we again pick some more topics to read for Friday. Now we're sure it's a heart case, so we're reading more heart Physiology, Biochem of mitochondrial injury (2-3 chapters), more heart drugs (HTN meds, lipid meds, etc), and the big one, Heart Pathology (ugh). Go home and read. A lot.
Thursday: No PBL. 2 hours of OMM lab today. Meet in lab with your PBL group (hope you like your group mates, if not you'll be switching next semester so don't worry). Partner up in groups of 2. Take turns being the patient and the doctor and getting cracked (or not, as is more often the case). Sometimes switch partners so you can try on other people/body types. Go home and read more for PBL. A lot.
Friday: More PBL. Just like Wed basically. Someone presents again. Get more tests if needed. Also some progress notes thrown in. Guy probably got a cath at some point, so we talk about that (good thing we read the anatomy), he was better for a bit, then he had a 2nd MI while in the hospital. Maybe he threw a clot this time and had a stroke too...who knows. Anyways, we work through all that, and finally get to treatment: What are we going to do to help this guy? What is he going home on? How do those meds work? When does he follow up? We make our guesses, then we get the last page with his D/C plan and treatment, as well as (if we're lucky) some details about how he did after follow up. We talk about how the case went overall, and how we felt we did on it. Where we could have done better. Then we select topics from this case that we want to be tested on. For this one, there's some debate, but it's pretty straight forward (only 1 organ system, simple drugs, etc). We wind up picking 7 chapters: Heart Anatomy, 2 of the heart physiology, 2 biochem, HTN drugs, and Heart Path. Then we start the next case...wash, rinse, repeat for 2 years.
So, that's a typical week. Some work happens in PBL...it's where you identify what you need to study, but the real work happens with you, at home, reading. A lot. But, you still have time to have fun and do stuff. I saw plenty of my family, went to Disney World once or twice a month, went to the beach almost weekly (and studied there, usually). The couple weeks leading up to a PBL test are worse. Forget about having a life the week before a PBL test (which you usually have almost 100% free to study...no class). PBL tests are basically mini-board exams, and I think, a HUGE reason why we do so well on boards. We basically take boards 3 times a semester, so we have lots of practice.
Anyways, it's a good program, and the self study + clinical reinforcement + desire to not look like a ***** in front of your peers helps drive you to study and do well. The rules are not a big deal and 99% of them will also apply in a hospital setting 3rd/4th year (food/drink only in certain areas, have to badge in/out, have to be on time, have to dress nice, etc)...so it prepares you well for these things also.
I'd also like to add that me and my classmates are getting, for the most part, TONS of residency interviews. I know that I'm doing psych (child), and it's pretty non-competitive, but I got interviews at pretty much every place I applied, including many top 20 schools, if those lists matter to you. Almost everyone I know in every field has more than 10 interviews. We do very well in our matches, on boards, and in life, I think. Plus, it's CHEAP.
