Neutrancer -- 🙂 lol. You want an honest opinion? Do I think the concern you have is unncessary? YUP! <grin> But that's just my opinion. I know that a PBL style school would have driven me nuts! I'm a person who needs a tad bit more structure although initially, it sounded wonderful to me. I can't answer some of the questions you have -- those are questions better answered by a physician. But the 3rd and 4th years that I know do not seem to have any problems (well, other than being tired, and having to write up reports and giving presentations and going to seminars, etc). But those are usual 3rd year problems anyone has. In fact, if I'm not mistaken, I was talking ot a 3rd year friend of mine while she was in the computer lab once working on something. I asked her what she was doing and she told me that during her gyn rotation, she had to present a real patient case and go through how she arrived at the diagnosis. Then again, you're more concerned about learning these things pre-3rd year, so never mind.
As far as thinkign like a physician, like I said, I can't really answer that. Like wally said -- there's no true PBL style learning, although there is a lot of clinical focus in the classes (its' quite easy to have classes that stick more towards the science without much clinical appliation). And from what my friends have told me, in 2nd year, you actually meet with an assigned small group to go over clinical cases and diagnosing. Also, in ITP, you spent 1st year honing learning all the physical exam techniques. You refine that in MSII. But a large chunk of the ITP is also spent on diagnosing based on presentation and how you arrive at certain conclusions. Also, annoyingly so, on many of the tests during MSI, some professors love to give you a history of a patient (brief, but still a "history"). Eventually, using the knowledge you've learned throughout the class, you tend to pick up certain things although the professor hasn't specifically gone over "how to diagnose based on history". This is especially true in physiology, but is also done in anatomy, neuroanatomy especially. Cell bio doesn't really do that -- cell bio tends to be more along the lines of listing the symptoms and asking you what disease. Biochem does is a little in between.
Plus, you start to learn to "think" like a physician when you actually start to do your LGM. At least, if you have a good learning experience. People will come in with issues. Your LGM, at least a good LGM, might immediately jump to a solution or he might even ask you what you think is wrong, and the two of you should go over it together based upon the history you have taken and the physical you have done on that patient.
So do I worry about being able to think like a physican? Not one ounce!
MSV -- CONGRATS!!!! 😀 TO answre your question -- ITP is introduction ot the patient. Basically, LGM (longitudinal general mentorship) is where you're assigned to your physician (they try to accomodate requests). You go into his office and use what you have learned from ITP. ITP is basically what is done at school. You have 1-2 hours of large group lecture (in the lecture hall) on most Tuesdays. Here, during the first semester, you go over how to take a history, and how to do the various components of hte physical exam (ie, musculoskeletal, neurological exam, etc). They quite often have physicians come in and lecture to you on this. Oh, they show the Bate's tapes which are tapes based on the Bates Book of Physical Examination (pretty much a standard in medical schools). Much of my class (along with the professor) hated those tapes, but he felt obligated to show it so that people who want to watch it have the opportunity. Either way, after the large group, you break off into small groups for ITP -- groups of 7 where you have a physician and a 4th year acting as facilitators. Here, your group is given a standardized patient and you actually perform what you learned in class. You pick up pointers, various techniques that can't be learned in a lrge group format, etc. Very invaluable time! Second semester, you have already conqured basic interviewing and physical exams. 2nd semester, you will actually perform what you've learned first semester for your LGM. THe LGM experience can really depend on you relationship with the LGM and what you tell him you want to do. My LGM, who has been doing this for years, basically threw me in with a patient and said -- do your history and physical and come out when you're done. So he gave me a lot of independence. You learn to pick up things along the way. But in ITP specifically, 2nd semester, you learn more abut medical practice -- health care -- motivational interviewing (the "module" is actually called Advanced Interiewing). But you spend ITP large group time learning about things like sexual and child abuse -- how to spot them, and coax the patient and have them feel secure. Sleep deprivation. Smoking cessation. ETC! I actually really enjoyed these lectures, although a lot of people said they were "useless" -- I personally don't see how such things are useless when they are very real issues you ought to learn, address and cope with during your career.
OBD = On Being a Doctor. COMPLETE WASTE OF TIME! Almost EVERYONE hated going. You will find that this class is also the oneo that is the most heavily attended. Do you know why? They know that this class is so useless that they have a sign in sheet to force students to come. (hehe, can you hear the bitterness??) Basically, it's supposed to well, talk about hte practice of being a doctor, but it's actually more of an ethics sort of course. But it's very inefficient. I would have actually LIKED an ethics class that met as small groups so that you can reasonably discuss issues. Instead, OBD is in the large lecture hall with everyone, and the guy (bless his heart though!) stands up there and rambles on for a LONG time. This class used to make me soo friggin agitated -- having to sit there, listening to him drone on. He rambles more than I do, and that's sayin a lot! I used the OBD time to study for other classes. Last year, the only thing they had to do was attend. Tihs year, they made us write a paper. But it's pretty easy, so no worries. Oh, this class is 2 hours, but it's only 1x / mo (at most).
Physiology? Bad? Define bad. It can be difficult -- cardiology will kick your a*s. It's a long and complicated topic, so they actually split it into cardio I and cardio II. I think our average for cardio II (before they gave back points for certain questions) was a 62 (71 afterwards). That is VERY low for my class. In the end, passing for that test was a 53. So phys can be tough. In the beginning, it's easy to say "I have 6 exams total for this class -- it'll be okay" -- but that's a bad habit to get into cuz it's hard to get out of. I loved physio though! (especially after cardio!). It's a great class that is much more concept and big picture oriented. Most other med school classes tend to be detail picky (I found neuro to be concept oriented, but I'm very sure a lot of people will argue with me on that one).
Worst class = OBD 🙂 ... Histology (this class surprisingly kicks a lot of people's butt -- unlike most med schools, they made us use glass slides and it was hugely lab oriented) ... BIOCHEM!
(My) favorite = physio and neuro (a lot of people love anatomy, but I found it hard to follow along -- although the peop who teach neuro taught anatomy)
<grin> Be crazy and and act the fool. hehe. People do act rather silly. The retreat is usually in the same place - Nags Head. It's almost tradition. The hotel room that I had gotten over looked the ocean -- the waves were beautiful, especially since the hotel rooms have balconies. There are a few educational things ranging from an amusing game of jeapordy involving the professors, to little classes such as learning to give massages or draw blood, or yoga. It changes every year. Actually, there are usually two retreats -- a fall one, and anothre one in the spring.
