A Crisis of Trust Between U.S. Medical Education and the NBME

[slowthai]

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"At Stanford, despite a faculty with 8 Nobel laureates and extensive clinical facilities that include 5 teaching hospitals, some medical students virtually ignore the preclerkship curriculum in favor of one or more parallel curricula they create on their own. Their teachers are First Aid (https://firstaidteam.com; published by McGrawHill Education), U World (https://www.uworld.com; Dallas, Texas), Pathoma (https://www.pathoma.com; Chicago, Illinois), Sketchy Medical (https://sketchymedical.com; Los Angeles, California), or one of 20 additional resources designed to help students maximize their Step 1 score.8 As the Step 1 exam approaches, classrooms and voluntary laboratory exercises are lightly attended. Students decrease interactions with one another. Community clinics, normally supported by medical students, are understaffed. Moreover, although this parallel curriculum no doubt has some merit, many of the techniques it inculcates are aimed to improve factual recall rather than understanding; that is, as Wartman has described, they focus on building “information” rather than the higher goal of building “knowledge.”11 Information is easily and reliably obtained in clinical practice by using a search tool on a smart phone, laptop, or portable tablet computer. Why graduate students would forgo an in-depth and multidimensional medical curriculum that helps them achieve knowledge and an understanding of medicine for, instead, learning tools that primarily encode memorization of facts might seem inexplicable. But students do, and the reason is Step 1 mania and the toxic storm it has created."



Link:

A Crisis of Trust Between U.S. Medical Education and the... : Academic Medicine

ted States. According to publicly available tax data, the NBME, which has increased its number of income-enhancing products, had revenues of $153.9 million (M) and net assets of $177.6M in 2017, earnings (revenue less expenses) of $39.7M in 2013–2017, and a highly compensated management team...

journals.lww.com

 

[slowthai]

I totally agree with this guy, just spot on. Preclinical curricula are so much better than boards resources. They actually teach you how to understand medicine while boards resources just teach you how to guzzle down information. It's such a shame that students purchase such expensive resources instead of getting their money's worth with these world class medical school curricula.











But no really, keep shedding those admin tears

 

[altblue]

I totally agree with this guy, just spot on. Preclinical curricula are so much better than boards resources. They actually teach you how to understand medicine while boards resources just teach you how to guzzle down information. It's such a shame that students purchase such expensive resources instead of getting their money's worth with these world class medical school curricula.











But no really, keep shedding those admin tears

View attachment 318584

At first I was like wow slowthai had a change of heart. But then I scrolled down lol

When our clinicians stop reading off slide after slide of disorganized minutiae I'll stop using board resources

 

[slowthai]

At first I was like wow slowthai had a change of heart. But then I scrolled down lol

When our clinicians stop reading off slide after slide of disorganized minutiae I'll stop using board resources

Bro, if I ever start talking crazy like that, just assume that I've been hacked lol

 

[Goro]

At Stanford, despite a faculty with 8 Nobel laureates and extensive clinical facilities that include 5 teaching hospitals, some medical students virtually ignore the preclerkship curriculum in favor of one or more parallel curricula they create on their own. Their teachers are First Aid (https://firstaidteam.com; published by McGrawHill Education), U World (https://www.uworld.com; Dallas, Texas), Pathoma (https://www.pathoma.com; Chicago, Illinois), Sketchy Medical (https://sketchymedical.com; Los Angeles, California), or one of 20 additional resources designed to help students maximize their Step 1 score.8 As the Step 1 exam approaches, classrooms and voluntary laboratory exercises are lightly attended. Students decrease interactions with one another. Community clinics, normally supported by medical students, are understaffed. Moreover, although this parallel curriculum no doubt has some merit, many of the techniques it inculcates are aimed to improve factual recall rather than understanding; that is, as Wartman has described, they focus on building “information” rather than the higher goal of building “knowledge.”11 Information is easily and reliably obtained in clinical practice by using a search tool on a smart phone, laptop, or portable tablet computer. Why graduate students would forgo an in-depth and multidimensional medical curriculum that helps them achieve knowledge and an understanding of medicine for, instead, learning tools that primarily encode memorization of facts might seem inexplicable. But students do, and the reason is Step 1 mania and the toxic storm it has created.



