First two years of medical school

[RickandMortyFan]

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Hello all!

So I've been doing some research on what the first two years of medical school will be like, and I am slowly reaching an unpleasant conclusion: please feel free to correct me if I'm wrong.

Do the first two years mostly serve to prepare students for USMLE 1?

In other words, how important is the information learned as MS1-2 in one's practice as a physician?
The idea of learning for two straight years for ONE test, information half relevant to medical practice kind of bums me out. It reminds me of the MCAT (which I thought was pretty stressful), where I had to learn basic physics and O-chem reactions, which was obviously 99% irrelevant to medicine. I understand why the MCAT is the way it is: it's important for doctors to be scientifically literate and it serves as a good weeding process. But I was hoping that the hoop jumping would end after getting into medical school.

So, do you guys feel that the USMLE 1 (and 2 and 3 for that matter) are good tests that accurately measures a student's capacity to be a good physician? Or is it just another hoop to jump through, but instead of the 3 months it takes to prepare for the MCAT, it's two years?

Thanks!

 

[blackroses]

If your goal is minimal hoop-jumping, you're headed down the wrong path. Medicine is a series of endless hoops to jump - some for a good reason, some a little more arbitrary.

 

[Goro]

The first two years are not only for you to prepare for Step I, but also to get ready for the clinic.

A career in Medicine requires life-long learning. I recommend another field for you.

Hello all!

So I've been doing some research on what the first two years of medical school will be like, and I am slowly reaching an unpleasant conclusion: please feel free to correct me if I'm wrong.

Do the first two years mostly serve to prepare students for USMLE 1?

In other words, how important is the information learned as MS1-2 in one's practice as a physician?
The idea of learning for two straight years for ONE test, information half relevant to medical practice kind of bums me out. It reminds me of the MCAT (which I thought was pretty stressful), where I had to learn basic physics and O-chem reactions, which was obviously 99% irrelevant to medicine. I understand why the MCAT is the way it is: it's important for doctors to be scientifically literate and it serves as a good weeding process. But I was hoping that the hoop jumping would end after getting into medical school.

So, do you guys feel that the USMLE 1 (and 2 and 3 for that matter) are good tests that accurately measures a student's capacity to be a good physician? Or is it just another hoop to jump through, but instead of the 3 months it takes to prepare for the MCAT, it's two years?

Thanks!

 

[TaroBubbleTea]

The first two years are not only for you to prepare for Step I, but also to get ready for the clinic.

A career in Medicine requires life-long learning. I recommend another field for you.

Ouch...buuurn!!

In all seriousness, while a good chunk of the preclinical years are geared towards step 1, they also prepare you for the large volume of information you will have to learn and maintain on a regular basis.

As @blackroses has said, medicine is a series of long hoops. If someone tells you to jump, all you need to do is ask how high.

 

[Ismet]

Hello all!

So I've been doing some research on what the first two years of medical school will be like, and I am slowly reaching an unpleasant conclusion: please feel free to correct me if I'm wrong.

Do the first two years mostly serve to prepare students for USMLE 1?

In other words, how important is the information learned as MS1-2 in one's practice as a physician?
The idea of learning for two straight years for ONE test, information half relevant to medical practice kind of bums me out. It reminds me of the MCAT (which I thought was pretty stressful), where I had to learn basic physics and O-chem reactions, which was obviously 99% irrelevant to medicine. I understand why the MCAT is the way it is: it's important for doctors to be scientifically literate and it serves as a good weeding process. But I was hoping that the hoop jumping would end after getting into medical school.

So, do you guys feel that the USMLE 1 (and 2 and 3 for that matter) are good tests that accurately measures a student's capacity to be a good physician? Or is it just another hoop to jump through, but instead of the 3 months it takes to prepare for the MCAT, it's two years?

Thanks!

You need to have a scaffold of knowledge before you get to clinical years. You need to understand basic physiology and pathology before you can understand what medications to prescribe and what procedures to perform. That's the purpose of the first 2 years. Step 1 is to ensure you've reached the minimum acceptable proficiency in pre-clinical knowledge. Step 2 is to ensure you've reached the minimum acceptable proficiency in a medical student-level clinical knowledge. Step 2CS ensures that you can effectively interact with patients, document clearly, and form correct differentials and diagnostic workups. Step 3 ... Board certification exams ... CME ... It never ends. It's a career of lifelong learning and lifelong tests to make sure you are lifelong learning.

