does medical school really work?

[marsupial]

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So I just got done trying to explain a certain medical topic (outside my specialty) to a relative, and did an awful job of it. granted, internship was 2 years ago, but seriously, it's too frequent that I think I should be able to roll comprehensive explanations of the science of a certain quirk of the human body off my tongue, because I went to med school. How solid do you feel when venturing outside your specialty?

on another topic, what are the things that SHOULD be covered in med school better that really weren't? I mean strictly in terms of body function and disease, not the obvious business/insurance type of education.

 

[gutonc]

How solid do you feel when venturing outside your specialty?

I do OK w/ IM, most Peds and Psych questions, and a fair amount of OB/Gyn and Gen Surg questions (the most basic ones anyway) I get from friends and family. When it comes to surg subspecialty questions though I always defer. My surgery rotation in med school was required to be all Gen Surg so I got no practical exposure to any of the subspecialties. Urology/Neurosurg/Ophtho/ENT/Ortho were covered in lectures only for me so I remember very little (3y out from 3rd year now) about those areas.

 

[StreamTeam]

In one sense the facts you are taught mean less than you might think. What counts most is learning how to think, how to keep learning, and keeping an open mind to change. Alot of what you are being taught as medical dogma will change totally in a few years. I am 25 years out from medical school. When I was in medical school, excess stomach acid caused ulcers, bacteria had nothing to do with it. ACE inhibitors were considered the worst thing you could give to someone in CHF. Digitalis was THE treatment of CHF, and aminophyline was THE treatment of asthma. I could go on and on.

 

[Law2Doc]

So I just got done trying to explain a certain medical topic (outside my specialty) to a relative, and did an awful job of it. granted, internship was 2 years ago, but seriously, it's too frequent that I think I should be able to roll comprehensive explanations of the science of a certain quirk of the human body off my tongue, because I went to med school. How solid do you feel when venturing outside your specialty?

on another topic, what are the things that SHOULD be covered in med school better that really weren't? I mean strictly in terms of body function and disease, not the obvious business/insurance type of education.

1. Med school gives you knowledge, but the ability to explain it well to lay people is never taught, and many don't do it well. It is a skill you have to work on throughout your career.

2. You will not remember all of what you learned in med school. If that were expected, resources like uptodate would go out of business, and there would be no reason for multiple steps, relicensing exams and the like.

3. Med school covers everything adequately -- you are expected to read things on your own to expand your knowledge. So it's not an issue of what should be covered better, it's an issue of why aren't you reading more. In law school they repeatedly stressed that the point wasn't to make you learn everything there was to know about the law, but to make you "think like a lawyer". Medicine is really the same thing -- you won't leave school knowing everything, but you have the basic tools and skillset. The rest you need to supplement from books/online resources on your own as warranted.

4. Do not feel confident when venturing outside of your specialty. Your insurance carrier sure won't. In general people specialize for the simple reason that there is too much for any one person to know. So rather than try to have someone become the expert in multiple fields (as was more common, but basically a failed experiment back in the 70s), you have people specialize, so that if you have a heart problem, you consult the cardiologist, and if you have a change in vision you consult the ophthalmologist and so on. A lot of people feel that it's good to get a generalist background first (hence the prelim years so many fields require), but nobody thinks trying to know all things is wise or possible, and you will get yourself in more trouble than it's worth trying.