Link:

A Crisis of Trust Between U.S. Medical Education and the... : Academic Medicine

ted States. According to publicly available tax data, the NBME, which has increased its number of income-enhancing products, had revenues of $153.9 million (M) and net assets of $177.6M in 2017, earnings (revenue less expenses) of $39.7M in 2013–2017, and a highly compensated management team...

journals.lww.com

Now do y'all see why Step I went to P/F?
Just tell NBOME, OK?

 

[Ho0v-man]

There’s a part in that article that says that studying for step 1 causes us to “...downgrade other topics and activities (e.g., understanding disease mechanisms; enhancing critical thinking and clinical reasoning...”.

Eff all the way off! As if people who grind it out for above average scores don’t understand disease mechanisms. These guys make it seem like high scorers just blow off understanding DM or CHF to just memorize pharyngeal arches and pretend it’s 70% of the test.

There was a good part that talked about how the specific mechanism of hormones doesn’t really need to be freely recalled IRL despite the fact that it’s tested on step 1. That’s a great point. But instead of changing the test to pass/fail, why not just get rid of that stuff? Seriously, why have what basically turned into a national campaign to make it pass/fail when they could just stop asking these obscure facts (which aren't even a significant part of the exam anyway)?

 

[slowthai]

There’s a part in that article that says that studying for step 1 causes us to “...downgrade other topics and activities (e.g., understanding disease mechanisms; enhancing critical thinking and clinical reasoning...”.

Eff all the way off! As if people who grind it out for above average scores don’t understand disease mechanisms. These guys make it seem like high scorers just blow off understanding DM or CHF to just memorize pharyngeal arches and pretend it’s 70% of the test.

That part pissed me off too. You have to know a mega crapton of these mechanisms for this exam. These people love to act like we're just robots regurgitating a bunch of unconnected facts.

 

[altblue]

There’s a part in that article that says that studying for step 1 causes us to “...downgrade other topics and activities (e.g., understanding disease mechanisms; enhancing critical thinking and clinical reasoning...”.

Eff all the way off! As if people who grind it out for above average scores don’t understand disease mechanisms. These guys make it seem like high scorers just blow off understanding DM or CHF to just memorize pharyngeal arches and pretend it’s 70% of the test.

There was a good part that talked about how the specific mechanism of hormones doesn’t really need to be freely recalled IRL despite the fact that it’s tested on step 1. That’s a great point. But instead of changing the test to pass/fail, why not just get rid of that stuff? Seriously, why have what basically turned into a national campaign to make it pass/fail when they could just stop asking these obscure facts (which aren't even a significant part of the exam anyway)?

There's also this false narrative that medical educators know how to write better exams without obscure facts, compared to Step 1/NBME. Maybe in theory, but not in practice. Anyone who's sat for an in-house exam knows that many many one-off facts are tested

 

[Matthew9Thirtyfive]

There’s a part in that article that says that studying for step 1 causes us to “...downgrade other topics and activities (e.g., understanding disease mechanisms; enhancing critical thinking and clinical reasoning...”.

Eff all the way off! As if people who grind it out for above average scores don’t understand disease mechanisms. These guys make it seem like high scorers just blow off understanding DM or CHF to just memorize pharyngeal arches and pretend it’s 70% of the test.

There was a good part that talked about how the specific mechanism of hormones doesn’t really need to be freely recalled IRL despite the fact that it’s tested on step 1. That’s a great point. But instead of changing the test to pass/fail, why not just get rid of that stuff? Seriously, why have what basically turned into a national campaign to make it pass/fail when they could just stop asking these obscure facts (which aren't even a significant part of the exam anyway)?

Also schools could, you know, teach better.

 

[Dantes]

Wow you'd think with 8 Nobel laureates they could create a curriculum that students would find useful

 

[ExplodingUlcers]

Also schools could, you know, teach better.

Nah bro that's way too reasonable of a request. You've gotta keep the admin circle jerk spinning.