 

[tortelliniboy]

I'm an anesthesia genius so I regularly apply long gone concepts like Le chatelier, pouiselle's law, Reynolds coefficient, etc to daily practice to the horror of med students. In all seriousness I thought the first two years was useless at the time but as another use shared, I'm glad I have such a strong foundation to build my clinical knowledge on rather than purely being driven by empirical knowledge. It has also helped me become a better teacher and able to justify my decisions rather than just saying "oh someone told me this is how it's done"

 

[TBV]

First two years are fine. Need to learn the theory before you learn the practice much like most things in life. It's not bad at all and step 1 is pretty much all clinical vignettes trying to mock clinic as well as a written multiple choice test can.

 

[Glandzburg]

How can you expect to diagnose and treat a disease if you don't first understand 1) how the physiology is supposed to work in a non-diseased individual and 2) how the disease disrupts that normal physiology? As others have already stated, you first need a fundamental knowledge base before you even attempt to treat patients. Think of Step 1 as a benchmark that makes sure you have enough of the foundational book smarts and medical reasoning skills to build on during the clinical years. Kind of like how the MCAT is a benchmark that makes sure you have the ability to learn and apply concepts in the preclinical years. There is always another benchmark you need to hit.

 

[SOMBound13]

A number of students don't really *like* the first two years, but you know you have to get thru it in order to get to your goal. It's all part of of the process. And, as others mention, the process never ends.

 

[SnakeDoc9497]

There is some truth to those scenes in medical movies/TV shows when the doctor remembers some obscure fact or statistic or procedure and says "I learned it in medical school".

Although I am just now leaving the pre-med life, I can tell you from talking with med students and other faculty that years M1 and M2 are not just for USMLE Step 1. Like others have said, it is about affording you a wealth of knowledge that serves as a base layer for the knowledge you will have to accumulate week to week as a physician. And it may even serve you well in those "pinch" scenarios where no one else knows what to do. That's the whole idea behind hiring residents from across the country, by the way--different minds and different strengths.

EDIT: All that being said, be prepared to jump through some hoops

 

[Lost in Translation]

Good schools teach to the Steps. Great schools teach you how to be a doctor.

 

[Glandzburg]

And the cheesy line of year award goes to...

Good schools teach to the Steps. Great schools teach you how to be a doctor.

But really, great schools help you do well on the Steps AND teach you how to be a good doctor.

 

[Goro]

Well, in reality you learn how to be a doctor in residency.

Good schools teach to the Steps. Great schools teach you how to be a doctor.

 

[mimelim]

Well, in reality you learn how to be a doctor in residency.

I think that you learn how to practice medicine in residency. I think that you learn how to be a doctor whenever you are around good doctors. That could be as a pre-med or as a medical student or as a resident.

 

[Goro]

Now I have to quote you AND 22031 Alum!

I think that you learn how to practice medicine in residency. I think that you learn how to be a doctor whenever you are around good doctors. That could be as a pre-med or as a medical student or as a resident.

 

[Glazedonutlove]

nvm, misread post

 

[Yleio381]

I might be wrong, but it is my understanding that some people have an issue with the way the scores of Step 1 are used by residency programs, not the exam itself. The argument is that the exam was designed to test minimum proficiency and should be pass/fail, not used to compare scores. Again, I may be mistaken, but it seems to me that the frustration is not the result of the information that is tested is clinically useless. So it technically is a hoop that students need to jump through, but in the same way that passing exams in medical school and learning the material are hoops that one needs to jump through. Passing the boards and passing the courses in medical school indicates that the student has acquired the minimum foundational knowledge required for physicians.

 

[getdown]

I'm an anesthesia genius so I regularly apply long gone concepts like Le chatelier, pouiselle's law, Reynolds coefficient, etc to daily practice to the horror of med students. In all seriousness I thought the first two years was useless at the time but as another use shared, I'm glad I have such a strong foundation to build my clinical knowledge on rather than purely being driven by empirical knowledge. It has also helped me become a better teacher and able to justify my decisions rather than just saying "oh someone told me this is how it's done"

Me too. I can't stress enough how much physiology and pharmacology are so evident in the practice of anesthesia. If you don't have the foundation knowledge you'd be completely lost and are no better than CRNAs who only know what to do in certain scenarios but never the why. And without the why you can never tailor your anesthesia to different patients which can prove disastrous in the sick ones. It's amazing how first year med students pooh pooh phsyiology when it's basically what they'll be doing for the rest of their careers.

