fundamental skillset

[pgoyal]

Hey guys,

had a question for those in the last years of medical school and beyond:

Do you feel you have a tangible/fundamental skillset similar to those of engineers, programmers and mathematicians?

Or would you say most of your knowledge is mostly memorized mechanisms and pathways - and your skillset comes down to evaluating and fitting various symptoms into a diagnosis?

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[Rendar5]

Hey guys,

had a question for those in the last years of medical school and beyond:

Do you feel you have a tangible/fundamental skillset similar to those of engineers, programmers and mathematicians?

Or would you say most of your knowledge is mostly memorized mechanisms and pathways - and your skillset comes down to evaluating and fitting various symptoms into a diagnosis?

I'm not sure I get the question.

 

[pgoyal]

I'm not sure I get the question.

hmm, i guess another way to ask it would be:

how much problem solving is there in medicine in a similar fashion that you solve physics or math problems. that is utilizing what you learned from before - set of laws/equations and applying them to various scenarios

or another way to phrase the question could be:
in math/physics/programming knowing about 20% of the material will allow you to solve 80% of the problems - because everything is either built upon the previous set of knowledge (as in math & physics) or after learning basic programming - data structures/algorithms - you can pretty much learn other languages.

is it the similar case in medicine? would knowing 20% of the stuff let you solve 80% of the cases?

hope that helps.

 

[Wordead]

hmm, i guess another way to ask it would be:

how much problem solving is there in medicine in a similar fashion that you solve physics or math problems. that is utilizing what you learned from before - set of laws/equations and applying them to various scenarios

or another way to phrase the question could be:
in math/physics/programming knowing about 20% of the material will allow you to solve 80% of the problems - because everything is either built upon the previous set of knowledge (as in math & physics) or after learning basic programming - data structures/algorithms - you can pretty much learn other languages.

is it the similar case in medicine? would knowing 20% of the stuff let you solve 80% of the cases?

hope that helps.

If you can't do 20% of your cases, you are going to get boned. Also there is so much overlap in information/symptoms, you'll probably **** up a lot more than that. You don't know what you don't know and all that.

To answer the essence of your question - yes, there is application, but no not to the degree of physics, and your question is moot because knowing 20% of the stuff will not let you pass the boards.

 

[peteB]

hmm, i guess another way to ask it would be:

how much problem solving is there in medicine in a similar fashion that you solve physics or math problems. that is utilizing what you learned from before - set of laws/equations and applying them to various scenarios

or another way to phrase the question could be:
in math/physics/programming knowing about 20% of the material will allow you to solve 80% of the problems - because everything is either built upon the previous set of knowledge (as in math & physics) or after learning basic programming - data structures/algorithms - you can pretty much learn other languages.

is it the similar case in medicine? would knowing 20% of the stuff let you solve 80% of the cases?

hope that helps.

well knowing data structures and algorithms isn't really enough to solve any problem in the real world. being able to code quicksort or a B-tree from scratch is nice, but most languages already have sorting functions and data structures built in. what you really need to master as a programmer is libraries and APIs and stuff like that. knowing how to figure out the big O of an algorithm doesn't really help you when the company wants you to make an iPhone app and you don't know objective C. yes, things do build on each other, like if you know C it's easier to learn any language that uses C syntax... and if you really understand OOP you can learn a lot of languages much easier, but you still have to learn everything so 20% isn't enough to solve 80% of problems. You don't ever have a set of skills that will solve every possible problem. You have to keep learning and updating your knowledge, even more so than doctors do because the world of computing changes far more quickly. Some of it is actually just taking the problem and fitting it into code that you already have... which is kind of like what a doctor does.

 

[pgoyal]

great, thanks for the informative post peteB! from your experience are there doctors out there that are able to keep in touch with medicine & programming? perhaps use it to create products

i'm kind of stuck between two hemispheres. from my shadowing experience i see how medicine will let me fulfill myself emotionally. but programming can be a lot of fun - esp. if your able to use it to create a product.

however, intellectually it seems a lot of fun to be programming.

 

[pgoyal]

If you can't do 20% of your cases, you are going to get boned. Also there is so much overlap in information/symptoms, you'll probably **** up a lot more than that. You don't know what you don't know and all that.