 

[Cornfed101]

Wow you'd think with 8 Nobel laureates they could create a curriculum that students would find useful

Actually that’s probably where TBL came from... please don’t let them develop any curriculum

 

[enchantments]

Even with the P/F decision looming over my class ('24), I still find that BnB/AnKing helps me nail down AND understand crucial topics MUCH faster than QID 60 slides of Where's Waldo 2: Medical Boogaloo

 

[Cornfed101]

Even with the P/F decision looming over my class ('24), I still find that BnB/AnKing helps me nail down AND understand crucial topics MUCH faster than QID 60 slides of Where's Waldo 2: Medical Boogaloo

This

I have a professor that seriously if there is a protein involved in anything we have to know the name of it and the gene that codes for it (80%+ of which are low yield). My brain can’t handle much more alphabet soup

 

[Matthew9Thirtyfive]

This

I have a professor that seriously if there is a protein involved in anything we have to know the name of it and the gene that codes for it (80%+ of which are low yield). My brain can’t handle much more alphabet soup

Thank God our curriculum was developed by an MD and is taught mostly by MDs.

 

[stickgirl390]

Where's Waldo 2: Medical Boogaloo

I’m 100% stealing this, you had me in tears

 

[Drrrrrr. Celty]

I don't think medicine actually makes any sense until you're a resident. And even then it's a lot of "what the culture is at your hospital".

First aid and sketchy and pathoma aren't any less about knowledge. They're about the fact that there's a lot of redundancy in medical education. People don't want to spend 5 hours studying what they can get out of 2 or 3. I don't have that time. And it frankly gets worse 3rd and 4th year. Everyone is mentored by a cat lover Dr. Williams of OME. Do you think his videos are less knowledge? He literally tells it to you straight and to the point and openly mocks the first 2 years of learning.

 

[Mad Jack]

I totally agree with this guy, just spot on. Preclinical curricula are so much better than boards resources. They actually teach you how to understand medicine while boards resources just teach you how to guzzle down information. It's such a shame that students purchase such expensive resources instead of getting their money's worth with these world class medical school curricula.











But no really, keep shedding those admin tears

View attachment 318584

This.

Like, the boards teach us the full foundation of medicine in a succinct way. Lectures and other nonsense tend to be geared toward things that are wholly irrelevant to day-to-day clinical practice or foundational medical knowledge. I would be a far worse doctor today if I didn't have to bust my ass for Step 1.

 

[Real McCoy]

There are many things that your professors teach you because it is on the board exams. Who decided it needed to be tested on a board exam in the first place is an entirely different story. Strong students don't need medical educators to help them memorize information. Strong students need professors to help them integrate material. Weaker students absolutely need professors to help them learn material, learn how to study, learn how to critically think, etc. I would much prefer to shift to pre-recorded lectures/modules and use in-class time for active learning and teamwork activities. There are many who disagree, and that's okay too.

Nobel laureate does not necessarily equate to being a good teacher. I've had many professors who were phenomenal scientists, but they never should've been allowed in a classroom. If we employed legitimate evidence-based education strategies, we could be much more efficient with our curricula across the medical school spectrum. PhDs tend to have a bottom-up approach to communicating information while clinical faculty tend to have a top-down approach. Being a legitimate physician-scientist requires fluency in both directions.

 

[Drrrrrr. Celty]

This.

Like, the boards teach us the full foundation of medicine in a succinct way. Lectures and other nonsense tend to be geared toward things that are wholly irrelevant to day-to-day clinical practice or foundational medical knowledge. I would be a far worse doctor today if I didn't have to bust my ass for Step 1.

I think step 1 was the point where the first two years stopped being random and they actually started to be meaningful. It made 3rd year a lot easier in my opinion.

 

[ineedhelpplse]

This.

Like, the boards teach us the full foundation of medicine in a succinct way. Lectures and other nonsense tend to be geared toward things that are wholly irrelevant to day-to-day clinical practice or foundational medical knowledge. I would be a far worse doctor today if I didn't have to bust my ass for Step 1.

Too many educators are more concerned with keeping their jobs and trying to convince students that their knowledge is important instead of making sure students properly learn what they actually need to. Everyone in my class who focused on board prep did better on in-house exams and Step 1. If I studied from the lectures/material my school provided me I would have failed out of medical school.

 

[slowthai]

Strong students need professors to help them integrate material.

Nope, that's what qbanks are for.

Weaker students absolutely need professors to help them learn material, learn how to study, learn how to critically think, etc.