I might be wrong, but it is my understanding that some people have an issue with the way the scores of Step 1 are used by residency programs, not the exam itself. The argument is that the exam was designed to test minimum proficiency and should be pass/fail, not used to compare scores. Again, I may be mistaken, but it seems to me that the frustration is not the result of the information that is tested is clinically useless. So it technically is a hoop that students need to jump through, but in the same way that passing exams in medical school and learning the material are hoops that one needs to jump through. Passing the boards and passing the courses in medical school indicates that the student has acquired the minimum foundational knowledge required for physicians.

Unfortunately, just like every other test it's used to weed out applicants with the justification that if they do well on STEP1 they'll pass the boards and that's what residency programs want ... people who will pass the board and make them look good. But it is how the game is played so try not to screw it up.

 

[Hangry]

I studied hard and learned as much as I could the first 2 years, and did very well both in classes and on step 1. I figured I had wrung everything I could from the first two years of medical school. Then third year started, and my only regret was not learning more the first two years. They truly are the foundation for EVERYTHING that comes after. Viewing it as a hoop to jump through will only hurt yourself in the future.

I don't have a day that goes by where I didn't wish I had retained some concept from the first two years better so I would have a better idea of how to diagnose/treat one of our patients. And trying to learn about a disease for the first time in third year is overwhelming because you are so busy taking in all the "intangibles" of how to function in a hospital- integrating in with your team and being a helpful member, learning to preround, round, present patients, write notes, function in the OR, deliver a baby, change wound dressings, take a thorough H&P, call a consult, see a consult, answer questions from patients and family, perform an accurate physical exam, seeing how diseases present in real life, interpret lab values, interpret imaging studies, apply evidence based guidelines...I could go on and on. Learning the physiology of the body and pathophysiology of disease is a full-time job for two years of medical school. Adding it on to everything else you are learning third and fourth year would be completely impossible. When you're a third year and a disease comes up that you've never heard of before and you're trying to cram the description, pathophys, diagnosis, differential, and treatment plan based on disease severity in the 5-10 minutes before you have some other task to take care of this will become abundantly clear to you.

Now I can only speak to how well years 1&2 prepare you for years 3&4, because that's all I've experienced so far. However, years 3 and 4 prepare your for PGY1 and PGY2, and so on and so forth. It all builds on top of each other. I imagine that most physicians that crap on the first two years of medical school don't realize just how much they use that knowledge because it has become so integrated in their minds that they just view it as second nature.

 

[Ad2b]

I'm surprised that no one picked up on the phrase that medicine has 99% nothing to do with physics or orgo.

Everything in the body is either physics or orgo just in a different fashion. True, no doctor that I know can rattle off the Strecker synthesis and frankly, I'd run if they could. But they do know the end result of all that crap we learned. Orgo and physics are not just weeder classes as some like to think.

And, edited, come to think of it: if I wanted to get very technical, everything in the body is related to physics. Everything.

 

[Cinclus]

I'm surprised that no one picked up on the phrase that medicine has 99% nothing to do with physics or orgo.

Everything in the body is either physics or orgo just in a different fashion. True, no doctor that I know can rattle off the Strecker synthesis and frankly, I'd run if they could. But they do know the end result of all that crap we learned. Orgo and physics are not just weeder classes as some like to think.

And, edited, come to think of it: if I wanted to get very technical, everything in the body is related to physics. Everything.

My rudimentary, vague understanding of physics got me through 3.5 years of med school. And I don't remember much of anything re: Orgo. I remember more biochem.

 

[NotYou20]

I'm surprised that no one picked up on the phrase that medicine has 99% nothing to do with physics or orgo.

Everything in the body is either physics or orgo just in a different fashion. True, no doctor that I know can rattle off the Strecker synthesis and frankly, I'd run if they could. But they do know the end result of all that crap we learned. Orgo and physics are not just weeder classes as some like to think.

And, edited, come to think of it: if I wanted to get very technical, everything in the body is related to physics. Everything.

Everything in the body is also related to quantum mechanics. Can we make that a prereq too?

Snark aside, I agree that having a foundation in ochem and physics is important

 

[Shams al Deen]

A career in Medicine requires life-long learning. I recommend another field for you.

Yeah the whole life-long learning thing is legit, I thought it was just a cliché but no.

