MD & DO Goro’s guide to success in medical school (2017 ed.)

[Goro]

That's why Goro and many of us just don't buy the arguments. You're lucky in your medical school. Suck it up or be a nurse

I agree that being in medical school is a privilege, and I very, very much appreciate the supportive words cellsaver, but I also think that adult learners paying a mortgage for their education should be treated better than recruits in boot camp.

This is why I am appalled that there are med schools that require lecture attendance, and that there are faculty who treat teaching as this chore to get to so they can get back to their labs, or who teach their research and not what you need to know, or as mentioned above, merely teach by saying "read Chapters 10-30 of Harrisons (it's one thing to be a good self-learner..this is a very important thing, but we Faculty are paid to get you to a goal, and this is not done by merely pointing to the horizon and saying "start running"). We should never force learning, but rather, guide it.

Lastly, I despise those faculty who teach over your heads, as if you're residents!

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[IslandStyle808]

The hell hath no fury quote is rather sexist so be careful with it. The quote is

Heav'n has no Rage, like Love to Hatred turn'd,
Nor Hell a Fury, like a Woman scorn'd.
William Congreve in the Mourning Bride, 1697 ​

But I get your point. As I have stated elsewhere, learning medicine is on the students. Medical school was never about spoon feeding students the content. If anything the medical students have it far easier today compared to 30 years ago. Back then textbooks were all they had, printed in black and white, no graphics, no ebooks, libraries poorly lit, no computers at home to surf google, and they drank coffee by the pot full to make it through their training. Today with Adderall, computers, lectures available in powerpoint via download, zillions of review books, all acquired illegally via download on torrent sites, and so many more resources, the complaining is pretty pathetic.

WE have it far easier today in medical school in America compared to the training our parents physicians experienced. the instructors were up tight, impatient, demanding and many were abusive.

If students feel like their time is being wasted, then they should drop out of school, unplug from reddit, FB, Twitter, etc or embrace the fact that our profession is an obscene one full of sacrifice and thankless loads of work. No one put a gun to their heads to pursue an MD Degree. If they don't want to do the work, thousands of other applicants would love to have their seat.

That's why Goro and many of us just don't buy the arguments. You're lucky in your medical school. Suck it up or be a nurse

As one medical student once told me, we have to learn 600 drugs off the top of our heads while back in the day they had to learn 60. Another physician told me, medical students back in the day craved more information while today we are on information overload.

Yes, we have easier in terms of technology. However, because we have it easier we have more to remember! We are worked just as hard as our ancestors in medical school (residency is a different story).

We should be striving to make ways to help us gather information better and be better doctors. If you don't do something about the system, it never changes and we never move forward. It may seem like bitching and whining, but because of like minded people who think "there has to be a better way" we have firecracker and even sketchy. Scores have gone up in comparison to our predecessors. So if books are the one true way, then why are we doing better than them when they had those same books? Because we push to have better resources (ex. USMLErx and Uworld) that we are doing better on standardized tests. If I had to choose between reading a textbook and doing Uworld (one or the other) only I would choose Uworld everytime. It doesn't replace the book, but I bet you it gives greater yields if I had to choose between the two during dedicated.

 

[cellsaver]

....there are faculty who treat teaching as this chore to get to so they can get back to their labs, or who teach their research and not what you need to know, or as mentioned above, merely teach by saying "read Chapters 10 but we Faculty are paid to get you to a goal, and this is not done by merely pointing to the horizon and saying "start running"). We should never force learning, but rather, guide it.
Lastly, I despise those faculty who teach over your heads, as if you're residents!

In a class of 200+ students I have seen some students who earned 260+ on Step 1 and pursued medicine because of their own personal bout with medicial illnesses, and they devoured everything in sight. These were awe inspiring, humble, driven students who wanted fo spare patients the ordeal they suffered with a medical illness. Then there is the other extreme where some were allergic to Katzung, found Robbin and Cotran big book, pocket book, brief book "too hard to understand" while others relied on Kaplan videos, BRS and FA from day 1, in the comfort of their home blowing off lectures their first two years. Their Step 1 Scores? They were tight lipped and only would reveal they had decided psychiatry as their profession. Of course they had. Their score forced them into a specialty they had to accept.

