Any other 1st year just about had it with learning basic science??

[cardsurgguy]

I can't stand this clinically irrelevant basic science obsessive detail. (Don't like basic science in general at all)

First year was way more basic science oriented and less clinically oriented than I thought it would be. It's more clinically oriented than undergrad science courses, but not dramatically so.

I'm sorry, but physicians do not need to know about Src Homology 2 domains or any of the million receptors in signal transduction pathways...
(well, the 95% of us who aren't MD/PhD that is)

Obviously there needs to be basic science taught, but it should be a clinical version of basic science that includes ONLY what is relevant to practicing clinical medicine. Maybe it's just me or maybe I'm wrong about all of this, but it seems this is not the case and that there a boat load of stuff that's just minute details that are clinically not relevant.

Anybody else at their wits end with this crap??

Thankfully summer is coming...

(at least 2nd year, despite being harder, should be more fun because it's actually clinically relevant)

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[strangeglove]

Better get used to it. Basic science, including SH2 domains, will always be the basis for understanding disease and therapeutics and will continue to come up on MS 3 and 4 and in residency. Just wait until you have to present on the role of SH2 domains in the pathogenesis of breast cancer at morning report in your 4th year of surgery residency, you'll be glad you learned this stuff. If you don't like it, there's always PA school.

 

[cardsurgguy]

Better get used to it. Basic science, including SH2 domains, will always be the basis for understanding disease and therapeutics and will continue to come up on MS 3 and 4 and in residency. Just wait until you have to present on the role of SH2 domains in the pathogenesis of breast cancer at morning report in your 4th year of surgery residency, you'll be glad you learned this stuff. If you don't like it, there's always PA school.

Well that sucks...

Oh well, such is life




Actually, let me add a question then. You mentioned it will always be the basis of understanding disease and therapeutics. I actually don't disagree with you on this.

My question is this: Is this level of understanding necessary for diagnosis and treatment of the disease?

Obviously one needs to understand disease to diagnose and understand therapeutics to treat. However it's a matter of degree.
If you can diagnose and treat a disease equally as well with and without a given piece of knowledge, then that piece of knowledge is clinically unimportant.

Now, I stress clinically unimportant because it may be critical for discovering the exact mechanism of the disease on the molecular/biochemical level and/or developing the treatment itself again on the molecular/biochemical level.

However, these two things are not physicians job. It's the PhD's job. They have much more expertise in the molecular/biochem nitty gritty and therefore are much better to do these two components of medicine.

Physicians on the other hand are much better at the clinical stuff obviously, and so just do that.

For example, a physician does not have the knowledge on the molecular/biochem level of a PhD pharmacologist who designs drugs, but they still do just fine using the drugs to treat the disease since having the molecular/biochem knowedge of a PhD pharmacologist doesn't add anything at all to the physician's ability to use that drug to treat the disease.

In other words, it's essential to come up with the drug, but not essential to use the drug clinically.

Who knows, maybe I'm wrong on any of this. Interesting discussion nonetheless.

 

[Critical Mass]

(well, the 95% of us who aren't MD/PhD that is)

Wash used to be something like a quarter mudphud.

Everyone agrees that med school shouldn't be the way you noted, but until they alter our board exams (e.g. step 1), I wouldn't expect to see rampant change soon. They had to do it, so we have to do it.

Ya know, I would have thought that they'd at least go over a handful of nursing skills or maybe guarantee that we can do a PE blindfolded.

 

[SoCuteMD]

Ha! I have news for you. 2nd year STILL involves memorizing minute details like the fact that the E6 protein of HPV binds p53, while the E7 protein binds RB.

I get the feeling that it probably doesn't end with 2nd year either!

 

[cardsurgguy]

Ha! I have news for you. 2nd year STILL involves memorizing minute details like the fact that the E6 protein of HPV binds p53, while the E7 protein binds RB.

I get the feeling that it probably doesn't end with 2nd year either!

Oh god, please tell me you're joking (even though I know you're not)

If that happens again, that'll be the 3rd time I'll be learning that...(ugrad, and 1st year med)

Ok then, forget the 2nd year thing I said. How about looking forward to 3rd year? Or will that get rejected too

 

[DoctorFunk]

I hear fourth year is pretty cool...

 

[cardsurgguy]

I hear fourth year is pretty cool...

Pretty soon we'll be up to "hey, retirement is where it's at"

 

[mojojojo]

Oh, just you wait until your last week of second year classes. JUST YOU WAIT.

Actually, don't worry, it all flies by pretty quickly. Today was our last day of classes! The last lecture I have to sit in, ever! Well, aside from hospital based, lectures, CME.... anyway, I'm glad. It seems like I started med school just yesterday.

Of course, now I have to boards to study for. It never truly ends.

 

[Labslave]

Just to make you feel a little better, I'll detail the coversation I had with an ID specialist the other day in small group:

Me: So we just "learned" every parasite we're ever supposed to know, which could easily be a semester-long course, in just under three hours. Seems a little ridiculous...