Couple days ago I was on a red-eye flight back to med school from thanksgiving break. I happened to be sitting next to a 3rd year resident. The ENTIRE flight he was studying a radiology text on his iPad. AND he had to be in the hospital 4 hours after the flight. Like damn. I thought the textbook reading ended after 2nd year. But it never stops--you just actually start working in addition to the reading. Was eye-opening for me.

I was playing iPhone nba jam the entire flight, and didn't have mandatory class for the next 3 days. First year is awesome!

 

[SOMBound13]

Yeah the whole life-long learning thing is legit, I thought it was just a cliché but no.

Couple days ago I was on a red-eye flight back to med school from thanksgiving break. I happened to be sitting next to a 3rd year resident. The ENTIRE flight he was studying a radiology text on his iPad. AND he had to be in the hospital 4 hours after the flight. Like damn. I thought the textbook reading ended after 2nd year. But it never stops--you just actually start working in addition to the reading. Was eye-opening for me.

I was playing iPhone nba jam the entire flight, and didn't have mandatory class for the next 3 days. First year is awesome!

yeah, well think about it....who wants to be treated by someone who hasn't stayed up on the latest and greatest?

 

[Med Ed]

Do the first two years mostly serve to prepare students for USMLE 1?

Perhaps if you are at a Caribbean school. Domestic institutions are much more concerned with your overall development across multiple domains, culminating not on the days you take the steps, but on the day you graduate and begin transitioning toward independent practice.

In other words, how important is the information learned as MS1-2 in one's practice as a physician? The idea of learning for two straight years for ONE test, information half relevant to medical practice kind of bums me out. It reminds me of the MCAT (which I thought was pretty stressful), where I had to learn basic physics and O-chem reactions, which was obviously 99% irrelevant to medicine.

This notion represents a fundamental misunderstanding of learning and memory that I see frequently in this forum. We are not computers where input data is either saved or not saved. We are more like sponges that continuously absorb information and synthesize it into new forms. Hence, even if your ability to easily recall isolated facts/concepts from physics and organic chemistry fades, you have still internalized and assimilated a lot of information necessary to progress in other disciplines, such as pharmacology and electrophysiology. Whether you appreciate it now or not, pretty much everything in medicine, even the complicated stuff, can be broken down into simple principles that are first encountered in introductory courses.

 

[Ad2b]

Everything in the body is also related to quantum mechanics. Can we make that a prereq too?

Wow. Quantum mechanics is physics and you need to understand the basics of the latter before undertaking the former. Your premise is faulty as is your bedside manner.

 

[Ad2b]

My rudimentary, vague understanding of physics got me through 3.5 years of med school. And I don't remember much of anything re: Orgo. I remember more biochem.

Huh... so the pumping of the fluids from physics didn't help you? or knowing what hydroxyl groups are from orgo? hmmm. everything I learned in biochem HAD to have a pretty solid foundation in orgo... not specific synthesis mind you but overall what is what... like ketones for diabetes, or rings for amino acids and deprotonating them; come to think of it, orgo helped me in genetics too.

 

[CliveStaples]

I hated the first two years and griped about how a lot of what I was taught was unnecessary.

Now I would be completely lost as a third year student if I hadn't built the foundation in the first two years.

 

[Cinclus]

Huh... so the pumping of the fluids from physics didn't help you? or knowing what hydroxyl groups are from orgo? hmmm. everything I learned in biochem HAD to have a pretty solid foundation in orgo... not specific synthesis mind you but overall what is what... like ketones for diabetes, or rings for amino acids and deprotonating them; come to think of it, orgo helped me in genetics too.

That is part of my rudimentary physics knowledge, along with understanding what radiation is, etc, etc. As for all that electromagnetism and tons of equations....nope. Useless to my daily functioning (I am not going into a field where I really have to think about magnets; I understand that radiologists may want to know more - I just need to know enough that I don't want to send a patient into an MRI with a metal lawn chair). I never found orgo to be that essential for understanding biochem. I remember saying something about orgo to my biochem professor back in undergrad (ahhh, summer 2008), and she said something about not really remembering any organic chemistry.

But regardless of what anybody thinks a 4th year med student should know about these subjects, this MS4 remembers very little when it comes to the details. Did just fine.

 

[vantheman]

The first two years are not only for you to prepare for Step I, but also to get ready for the clinic.

A career in Medicine requires life-long learning. I recommend another field for you.

I think that was a bit harsh. Why would you say such a thing based off 1 post? I respect this individual because he/she is actually taking initiative to explore what medicine is going to be like and is really questioning if they are interested in the not-so-sexy parts of medicine. Would you rather have this pre-med individual fulfill the stereotype where he/she is "highly interested and passionate about medicine" but knows nothing about it and the lifestyle that comes along with it?