Weaker students might benefit the most from a tutor, really. And honestly, it's not the professor's job to do any of those things. Their job is to teach.

If we employed legitimate evidence-based education strategies, we could be much more efficient with our curricula across the medical school spectrum.

The greater point here is that their curricula have been made obsolete with the advent of boards resources, so anything they could come up with would just slow me down.

 

[deleted610572]

There are many things that your professors teach you because it is on the board exams. Who decided it needed to be tested on a board exam in the first place is an entirely different story. Strong students don't need medical educators to help them memorize information. Strong students need professors to help them integrate material. Weaker students absolutely need professors to help them learn material, learn how to study, learn how to critically think, etc. I would much prefer to shift to pre-recorded lectures/modules and use in-class time for active learning and teamwork activities. There are many who disagree, and that's okay too.

Nobel laureate does not necessarily equate to being a good teacher. I've had many professors who were phenomenal scientists, but they never should've been allowed in a classroom. If we employed legitimate evidence-based education strategies, we could be much more efficient with our curricula across the medical school spectrum. PhDs tend to have a bottom-up approach to communicating information while clinical faculty tend to have a top-down approach. Being a legitimate physician-scientist requires fluency in both directions.

My professors couldn’t have helped me integrate medical knowledge if their life depended on it.

 

[Fatalis]

There's also this false narrative that medical educators know how to write better exams without obscure facts, compared to Step 1/NBME. Maybe in theory, but not in practice. Anyone who's sat for an in-house exam knows that many many one-off facts are tested

Agreed, more over I say just because a Med school has x amount of Nobel laureates, etc doesn’t equate to good teachers. Yes your professors are awesome at isolating a gene linked to a certain disease.... it doesn’t mean they can teach medical students.
And according to the article Med students forget integration for memorization; that couldn’t be further from the truth.

 

[Matthew9Thirtyfive]

Nope, that's what qbanks are for.



Weaker students might benefit the most from a tutor, really. And honestly, it's not the professor's job to do any of those things. Their job is to teach.



The greater point here is that their curricula have been made obsolete with the advent of boards resources, so anything they could come up with would just slow me down.

Mostly agree with you but our curriculum has a really solid clinical reasoning/skills component that I just don’t get from any of the boards resources.

 

[Matthew9Thirtyfive]

Agreed, more over I say just because a Med school has x amount of Nobel laureates, etc doesn’t equate to good teachers. Yes your professors are awesome at isolating a gene linked to a certain disease.... it doesn’t mean they can teach medical students.
And according to the article Med students forget integration for memorization; that couldn’t be further from the truth.

Yeah I guess they think step is all first order regurgitation.

 

[slowthai]

Agreed, more over I say just because a Med school has x amount of Nobel laureates, etc doesn’t equate to good teachers. Yes your professors are awesome at isolating a gene linked to a certain disease.... it doesn’t mean they can teach medical students.
And according to the article Med students forget integration for memorization; that couldn’t be further from the truth.

Exactly, like just because we're blowing off your crappy curriculum doesn't mean that we don't know how to understand or integrate, like shut up lol

 

[slowthai]

Mostly agree with you but our curriculum has a really solid clinical reasoning/skills component that I just don’t get from any of the boards resources.

Yeah, I'm usually speaking generally when I say this stuff; your school is the exception in a lot of ways.

 

[DrRedstone]

I don't think medicine actually makes any sense until you're a resident. And even then it's a lot of "what the culture is at your hospital".

First aid and sketchy and pathoma aren't any less about knowledge. They're about the fact that there's a lot of redundancy in medical education. People don't want to spend 5 hours studying what they can get out of 2 or 3. I don't have that time. And it frankly gets worse 3rd and 4th year. Everyone is mentored by a cat lover Dr. Williams of OME. Do you think his videos are less knowledge? He literally tells it to you straight and to the point and openly mocks the first 2 years of learning.

One of my OB attendings told me OME was garbage. I made the mistake of believing her for that rotation and my shelf score suffered. Good ol' Dustyn knows what's up.