ID Doc: Yeah, don't sweat it. Learn it now as best you can. Two weeks later you'll forget pretty much everything. You'll memorize it again for the boards and then promptly forget it once again.

Me: Then what's the point? I mean, you're an ID specialist and you're telling me you can't distinguish a lot of these parasites from one another?

Doc: Labslave, they're called BOOKS.

Hence, even the more clinically relevant information isn't going to be stuff you'll have to have in your head all the time. All of us underestimate the importance of being familiar with resources and how to utilize them to help us diagnose and treat patients. Working in medicine is going to be like taking an open book exam a lot of times (not saying all the time or even the majority of times, but you get the point), and if you look up the mechanism of a drug, what you will need to have is the tools to understand the literature and apply the knowledge you gain.

 

[strangeglove]

Well that sucks...

Oh well, such is life




Actually, let me add a question then. You mentioned it will always be the basis of understanding disease and therapeutics. I actually don't disagree with you on this.

My question is this: Is this level of understanding necessary for diagnosis and treatment of the disease?

Obviously one needs to understand disease to diagnose and understand therapeutics to treat. However it's a matter of degree.
If you can diagnose and treat a disease equally as well with and without a given piece of knowledge, then that piece of knowledge is clinically unimportant.

Now, I stress clinically unimportant because it may be critical for discovering the exact mechanism of the disease on the molecular/biochemical level and/or developing the treatment itself again on the molecular/biochemical level.

However, these two things are not physicians job. It's the PhD's job. They have much more expertise in the molecular/biochem nitty gritty and therefore are much better to do these two components of medicine.

Physicians on the other hand are much better at the clinical stuff obviously, and so just do that.

For example, a physician does not have the knowledge on the molecular/biochem level of a PhD pharmacologist who designs drugs, but they still do just fine using the drugs to treat the disease since having the molecular/biochem knowedge of a PhD pharmacologist doesn't add anything at all to the physician's ability to use that drug to treat the disease.

In other words, it's essential to come up with the drug, but not essential to use the drug clinically.

Who knows, maybe I'm wrong on any of this. Interesting discussion nonetheless.

I suppose much of this information is not directly relevant to diagnosing and treating your patients. Keep in mind, however, that it is not only PhDs or MD-PhDs who do research. Some of the most important research has been done by MDs who went to medical school with the idea that their education would qualify them in some way to engage in research. Thus, to wish that medical education included less basic science would be to deprive the population as a whole of this potential pool of researchers. As I said before, you can do a lot as a PA and you wouldn't have to learn all the basic science.

 

[student101]

I can't stand this clinically irrelevant basic science obsessive detail. (Don't like basic science in general at all)

First year was way more basic science oriented and less clinically oriented than I thought it would be. It's more clinically oriented than undergrad science courses, but not dramatically so.

I'm sorry, but physicians do not need to know about Src Homology 2 domains or any of the million receptors in signal transduction pathways...
(well, the 95% of us who aren't MD/PhD that is)

Obviously there needs to be basic science taught, but it should be a clinical version of basic science that includes ONLY what is relevant to practicing clinical medicine. Maybe it's just me or maybe I'm wrong about all of this, but it seems this is not the case and that there a boat load of stuff that's just minute details that are clinically not relevant.

Anybody else at their wits end with this crap??

Thankfully summer is coming...

(at least 2nd year, despite being harder, should be more fun because it's actually clinically relevant)

Actually, I've heard that some schools are starting to feel the same way you do about this. My understanding is that Duke has whittled the basic sciences down to just one year while some other schools have cut it down to a year and a half. At first I thought they just compressed the info into that time, making it extremely difficult on the students. I've since heard that it was less of a compression and more of an elimination of some of the less clinically important material. Can any Duke, Baylor, or UPenn students confirm this?

 

[cardsurgguy]

I suppose much of this information is not directly relevant to diagnosing and treating your patients. Keep in mind, however, that it is not only PhDs or MD-PhDs who do research. Some of the most important research has been done by MDs who went to medical school with the idea that their education would qualify them in some way to engage in research. Thus, to wish that medical education included less basic science would be to deprive the population as a whole of this potential pool of researchers. As I said before, you can do a lot as a PA and you wouldn't have to learn all the basic science.

True. Good point.

I don't regret my decision to go to medical school. The clinical training (by itself, excluding the basic sciences) is more in depth than PA school, so that's all the motivation I need to be here; not to mention that I like surgery, as in doing the surgery, not first assisting.

Just needed to vent a little bit, but as I said, summer is coming up soon

 

[Doctor Bagel]

I suppose much of this information is not directly relevant to diagnosing and treating your patients. Keep in mind, however, that it is not only PhDs or MD-PhDs who do research. Some of the most important research has been done by MDs who went to medical school with the idea that their education would qualify them in some way to engage in research. Thus, to wish that medical education included less basic science would be to deprive the population as a whole of this potential pool of researchers. As I said before, you can do a lot as a PA and you wouldn't have to learn all the basic science.