An earlier thread was based on the theme of what we would do if we could change the medical school curriculum. My answer: dismiss students who shun the work and demonstrate no fire. For every dismissed student there would be hundreds of rejected who would jump at the offer.

Medical school is an honor.

Back in my day, we literally rubbed dirt in all our wounds! Sure, half of us died of infection, but we died knowing the glory of sacrifice! and commitment!

Leeches were more effective. Built character and taught you principles of metabolic acidosis. You dont know sacrifice and commitment till you have blood suckers attached to you 24/7 while still looking beautiful

 

[IsWhat]

These discussions always remind me of a Steve Jobs quote:

"When you grow up you tend to get told that the world is the way it is and your life is just to live your life inside the world. Try not to bash into the walls too much. Try to have a nice family life, have fun, save a little money.

That's a very limited life.

Life can be much broader once you discover one simple fact: Everything around you that you call life was made up by people that were no smarter than you. And you can change it, you can influence it… Once you learn that, you'll never be the same again."

Modern medicine has many complex issues that will require our researchers and practitioners to be more creative than past decades and centuries. We lose a lot of brilliant and creative minds to other fields due to medicines often inaccessible teaching structure starting in grade school and continuing through undergrad and graduate school. Telling students to just read a book is a regressive style of learning for many folks - it's that simple. Sure, this style of learning works for some people, but medicine innovates at a snails pace in many regards and I don't think that is a coincidence.

Personally I'd like to see full curriculums built around visual learning like sketchy/picmonic. I also wouldn't mind nationalizing medical education - give every student the same material/lectures with on-campus faculty for extra support. I hope there will be a day where we won't need 1,000 different biochemistry professors teaching 50,000 different medical students.

One can dream.

 

[Soccer171983]

@Goro ....has a lot of good points and his post is a good start for the imminent med student population who are about to poo themselves. If nothing else it helps them formulate a game plan. Some classes I recall the level of detail in the lecture was so extensive that I didnt need much from a text book (medical micro) but there were others where I had to rely on the text book to figure out what the heck was being taught (physiology year 1). I think he was pointing out a key fact....memorization only gets you so far and understanding does so much more whether it be reading the text book cover to cover or using it as a supplement to class material if the lectures are very strong. Asking students who have done well at a respective school is also a wise option along with bugging upper classmen if they are willing to spend the time. Not all students are the same and not all teachers are the same (Johari's window about teaching). Anyway, props to @Goro for taking a stab and helping lead the blind all while knowing the criticism will come. I think there was a saying about important/interesting people not being universally liked..... Well thats my 10 minute study break wasted

 

[Goro]

Personally I'd like to see full curriculums built around visual learning like sketchy/picmonic. I also wouldn't mind nationalizing medical education - give every student the same material/lectures with on-campus faculty for extra support. I hope there will be a day where we won't need 1,000 different biochemistry professors teaching 50,000 different medical students.

One can dream.

An interesting idea, but not one that is likely to succeed for the same reasons that two different clinicians will treat the same condition in two different ways. Different faculty have different ideas as what's important to know. My two Micro colleagues are in perfect sync, but my Anatomy colleagues can be at each other's throats at time!

Then layer onto that we have different learning styles among students!

 

[mehc012]

These discussions always remind me of a Steve Jobs quote:

"When you grow up you tend to get told that the world is the way it is and your life is just to live your life inside the world. Try not to bash into the walls too much. Try to have a nice family life, have fun, save a little money.

That's a very limited life.

Life can be much broader once you discover one simple fact: Everything around you that you call life was made up by people that were no smarter than you. And you can change it, you can influence it… Once you learn that, you'll never be the same again."