 

[altblue]

Agreed, more over I say just because a Med school has x amount of Nobel laureates, etc doesn’t equate to good teachers. Yes your professors are awesome at isolating a gene linked to a certain disease.... it doesn’t mean they can teach medical students.
And according to the article Med students forget integration for memorization; that couldn’t be further from the truth.

I'm a huge fan of NBMEs and QBanks because they actually encourage us to think and apply first principles to medical cases. Yes Rx is nitpicky at times, or Kaplan/AMBOSS can be ridiculous, but at least they discourage massive amounts of memorization. Our in-house exams do have extra clinically relevant points, but they won't make much sense or stick unless you're a clinical med student with actual clinical learning and UWorld/AMBOSS to practice them. It ends up being a cram-and-dump of M3/M4 level guidelines and treatments, or obscure symptoms/conditions (and molecules for our PhD lecturers) that won't be remembered in a year or two.

 

[Mad Jack]

Too many educators are more concerned with keeping their jobs and trying to convince students that their knowledge is important instead of making sure students properly learn what they actually need to. Everyone in my class who focused on board prep did better on in-house exams and Step 1. If I studied from the lectures/material my school provided me I would have failed out of medical school.

Same

 

[libertyyne]

Are medical students adults that learn in their own ways or do they children that need to be taught a specific way?
Is the goal to train people to be self directed life long learners or people who need to be spoonfeed information.
Are school lectures high quality or are they 10 year old slides that the instructor reads in a monotone.

This whole premise is non-sensical.
If medical students are adults and they know what works for them, and are able to find the information, memorize it and apply it appropriate for in house exams and board exams these people should not be complaining, rather they should try to learn from the lessons that can be learned from third party sources and zanki.


Now on to the specifics
"They downgrade other topics and activities (e.g., understanding disease mechanisms; enhancing critical thinking and clinical reasoning; improving physical examination, interview, and communication skills; understanding the psychosocial context of illness; undertaking early clinical experiences and community engagement; volunteering; maintaining physical and emotional health and healthy relationships) as they, instead, elevate Step 1. "
1. Underlying disease mechanisms are learned as is evidenced by mastery of content for both in house and board exams.
2. Critical thinking, see above.
3. Physical exam is learned quickly and efficeintly in year 3.
4. Interview- see above.
5. Understanding psychosocial context, learned and actually applied during in house and board exams, and takes like an afternoon to learn this
6. Early clinical experience? what purpose will it serve?
7. Volunteering , maintaining physical and emotional health. Most students do this and them taking part of the external parrallel curriculum does not mean that they wouldnt ignore this if they were fully invested in the home curriculum.

This article just shows how far medical educators are willing to go to put down students who are doing what they find is the best way to learn and apply the material. Rather than say we as educators have failed them in not providing the best way to gain this information. They are doubling down on their superiority of curriculum without any evidence that their curriculum or way is superior, provides better physicians , or generates better outcomes.

 

[Ho0v-man]

Since this thread has reignited a long dormant hatred of preclinical admins, I’ll just further comment that out of all of the basic science from the first two years that I’ve been expected to know in the clinical setting, literally 100% of it is in BUFAPS. I have yet to be pimped on anything from preclinical that was exclusive to my curriculum alone and I knew my schools material very well.

I also think the biggest example of hypocrisy by people like the authors of this article is that our schools sure as heck don’t mind that most of what we learn for step 2 is from outside resources. The school literally stops teaching you after preclinical and rolls the dice that someone at the random clinical site they toss you into will actually care enough to teach you anything. They straight up tell you to use outside resources if you want to succeed in third year but it’s somehow inappropriate to do so in the first two.

In fact, if you ask for any guidance you’ll very often be told to look it up or be given **** for not already knowing it cold from an outside resource that your school likely doesn’t even provide.

edited because I needed to vent even more

 

[libertyyne]

Since this thread has reignited a long dormant hatred of preclinical admins, I’ll just further comment that out of all of the basic science from the first two years that I’ve been expected to know in the clinical setting, literally 100% of it is in BUFAPS. I have yet to be pimped on anything from preclinical that was exclusive to my curriculum alone and I knew my schools material very well.

I also think the biggest example of hypocrisy by people like the authors of this article is that our schools sure as heck don’t mind that most of what we learn for step 2 is from outside resources. The school literally stops teaching you after preclinical and rolls the dice that someone at the random clinical site they toss you into will actually care enough to teach you anything. They straight up tell you to use outside resources if you want to succeed in third year but it’s somehow inappropriate to do so in the first two.