But the level of detail that we have to learn is all stuff that an MD could easily study on her own if she desired to do research in that field. Memorizing it just to forget it later doesn't do much to further scientific study. For example, why the heck do I need to know how many subunits are in a nicotinic receptor and how many are alpha or beta? That's the type of information that's only relevant to people who are specifically doing research on the nicotinic receptor or drugs that affect it. If I'm doing that type of research, I can easily learn it.

Why do I need to know all the intermediaries in the CAC? I've learned it and forgotten it multiple times already. As labslave said, I can look it up if I need to, and I can learn those tedious facts easily if it actually matters for anything I'm doing.

IMO, learning more about critical scientific inquiry and research would be more useful in promoting MD driven research than forcing us to memorize endless amounts of clinically irrelevant details.

 

[45408]

Why do I need to know all the intermediaries in the CAC? I've learned it and forgotten it multiple times already. As labslave said, I can look it up if I need to, and I can learn those tedious facts easily if it actually matters for anything I'm doing.

No kidding. An introduction to these things would be one thing, but requiring you to memorize everything (that you'll forget in the drinking binge after the exam) is not necessary. Anatomy? Physiology? Understandable. Biochem? C'mon.

 

[student101]

IMO, learning more about critical scientific inquiry and research would be more useful in promoting MD driven research than forcing us to memorize endless amounts of clinically irrelevant details.

This makes a mountain of sense to me. Teaching an MD how to think critically, make scientific inquiry, and do clinical research seems much more useful than making them memorize volumes of details that will be forgotten and can easily be looked up in a book if needed.

 

[Doctor Bagel]

No kidding. An introduction to these things would be one thing, but requiring you to memorize everything (that you'll forget in the drinking binge after the exam) is not necessary. Anatomy? Physiology? Understandable. Biochem? C'mon.

Another reason why biochem was my least favorite class.

 

[Noeljan]

Ha! I have news for you. 2nd year STILL involves memorizing minute details like the fact that the E6 protein of HPV binds p53, while the E7 protein binds RB.

I get the feeling that it probably doesn't end with 2nd year either!

Yay I knew grad school would come in handy, that was just on my last exam of grad school ever.....now a two month break till med school and I get to learn it again, yippie

 

[sirus_virus]

So how much of this memorization goes on in residency? Is it pretty much the same thing over again?

 

[Critical Mass]

Doc: Labslave, they're called BOOKS.

Not where I work. They prefer "call the med tech" to "BOOKS." Saves time that could be better spent making more money.

<----------the med tech

 

[deleted50541]

This makes a mountain of sense to me. Teaching an MD how to think critically, make scientific inquiry, and do clinical research seems much more useful than making them memorize volumes of details that will be forgotten and can easily be looked up in a book if needed.

Cheers to that! I went to grad school where I was trained exactly as you described. Being in medical school has felt like a step back, where it's almost as if that sort of training and critical thinking are discouraged: "memorize, memorize my little monkey".

It's not like I didn't know what I was getting into when I entered med school. Every doc I knew told me that it's all about memorizing info, spitting said info back out for a test, forgetting that info, and moving on to the next stack of info. But damn, when we started our module on GI and had 10 hours of basic science lectures (why do we need to hear about cell phyisio and osmosis AGAIN?!!!??) after an entire semester of that bull****, I almost threw a fit.

I have no problem with being forced to learn every bug and drug under the sun because it's clinically relevant and I'll at least recognize it when I have to look it up for real. But relearning the minutia of basic science is infuriating.

 

[towards stardom]

ah...the wonders of taking formal education. we learn a bunch of s*** that we feel we dont need to then turn around and find that we actually did need to know. only to be utterly humiliated by the fact that one has forgotten those "minute details" the second they stepped out of the testing room...

yes..pessimistic, but thats the life of a doctor. a bunch of crap that we need to know but dont wanna

 

[megadon]

Remember, the point of med school is to pump out lot of little pleuripotent stem cell doctors. Am I going to be an OB/GYN, no, am I going to be a surgeon, no. But unfortunately, I have to learn the background before I knowledge dump all that stuff. So, pathologists care a lot about all this junk (I personally have a vested interest in my p53 and RB genes), but others don't. Welcome to the great suck, we all have to learn it for at least step one. My school had a weird first year course, called Molecular Basis of Disease, which rolled up genetics, biochem and other random things. Worst class of first year, cause it had genetics and biochem. However, they recognized that and tried to make it clinically relevant, by talking about what goes wrong. At least once a block they would bring in families with genetic problems, sickle cell, albinism, etc. It deffinitely helped. Plus it helped me gain an appreciation for how terrible sickle cell really is. If you make it to thirty, you have probably had at least one hip replacement.

Granted the first year stuff is dry, there are ways to make it seem more relevant.