To answer the essence of your question - yes, there is application, but no not to the degree of physics, and your question is moot because knowing 20% of the stuff will not let you pass the boards.

on a tangent, do you personally feel the boards are outdated & emphasize memorization? with applications like watson being built - do you believe medical education needs to change or has that already been happening - i.e. are up & coming technologies being incorporated into medical curriculum?

 

[ToldYouSo]

I imagine that someone interested in medicine & programming (like I am) could get into the bioinformatics field, electronic medical records or even pharmaceutical target simulation/modeling. Algorithms are an important aspect of both fields so I definitely see applications where you could combine both.

 

[peteB]

great, thanks for the informative post peteB! from your experience are there doctors out there that are able to keep in touch with medicine & programming? perhaps use it to create products

i'm kind of stuck between two hemispheres. from my shadowing experience i see how medicine will let me fulfill myself emotionally. but programming can be a lot of fun - esp. if your able to use it to create a product.

however, intellectually it seems a lot of fun to be programming.

Programming is really awesome, I love it. I've found it really hard to keep up with the latest stuff in the programming world while in med school, though. Back in high school and college I was always up to date with the latest developments in programming but now I'm just so far behind, it's honestly depressing. Recently I was talking to my coding buddies and they were all going on about Node JS and MongoDB and all this stuff that i've never even heard of because I've been so busy studying for med school....

I think once you finish residency and become a full fledged doctor you can definitely make some time to code and there are many doctors who have gone on to work in medical informatics and stuff, so it is definitely possible.

I do find myself day dreaming about code while i'm on the wards sometimes and wishing I'd have taken that path instead. So if your heart is really in coding, I would say do that instead.

 

[Wordead]

on a tangent, do you personally feel the boards are outdated & emphasize memorization? with applications like watson being built - do you believe medical education needs to change or has that already been happening - i.e. are up & coming technologies being incorporated into medical curriculum?

I really cant even begin to speculate.....I want to say its a long ways away from computerized medicine, if only due to the many forces opposing it - patients, docs, lawyers, even NPs/PAs would probably all fight it tooth and nail. But who knows.

And I personally dont think the boards are outdated...its usually patient comes in with this, what does he have / what causes it / how do we treat it. Seems pretty relevant to me.

 

[peteB]

I really cant even begin to speculate.....I want to say its a long ways away from computerized medicine, if only due to the many forces opposing it - patients, docs, lawyers, even NPs/PAs would probably all fight it tooth and nail. But who knows.

And I personally dont think the boards are outdated...its usually patient comes in with this, what does he have / what causes it / how do we treat it. Seems pretty relevant to me.

Well a good deal of step 1 stuff is like - what enzyme causes this - and that isn't totally relevant.

I think there is a ton of random minutia in the first two years that could be emphasized less and more time could be spent on the important stuff.

 

[Wordead]

Well a good deal of step 1 stuff is like - what enzyme causes this - and that isn't totally relevant.

I think there is a ton of random minutia in the first two years that could be emphasized less and more time could be spent on the important stuff.

Well if the enzyme is where pharmaceuticals target why isn't that relevant? I think knowing the underlying mechanism is really the only thing that separates us from the mid-levels.

 

[yuiness]

on a tangent, do you personally feel the boards are outdated & emphasize memorization? with applications like watson being built - do you believe medical education needs to change or has that already been happening - i.e. are up & coming technologies being incorporated into medical curriculum?

I think we're a long ways off from being able to use Watson to replace the amount of clinical knowledge required to become a successful physician, if only because Watson still requires the right inputs. A good history & physical is performed with a differential in mind. You come in with a number of possible diagnoses based on a chief complaint, and having that mental list allows you to ask the right questions, perform the right physical exam maneuvers, and order to the right diagnostic tests to differentiate between those possibilities. Something that my attendings have often said is that you can't diagnose something if it's not on your differential. Formulating that differential and knowing which history details/physical findings/lab or imaging results are relevant to each diagnosis requires the knowledge that you learn in medical school. While that does require a great deal of rote memorization, especially early on, I think it will be quite some time before having this kind of vast knowledge becomes irrelevant.

 

[PikminOC]

on a tangent, do you personally feel the boards are outdated & emphasize memorization? with applications like watson being built - do you believe medical education needs to change or has that already been happening - i.e. are up & coming technologies being incorporated into medical curriculum?