Modern medicine has many complex issues that will require our researchers and practitioners to be more creative than past decades and centuries. We lose a lot of brilliant and creative minds to other fields due to medicines often inaccessible teaching structure starting in grade school and continuing through undergrad and graduate school. Telling students to just read a book is a regressive style of learning for many folks - it's that simple. Sure, this style of learning works for some people, but medicine innovates at a snails pace in many regards and I don't think that is a coincidence.

Personally I'd like to see full curriculums built around visual learning like sketchy/picmonic. I also wouldn't mind nationalizing medical education - give every student the same material/lectures with on-campus faculty for extra support. I hope there will be a day where we won't need 1,000 different biochemistry professors teaching 50,000 different medical students.

One can dream.

I hope they don't take both of your suggestions. I personally cannot stand resources like sketchy or picmonic. They make no sense to me and are extra things to memorize instead of making it easier. Fine if there's a med school out there doing it, but if that were the only way? I'd be skipping pretty much everything and going back to my much-simpler textbook method.

 

[JustPlainBill]

I agree that being in medical school is a privilege, and I very, very much appreciate the supportive words cellsaver, but I also think that adult learners paying a mortgage for their education should be treated better than recruits in boot camp.

This is why I am appalled that there are med schools that require lecture attendance, and that there are faculty who treat teaching as this chore to get to so they can get back to their labs, or who teach their research and not what you need to know, or as mentioned above, merely teach by saying "read Chapters 10-30 of Harrisons (it's one thing to be a good self-learner..this is a very important thing, but we Faculty are paid to get you to a goal, and this is not done by merely pointing to the horizon and saying "start running"). We should never force learning, but rather, guide it.

Lastly, I despise those faculty who teach over your heads, as if you're residents!

@Goro Were you hanging around TCOM in the mid to late 2000's? This sounds strangely familiar ---

 

[cellsaver]

I personally cannot stand resources like sketchy or picmonic. They make no sense to me and are extra things to memorize instead of making it easier.

The videos of shepherds walking in the Egyptian desert with camels, associations with Staph aureus, birds in cages, animals at the zoo, Salmon fish on a plate... they were over the top. My husband saw them on youtube and he won't let it go. "best of the best, huh?" Louis Pasteur had it right:

 

[cellsaver]

I agree that being in medical school is a privilege, and I very, very much appreciate the supportive words cellsaver, but I also think that adult learners paying a mortgage for their education should be treated better than recruits in boot camp.

cultural paradigm shifts, Goro. Adult learners is not today what it was a couple of decades ago. Behaviors we see on university campuses today are akin to junior high school behavior years ago. I look at old black and white photos of medical students hanging in our academic building hallways or bookcases, dressed formally, body language showed humility, deference towards faculty....fast forward to today. Shall we discuss the hard work you have exhibited to teach others on these forums and the responses therein?

Don't get me started.

Lastly, I despise those faculty who teach over your heads, as if you're residents!

Yup. That's what office hours are for and yes, textbooks.

Others might be surprised how many students will help each other when they are confused, need help or are drowning. There are some really bright spots in medical education. For those negative ones, cest la vie. I have relatives in Venezuela and we haven't heard from them. We've got it really good in America. I wish people who complained could be transported to Venezuela or Mexico for a week. They'd change their tunes really quick

 

[T800'sThumb]

cultural paradigm shifts, Goro. Adult learners is not today what it was a couple of decades ago. Behaviors we see on university campuses today are akin to junior high school behavior years ago. I look at old black and white photos of medical students hanging in our academic building hallways or bookcases, dressed formally, body language showed humility, deference towards faculty....fast forward to today. Shall we discuss the hard work you have exhibited to teach others on these forums and the responses therein?

Don't get me started.



Yup. That's what office hours are for and yes, textbooks.

Others might be surprised how many students will help each other when they are confused, need help or are drowning. There are some really bright spots in medical education. For those negative ones, cest la vie. I have relatives in Venezuela and we haven't heard from them. We've got it really good in America. I wish people who complained could be transported to Venezuela or Mexico for a week. They'd change their tunes really quick

You sound like the sort of person someone helpful acknowledges exists but is thankfully a minority.