@Richandmortfan, Keep doing your research and keep questioning your motivation for going into medicine. This is healthy! I did this as well around 2 years back and there were times where I was not confident medicine was for me. But I kept searching and exposing myself to the field and have come to the conclusion that a career in medicine is what I want. Oh and don't take anything anyone says on here too seriously. Just because you have your doubts, doesn't mean you aren't going to be able to figure them out or become a successful doctor some day.

 

[Goro]

This level of superficiality and/or ignorance disturbs me, van.

The idea of learning for two straight years for ONE test, information half relevant to medical practice kind of bums me out. It reminds me of the MCAT (which I thought was pretty stressful), where I had to learn basic physics and O-chem reactions, which was obviously 99% irrelevant to medicine. I understand why the MCAT is the way it is: it's important for doctors to be scientifically literate and it serves as a good weeding process. But I was hoping that the hoop jumping would end after getting into medical school.

I think that was a bit harsh. Why would you say such a thing based off 1 post? I respect this individual because he/she is actually taking initiative to explore what medicine is going to be like and is really questioning if they are interested in the not-so-sexy parts of medicine. Would you rather have this pre-med individual fulfill the stereotype where he/she is "highly interested and passionate about medicine" but knows nothing about it and the lifestyle that comes along with it?

 

[NotYou20]

Wow. Quantum mechanics is physics and you need to understand the basics of the latter before undertaking the former. Your premise is faulty as is your bedside manner.

Lol, no. Quantum is not physics 1&2, though it seems you forgot that's what you were talking about.

I'd be embarrassed to infer anything about one's bedside manner based on that post.

 

[Ismet]

Like damn. I thought the textbook reading ended after 2nd year

Good thing you realized this earlier rather than later. In my experience, the only thing that ends after 2nd year is the spoon feeding. We were given lecture notes for our pre-clinical courses and if we knew what was in lecture, we would do well on the exam. 3rd year and beyond gets progressively more self directed learning, and it's on you and your own initiative to learn what you're expected to learn. There's always more to read and more to learn.

 

[moisne]

How can you expect to diagnose and treat a disease if you don't first understand 1) how the physiology is supposed to work in a non-diseased individual and 2) how the disease disrupts that normal physiology? As others have already stated, you first need a fundamental knowledge base before you even attempt to treat patients.

Damn, you mean, watching HOUSE MD isn't enough to teach me about being a good doctor? Ugh!

 

[Ad2b]

Lol, no. Quantum is not physics 1&2, though it seems you forgot that's what you were talking about.

I'd be embarrassed to infer anything about one's bedside manner based on that post.

Since you seem to want to argue, let's go 😉

First, I did not say quantum = physics 1 & 2, I said it was required you HAVE them before taking quantum. Here's a link to help you with evidence of that. https://www.physicsforums.com/threads/prerequisites-of-quantum-mechanics.486773/

Second, his comment to me was rude, unnecessary and a bit obtuse. THAT is why I said I hope his bedside manner is better with patients because you really only get 1 chance in life to make a good impression and especially, in medicine.

I'm a firm believer in that how people operate and treat each other online, behind the anonymity of a pixelated screen = how they treat people in life. (and yes, I am very, very kind in real life ... to a point but I do have a backbone)

 

[NotYou20]

Since you seem to want to argue, let's go 😉

First, I did not say quantum = physics 1 & 2, I said it was required you HAVE them before taking quantum. Here's a link to help you with evidence of that. https://www.physicsforums.com/threads/prerequisites-of-quantum-mechanics.486773/

Second, his comment to me was rude, unnecessary and a bit obtuse. THAT is why I said I hope his bedside manner is better with patients because you really only get 1 chance in life to make a good impression and especially, in medicine.

I'm a firm believer in that how people operate and treat each other online, behind the anonymity of a pixelated screen = how they treat people in life. (and yes, I am very, very kind in real life ... to a point but I do have a backbone)

I've taken quantum, but thanks for the forum post explaining that physics is a prereq. The comment I responded to was you saying physics is important because it's related to everything in the body in some way. This is also true of quantum mechanics, which is not mutually exclusive with physics in general (obviously).

I made a tongue in cheek comment that you misinterpreted and got worked up about. Your backbone is protruding, might want to fix that.

You can have the last word