Oral boards for board certification are a better test of skill and how a physician uses their 'skill set' and applies it in the real world. In psychiatry, part of our oral boards is interviewing a real patient for 30 minutes and presenting/answering questions about the evaluation. This is of course after the written board has been passed.

 

[docB]

Hey guys,

had a question for those in the last years of medical school and beyond:

Do you feel you have a tangible/fundamental skillset similar to those of engineers, programmers and mathematicians?

Or would you say most of your knowledge is mostly memorized mechanisms and pathways - and your skillset comes down to evaluating and fitting various symptoms into a diagnosis?

Interesting question. I'd say that a freshly graduated doctor does have a particular knowledge base/Skill set. But it's not the same as an engineer or programmer. Either of those professionals are supposed to be ready to join the workforce after graduation as inexperienced but competent workers. A green doctor is really only expected to know enough to progress on to the next phase of learning in residency. The medical education system is no longer designed to produce competent physicians at med school graduation or even really after one post graduate year. The goal is to generate a resident who will have enough general background in medicine that they can quickly assimilate the detailed, specialty specific knowledge they learn in residency.

 

[evilbooyaa]

Well if the enzyme is where pharmaceuticals target why isn't that relevant? I think knowing the underlying mechanism is really the only thing that separates us from the mid-levels.

Agree with this. Not the only thing, but one of the things, for sure.

At the very least, if we're not memorizing it, having it come back to us faster when we look it up, which sets off a series of other thought processes regarding that piece of information.

 

[peteB]

Well if the enzyme is where pharmaceuticals target why isn't that relevant? I think knowing the underlying mechanism is really the only thing that separates us from the mid-levels.

But do you really need to understand all the fine biochemical details of that enzyme and the mechanism it is part of in order to treat patients on a day to day basis? I don't really think so. I think it is essential for research and drug development, but I don't think it's that important for most clinical practice.

I have experienced first hand doctors who remember very little if any biochemistry. They're vaguely familiar with the enzyme names but don't know a whole lot more than that, and they do their jobs fine.

 

[Wordead]

But do you really need to understand all the fine biochemical details of that enzyme and the mechanism it is part of in order to treat patients on a day to day basis? I don't really think so. I think it is essential for research and drug development, but I don't think it's that important for most clinical practice.

I have experienced first hand doctors who remember very little if any biochemistry. They're vaguely familiar with the enzyme names but don't know a whole lot more than that, and they do their jobs fine.

What about if the drug is metabolized by the p450 system and the drug reactions from that? Or comorbidities that can interfere? Are you just going to straight memorize it all?

And no, I don't think it's necessary for day-to-day, especially if youre a primary care doc. But I think a nurse/PA would be capable of handling most of that too. So aren't you obsolete then?

 

[Medstudent1968]

A human being should be able to change a diaper, plan an invasion, butcher a hog, conn a ship, design a building, write a sonnet, balance accounts, build a wall, set a bone, comfort the dying, take orders, give orders, cooperate, act alone, solve equations, analyze a new problem, pitch manure, program a computer, cook a tasty meal, fight efficiently, die gallantly.

Know those and you're set

 

[peteB]

What about if the drug is metabolized by the p450 system and the drug reactions from that? Or comorbidities that can interfere? Are you just going to straight memorize it all?

And no, I don't think it's necessary for day-to-day, especially if youre a primary care doc. But I think a nurse/PA would be capable of handling most of that too. So aren't you obsolete then?

From what I can tell most people in my class really did just straight memorize that stuff, as did I, and that was more than enough to get me through exams and step 1.

Also that kind of stuff can be easily found on various iphone apps and eprescribing software, so you don't even really have to memorize all the details of it for day to day purposes. That will only be more prevalent in the future.

I don't think I'm obsolete totally, but I definitely won't be as useful as I would have been in the past if I end up doing anything non-surgical, and especially primary care.

 

[Rendar5]

What about if the drug is metabolized by the p450 system and the drug reactions from that? Or comorbidities that can interfere? Are you just going to straight memorize it all?

Yes.

 

[Wordead]

Yes.