 

[IsWhat]

An interesting idea, but not one that is likely to succeed for the same reasons that two different clinicians will treat the same condition in two different ways. Different faculty have different ideas as what's important to know. My two Micro colleagues are in perfect sync, but my Anatomy colleagues can be at each other's throats at time!

Then layer onto that we have different learning styles among students!

This is exactly why standardizing the pre-clinical years would be so beneficial. We would still have variation in the way physicians treat patients, since there is no way to completely standardize the clinical years and/or residency.

We could also have different "tracts" in the curriculum - like fully developed visual learning curriculums - to accomodate the students who prefer a more innovative approach to learning. I would like to see these types of learning approaches starting in grade school. Again, we lose a lot of innovative and brilliant minds to other fields, because the way science and medicine is taught doesn't jive with a lot of people.

Now I'm just rambling, but my point is we can't keep doing the same things we did back in 1920 and expect to innovate. Just last week Facebook had to turn off their AI which developed a new language we couldn't speak, and yet some hospitals and clinics still use paper charting.

 

[IslandStyle808]

cultural paradigm shifts, Goro. Adult learners is not today what it was a couple of decades ago. Behaviors we see on university campuses today are akin to junior high school behavior years ago. I look at old black and white photos of medical students hanging in our academic building hallways or bookcases, dressed formally, body language showed humility, deference towards faculty....fast forward to today. Shall we discuss the hard work you have exhibited to teach others on these forums and the responses therein?

Don't get me started.

Yup. That's what office hours are for and yes, textbooks.

Others might be surprised how many students will help each other when they are confused, need help or are drowning. There are some really bright spots in medical education. For those negative ones, cest la vie. I have relatives in Venezuela and we haven't heard from them. We've got it really good in America. I wish people who complained could be transported to Venezuela or Mexico for a week. They'd change their tunes really quick

My mom had a few stories of my dad during his residency years, that were at the level of junior high school level behavior. Yet, he somehow turned out to be a fine doctor (LOL). I have read books of several doctors during their residency years where they would strap unsuspecting surgery residents to the gurneys they were sleeping on and the likes. Hate to break it to you, but doctors back in the day were just as immature and braty as the doctors today. Unfortunately those images of student doctors in their suits are pretty much illusions that can't be uncovered by facebooks, instagram, and the likes that we see today. They probably got away with a lot more than we can today, so they can go on and on about morals without the fear of their "bad boy" days being exposed.

While, I understand the plight of those living in Venezuela and Mexico, because I have given more than enough of my pocket change to the poor children in India, but that is going a bit over board. There are people who riot on streets of Turkey and Egypt due to lost opportunities created by those in power. However, while our struggles are no where near as bad as those in those countries, we should still strive to be that 'squeaky wheel' to promote better change here as well. If you don't see the flaws in society no matter how small and change them, then greater progress cannot be made. We are what we are today because we complained about the things that our ancestors considered to be trivial.

 

[IsWhat]

The videos of shepherds walking in the Egyptian desert with camels, associations with Staph aureus, birds in cages, animals at the zoo, Salmon fish on a plate... they were over the top. My husband saw them on youtube and he won't let it go. "best of the best, huh?" Louis Pasteur had it right:


View attachment 222316

Your inability to look beyond what works for you is, unfortunately, all too common in medicine. People with your line of thinking will be a major impediment to medical innovation (including education) in the years to come.

As a side note - you should watch the movie Midnight in Paris. It might speak to you.

 

[mehc012]

This is exactly why standardizing the pre-clinical years would be so beneficial. We would still have variation in the way physicians treat patients, since there is no way to completely standardize the clinical years and/or residency.

We could also have different "tracts" in the curriculum - like fully developed visual learning curriculums - to accomodate the students who prefer a more innovative approach to learning. I would like to see these types of learning approaches starting in grade school. Again, we lose a lot of innovative and brilliant minds to other fields, because the way science and medicine is taught doesn't jive with a lot of people.

Now I'm just rambling, but my point is we can't keep doing the same things we did back in 1920 and expect to innovate. Just last week Facebook had to turn off their AI which developed a new language we couldn't speak, and yet some hospitals and clinics still use paper charting.