These people are like carriage builders after the advent of the automobile making up reasons why the automobile is worse. They are trying to advance their position by changing the system. but that only works for so long.And it doesnt address the intrinsic existential issues they have. Either adapt or be relegated to obsolescence. These people fail to see that and refuse to change.

How about if a curriculum gave you anki cards for the lectures, or gave you in house picmonics or sketchy equivalent, or provided you with in house q banks. Sat down with you after a practice exam and gave feedback. or god forbid actually sat down with you after a standardized patient encounter and provided feedback. Had built in questions after the lecture after you watch a video remotely?

 

[Lawpy]

I'm just hoping preclinical is shortened to 1 year now

 

[fldoctorgirl]

I also think the biggest example of hypocrisy by people like the authors of this article is that our schools sure as heck don’t mind that most of what we learn for step 2 is from outside resources. The school literally stops teaching you after preclinical and rolls the dice that someone at the random clinical site they toss you into will actually care enough to teach you anything. They straight up tell you to use outside resources if you want to succeed in third year but it’s somehow inappropriate to do so in the first two.

This is my biggest pet peeve with my school. They straight up gave us ZERO resources for M3, like we didn't even get access to a qbank. The only thing we got was an OME subscription and the quick tables book, and we're told to buy every other outside resource and use that. But in M2 every path or pharm lecturer would go on and on about how sketchy wasn't a good resource, but memorizing PhD-level details about drug trials was a good use of my time. Pathoma? Not as good as the 10-year old powerpoint with one word and image on it. We need Flexner 2.0.

 

[Real McCoy]

It really is fascinating to learn how faculty, administration, and students view their individual and each other’s roles in medical education.

 

[slowthai]

Are medical students adults that learn in their own ways or do they children that need to be taught a specific way?
Is the goal to train people to be self directed life long learners or people who need to be spoonfeed information.
Are school lectures high quality or are they 10 year old slides that the instructor reads in a monotone.

This whole premise is non-sensical.
If medical students are adults and they know what works for them, and are able to find the information, memorize it and apply it appropriate for in house exams and board exams these people should not be complaining, rather they should try to learn from the lessons that can be learned from third party sources and zanki.


Now on to the specifics
"They downgrade other topics and activities (e.g., understanding disease mechanisms; enhancing critical thinking and clinical reasoning; improving physical examination, interview, and communication skills; understanding the psychosocial context of illness; undertaking early clinical experiences and community engagement; volunteering; maintaining physical and emotional health and healthy relationships) as they, instead, elevate Step 1. "
1. Underlying disease mechanisms are learned as is evidenced by mastery of content for both in house and board exams.
2. Critical thinking, see above.
3. Physical exam is learned quickly and efficeintly in year 3.
4. Interview- see above.
5. Understanding psychosocial context, learned and actually applied during in house and board exams, and takes like an afternoon to learn this
6. Early clinical experience? what purpose will it serve?
7. Volunteering , maintaining physical and emotional health. Most students do this and them taking part of the external parrallel curriculum does not mean that they wouldnt ignore this if they were fully invested in the home curriculum.

This article just shows how far medical educators are willing to go to put down students who are doing what they find is the best way to learn and apply the material. Rather than say we as educators have failed them in not providing the best way to gain this information. They are doubling down on their superiority of curriculum without any evidence that their curriculum or way is superior, provides better physicians , or generates better outcomes.

I literally liked this comment 5x. You absolutely demolished this tired and downright ignorant perspective. Loved Ho0v-man's comment as well. I think that really and truly, this behavior stems from insecurity and boomerhood. These people are insecure about the fact that they have become effectively worthless as far as preclinical learning goes.

 

[paperclip2018]

How about if a curriculum gave you anki cards for the lectures, or gave you in house picmonics or sketchy equivalent, or provided you with in house q banks. Sat down with you after a practice exam and gave feedback. or god forbid actually sat down with you after a standardized patient encounter and provided feedback. Had built in questions after the lecture after you watch a video remotely?