Seriously? You must have a great memory...I'd never be able to keep all the CIs straight if I was just memorizing things that interfere

 

[Rendar5]

Seriously? You must have a great memory...I'd never be able to keep all the CIs straight if I was just memorizing things that interfere

You end up memorizing the more clinically relevant important stuff and forgetting the less relevant stuff because of what you use everyday. Other esoterica like rare drug-drug interactions are the reason that pharmacists have a job, or they're the domain of the subspecialist, like toxicologists.

 

[yappy]

I'm honestly surprised any coding junkies make it into medical school. For what ever reason - I've found they have an aversion to actually learning anything. From the convo in this thread it also seems like they've carried that attitude inot med school and would like to water down the medical degree, learn less, and rely on an algorithm. It's an idiocracy in the making.

Or for TNG fans - Pakleds...

 

[MedicalIronman]

The daily efforts you make in practice will sear the relevant knowledge into rote knowledge. Depending on the type of practice you run the rare cases will call for research or wisely a referral.

 

[peteB]

I'm honestly surprised any coding junkies make it into medical school. For what ever reason - I've found they have an aversion to actually learning anything. From the convo in this thread it also seems like they've carried that attitude inot med school and would like to water down the medical degree, learn less, and rely on an algorithm. It's an idiocracy in the making.

Or for TNG fans - Pakleds...

That's not true at all. You need to learn a LOT to be a good coder. The best software engineers have a deep understanding of numerous programming languages, inner workings of operating systems, theory of computation, advanced mathematics, logic, sophisticated algorithms, a solid grasp of hardware electronics and so much more. The idea that coders don't learn anything is absurd. We are always learning. Technology changes so frequently that we have to constantly be studying new languages, devices, etc to keep up. It honestly changes a lot more than medicine does. And having studied both, I can tell you that the most difficult concepts in computer science are many times more difficult to wrap your head around than the most difficult topics I have encountered in medical school. For example, studying Artificial Intelligence challenged me far more than anything in 3 years of medical school has.

What we don't like to do is rote memorization. We prefer to think. We like to use our brain power to solve challenging problems instead of stuffing information in our heads that we will most likely forget, or may not even ever need. Rote memorization was useful before the age of computers and the internet. Now you can easily look up a fact if you need it. So what we think matters is how much you understand and how good you are at working through complex problems, not how many facts you can recite off the top of your head.

Your comment about an 'idiocracy in the making' is just plain ignorant. What we want is to rely on rote memorization less and use more of our time and energy sharpening our logical thinking and reasoning skills. If anything, that will make us smarter, more efficient, and more capable doctors.

I don't think you should be talking cr*p about a field and people you obviously know very little about. Programming your DVR doesn't count.

Edit: I just noticed you're "pre-health". If that's true, that's hilarious. You know literally nothing about medicine or coding, so I just wasted my time writing this post.

 

[yappy]

What? Are you kidding me. Most the coding guys at my UG get a huge pass on the actual science classes. It's basically a training program to create competent computer science or computer engineering (*I cringe at that term*) employees. All of us in other disciplines of engineering know they're not real engineers. They don't take the full maths or sciences to understand the fundamentals of engineering. So yeah - I stand by my original statements.

Maybe in the future you'll write a cool app while I'm developing a new polymer that will change the delivery system of medication. GL

That's not true at all. You need to learn a LOT to be a good coder. The best software engineers have a deep understanding of numerous programming languages, inner workings of operating systems, theory of computation, advanced mathematics, logic, sophisticated algorithms, a solid grasp of hardware electronics and so much more. The idea that coders don't learn anything is absurd. We are always learning. Technology changes so frequently that we have to constantly be studying new languages, devices, etc to keep up. It honestly changes a lot more than medicine does. And having studied both, I can tell you that the most difficult concepts in computer science are many times more difficult to wrap your head around than the most difficult topics I have encountered in medical school. For example, studying Artificial Intelligence challenged me far more than anything in 3 years of medical school has.

What we don't like to do is rote memorization. We prefer to think. We like to use our brain power to solve challenging problems instead of stuffing information in our heads that we will most likely forget, or may not even ever need. Rote memorization was useful before the age of computers and the internet. Now you can easily look up a fact if you need it. So what we think matters is how much you understand and how good you are at working through complex problems, not how many facts you can recite off the top of your head.

Your comment about an 'idiocracy in the making' is just plain ignorant. What we want is to rely on rote memorization less and use more of our time and energy sharpening our logical thinking and reasoning skills. If anything, that will make us smarter, more efficient, and more capable doctors.