But those resources do exist! Who cares what they use in lecture; half of med students don't go to lecture anyway! The beauty here is that you are welcome to use visual resources such as Sketchy and Picmonic while I stick to my text-based resources like Ross and Pawlina. I'm free to go to lecture, where engaging with the material and asking the lecturer questions along the way keeps me focused and learning, and you are free to watch at 2x at home. We have different tracks and flexibility; you just have to find them. If you're not willing to seek out the resources that work best for you, you really shouldn't be in med school no matter how 'innovative' you are (and side note, but being a visual learner ≠ being innovative, and innovative ≠ 'better' just different). Goro shortened that to 'buy the textbooks' here, but the real point is 'it is worth spending the time and money to get the resources you need in order to actually learn concepts before you focus solely on review resources' and that advice applies to ALL med students.

However, don't conflate an innovative review resource for a learning resource. A picture of a crone with a whatever may help information stick, but at some point you still have to learn the actual useful information regardless of how you code it for retrieval in your head. I guess a better analogue for visual learning resources vs text would be videos like Khan or whatnot. I'd read a textbook anyday over watching those; they put me to sleep and don't have enough detail for me to really get it...but my friends swear by them. And then I use Anki or Firecracker to keep it in my head, and they prefer Sketchy or Picmonic. To each their own; but it's already available.

 

[IsWhat]

But those resources do exist! Who cares what they use in lecture; half of med students don't go to lecture anyway! The beauty here is that you are welcome to use visual resources such as Sketchy and Picmonic while I stick to my text-based resources like Ross and Pawlina. I'm free to go to lecture, where engaging with the material and asking the lecturer questions along the way keeps me focused and learning, and you are free to watch at 2x at home. We have different tracks and flexibility; you just have to find them. If you're not willing to seek out the resources that work best for you, you really shouldn't be in med school no matter how 'innovative' you are (and side note, but being a visual learner ≠ being innovative, and innovative ≠ 'better' just different). Goro shortened that to 'buy the textbooks' here, but the real point is 'it is worth spending the time and money to get the resources you need in order to actually learn concepts before you focus solely on review resources' and that advice applies to ALL med students.

However, don't conflate an innovative review resource for a learning resource. A picture of a crone with a whatever may help information stick, but at some point you still have to learn the actual useful information regardless of how you code it for retrieval in your head. I guess a better analogue for visual learning resources vs text would be videos like Khan or whatnot. I'd read a textbook anyday over watching those; they put me to sleep and don't have enough detail for me to really get it...but my friends swear by them. And then I use Anki or Firecracker to keep it in my head, and they prefer Sketchy or Picmonic. To each their own; but it's already available.

See, that's the point - sketchy and picmonic are REVIEW resources (for the most part). I would like to see these types of learning tools expanded to the point where they are no longer review, but full blown learning resources. This really isn't a hard concept to understand.

Also, visual learning resources are rarely available to students in Americas public school system. Medical students shouldn't be the ones seeing these types of resources for the first time. You also greatly exaggerate just how many visual learning resources there actually are.

Medical school is skewed towards people who enjoy opening a textbook and digging in - this isn't really debatable. I'd like to see that changed.

 

[mehc012]

See, that's the point - sketchy and picmonic are REVIEW resources (for the most part). I would like to see these types of learning tools expanded to the point where they are no longer review, but full blown learning resources. This really isn't a hard concept to understand.

Also, visual learning resources are rarely available to students in Americas public school system. Medical students shouldn't be the ones seeing these types of resources for the first time. You also greatly exaggerate just how many visual learning resources there actually are.

Medical school is skewed towards people who enjoy opening a textbook and digging in - this isn't really debatable. I'd like to see that changed.

It's not a hard concept to understand...which is why I was the one who brought up the difference and provided examples of resources that were geared towards visual learners and actual learning. They exist, they're just not as powerful as textbooks...and I'm not sure that's due to lack of effort, but simply the fact that those learning schemes are way less efficient than texts are. They're out there, but despite that, not a single one of them comes close to providing as much information as even a concise textbook. Those sorts of resources exist to supplement texts by explaining the more difficult concepts for those who find that helpful.