The article raises good points regarding the COI that exist for the NBME. As a current SMS student going through these classes, it's interesting that admin believes this is the explanation of why we do not attend class, rather than perhaps that lectures are ineffective or contain too much irrelevant content. Stanford micro has created their picmonic/sketchy equivalent, it is much worse.

 

[Matthew9Thirtyfive]

These people are like carriage builders after the advent of the automobile making up reasons why the automobile is worse. They are trying to advance their position by changing the system. but that only works for so long.And it doesnt address the intrinsic existential issues they have. Either adapt or be relegated to obsolescence. These people fail to see that and refuse to change.

How about if a curriculum gave you anki cards for the lectures, or gave you in house picmonics or sketchy equivalent, or provided you with in house q banks. Sat down with you after a practice exam and gave feedback. or god forbid actually sat down with you after a standardized patient encounter and provided feedback. Had built in questions after the lecture after you watch a video remotely?

Wow I have to say, every time I read these threads it makes me really happy I go to school where I do. The majority of med schools need a serious overhaul.

 

[7331poas]

Crazy to me that undergraduate students can learn objectively harder topics on their own like organic chemistry, modern physics, etc etc. But for some reason med school microbio is completely unlearnable without TBL.

 

[paperclip2018]

I'm just hoping preclinical is shortened to 1 year now

Interestingly, Stanford is 2 years and now optionally 3 years. Key Features

 

[altblue]

Crazy to me that undergraduate students can learn objectively harder topics on their own like organic chemistry, modern physics, etc etc. But for some reason med school microbio is completely unlearnable without TBL.

It's also crazy to me that many students have to use outside resources to do well, or run the risk of a borderline or failing performance

 

[Matthew9Thirtyfive]

Interestingly, Stanford is 2 years and now optionally 3 years. Key Features

Yes, because that’s the right direction. Longer preclinical. Smh.

 

[libertyyne]

Yes, because that’s the right direction. Longer preclinical. Smh.

I actually think flexible curricula are the future. If people are able to go through all of preclinical at their own pace in 6 months, ok , if some people take 3 years thats ok too.
This would be in line with the principles of self paced, self directed learning, and individualized learning.

 

[Matthew9Thirtyfive]

I actually think flexible curricula are the future. If people are able to go through all of preclinical at their own pace in 6 months, ok , if some people take 3 years thats ok too.
This would be in line with the principles of self paced, self directed learning, and individualized learning.

Yeah well the match will have to adjust to not disadvantage people who take 5 years to finish med school.

Also that would be hell for clerkship coordinators.

 

[VA Hopeful Dr]

Yeah well the match will have to adjust to not disadvantage people who take 5 years to finish med school.

It won't. After all, whoever finishes preclinicals the fastest must be the best. It's just another arms race.

 

[libertyyne]

Yeah well the match will have to adjust to not disadvantage people who take 5 years to finish med school.

the people who need three years were going to need three years in the current system anyway. I still think people will average 18 months give or take 6 months. But who knows what the match will have to incorporate going forward.

Edit: I dont think Medical schools give special dispensation for finishing UG earlier, so I dont think residencies will have to give special dispensation for that question either. People will have to fill the other time with research to stay on schedule so it will be ok.

But there needs to conversations about changing the structure of medical school and not just changing step 1 to p /f . that was merely a symptom of the way our healthcare system and medical education is structured.

 

[Splenda88]

The 8-yr med curriculum in the US is a scam...80-90% of what you learn to practice medicine is during residency. I am working interns right and can't not tell who got 250 or 210 in step1. They are all awful. I was just as awful as them

5-yr instead of 8-yr of foundational knowledge should be more sufficient to make the transition to clinical medicine

 

[7331poas]

the people who need three years were going to need three years in the current system anyway. I still think people will average 18 months give or take 6 months. But who knows what the match will have to incorporate going forward.

Edit: I dont think Medical schools give special dispensation for finishing UG earlier, so I dont think residencies will have to give special dispensation for that question either. People will have to fill the other time with research to stay on schedule so it will be ok.

But there needs to conversations about changing the structure of medical school and not just changing step 1 to p /f . that was merely a symptom of the way our healthcare system and medical education is structured.

Should do more stuff like the newer schools are doing. 3 year programs for select residencies.