I don't think you should be talking cr*p about a field and people you obviously know very little about. Programming your DVR doesn't count.

Edit: I just noticed you're "pre-health". If that's true, that's hilarious. You know literally nothing about medicine or coding, so I just wasted my time writing this post.

 

[peteB]

What? Are you kidding me. Most the coding guys at my UG get a huge pass on the actual science classes. It's basically a training program to create competent computer science or computer engineering (*I cringe at that term*) employees. All of us in other disciplines of engineering know they're not real engineers. They don't take the full maths or sciences to understand the fundamentals of engineering. So yeah - I stand by my original statements.

Maybe in the future you'll write a cool app while I'm developing a new polymer that will change the delivery system of medication. GL

I don't know what the curriculum is like at your school, but real computer science involves very heavy math and courses in the sciences as well. It's very difficult stuff, but you have no idea what it involves because you haven't taken it. Computer science doesn't involve the 'full maths'? Really? That's the most idiotic thing I've ever heard. Computer science is a branch of mathematics! Also, a CS degree is only the beginning. There's a ton more you have to learn when you're working in the industry to be competent.

You are so arrogant. Do you even have any idea how important computer software is to medical research?? I'd love to see you develop that polymer with pencil and paper. How dare you belittle coders when you are using the fruits of their hard work right now to post on this forum.

Maybe in the future you'll be spending your days as a primary care doc handing out cold medication and doing DREs while the software engineers and computer scientists you mock end up designing the software that powers the next generation of imaging technology, or discovers a cure via protein folding, or rehabilitates stroke patients, or helps more accurately diagnose conditions, or any of the numerous uses of computer technology in medical science. Just recently a computer scientist at MIT created a "cool app" that can very accurately detect early Parkinson's disease from analyzing a patient's voice. Not to mention that every single branch of engineering uses specialized computer software too. There's no engineer out there today that can do his/her job without the tools that software engineers and computer scientists have invented and built.

That is if you even get into med school in the first place, which seems unlikely with this ridiculous attitude and arrogance you have. I'm actually 3 years into med school... so yeah. I have an infinitely greater chance of contributing to medicine right now than you, a person who hasn't even gotten into a med school.

Anyway, I'm ending this because I have better things to do than argue with arrogant, idiotic premeds who think they know everything. Sooner or later you'll be put in your place.

In the meantime, if you are going to put down coders, you should get off your computer permanently and stop benefiting for our hard work.

 

[yappy]

I apologize - I just got a little heated.

I don't know what the curriculum is like at your school, but real computer science involves very heavy math and courses in the sciences as well. It's very difficult stuff, but you have no idea what it involves because you haven't taken it. Computer science doesn't involve the 'full maths'? Really? That's the most idiotic thing I've ever heard. Computer science is a branch of mathematics! Also, a CS degree is only the beginning. There's a ton more you have to learn when you're working in the industry to be competent.

You are so arrogant. Do you even have any idea how important computer software is to medical research?? I'd love to see you develop that polymer with pencil and paper. How dare you belittle coders when you are using the fruits of their hard work right now to post on this forum.

Maybe in the future you'll be spending your days as a primary care doc handing out cold medication and doing DREs while the software engineers and computer scientists you mock end up designing the software that powers the next generation of imaging technology, or discovers a cure via protein folding, or rehabilitates stroke patients, or helps more accurately diagnose conditions, or any of the numerous uses of computer technology in medical science. Just recently a computer scientist at MIT created a "cool app" that can very accurately detect early Parkinson's disease from analyzing a patient's voice. Not to mention that every single branch of engineering uses specialized computer software too. There's no engineer out there today that can do his/her job without the tools that software engineers and computer scientists have invented and built.

That is if you even get into med school in the first place, which seems unlikely with this ridiculous attitude and arrogance you have. I'm actually 3 years into med school... so yeah. I have an infinitely greater chance of contributing to medicine right now than you, a person who hasn't even gotten into a med school.

Anyway, I'm ending this because I have better things to do than argue with arrogant, idiotic premeds who think they know everything. Sooner or later you'll be put in your place.

In the meantime, if you are going to put down coders, you should get off your computer permanently and stop benefiting for our hard work.

 

[peteB]

I apologize - I just got a little heated.

Ok, apology accepted.