So yes, medical school is skewed towards people who, if not enjoy, are at least capable of parsing through text to learn. So is pretty much every other field out there. The only difference is the quantity of information being taught. And until medical literature starts being published in video or picmonic format, should we not prefer that our graduating physicians demonstrate the ability to learn, at least to some extent, from texts and figures?

 

[IsWhat]

They exist, they're just not as powerful as textbooks...and I'm not sure that's due to lack of effort, but simply the fact that those learning schemes are way less efficient than texts are.

And you know this to be a fact, how? Because, it has always been this way?

And until medical literature starts being published in video or picmonic format, should we not prefer that our graduating physicians demonstrate the ability to learn, at least to some extent, from texts and figures?

You are describing basic reading comprehension - something we all learn early in our education - which is very different from actual learning.

 

[mehc012]

And you know this to be a fact, how? Because, it has always been this way?

You are describing basic reading comprehension - something we all learn early in our education - which is very different from actual learning.

Sorry, my bad. The forms of visual learning tools that have thus far been developed and implemented pretty much anywhere are less efficient than text learning...yes because it has always been this way. I forgot to include all of the magic pill visual learning tools that don't exist yet but which I'm sure will spring forth into being as soon as you convince someone to look into them, because that gap exists solely because nobody but you has ever thought of trying different approaches to educational materials.

And no, I'm not describing basic reading comprehension, I'm describing the process of critically reading, evaluating, and yes learning from primary literature. This is not only neither 'basic' nor learned early in our education system...it's not even something that most people are able to do comfortably with any degree of success.

 

[IslandStyle808]

And until medical literature starts being published in video or picmonic format, should we not prefer that our graduating physicians demonstrate the ability to learn, at least to some extent, from texts and figures?

On a side note, I'd rather they know how to analyze a journal article than be able crack opening a text book alone. If textbooks are the only way doctors can 'keep up' with the times, then they will always be behind.

 

[IsWhat]

Sorry, my bad. The forms of visual learning tools that have thus far been developed and implemented pretty much anywhere are less efficient than text learning...yes because it has always been this way. I forgot to include all of the magic pill visual learning tools that don't exist yet but which I'm sure will spring forth into being as soon as you convince someone to look into them, because that gap exists solely because nobody but you has ever thought of trying different approaches to educational materials.

Oh, you are mistaken if you think I'm the only one looking into these changes in education. People far smarter than I are already on it - take a look at some of Sweden's and/or Denmark's grade schools. It's pretty innovative stuff, and their students out perform ours (by a considerable margin) in almost every measurable way. I just want more of this to make its way into advanced education, like medical school. It will, no doubt, but it will take time.

And no, I'm not describing basic reading comprehension, I'm describing the process of critically reading, evaluating, and yes learning from primary literature. This is not only neither 'basic' nor learned early in our education system...it's not even something that most people are able to do comfortably with any degree of success.

A decent biostats and epidemiology course makes reading and analyzing scientific literature pretty standard. Not something I would write home about. I guess if your argument to keep medical education static hinges on us losing our ability to read and/or analyze scientific literature as physicians, well, I don't think you or I will be changing each others' minds.

 

[mehc012]

Oh, you are mistaken if you think I'm the only one looking into these changes in education. People far smarter than I are already on it - take a look at some of Sweden's and/or Denmark's grade schools. It's pretty innovative stuff, and their students out perform ours (by a considerable margin) in almost every measurable way. I just want more of this to make its way into advanced education, like medical school. It will, no doubt, but it will take time.

A decent biostats and epidemiology course makes reading and analyzing scientific literature pretty standard. Not something I would write home about. I guess if your argument to keep medical education static hinges on us losing our ability to read and/or analyze scientific literature as physicians, well, I don't think you or I will be changing each others' minds.

I don't think you are the only one looking into it; that was sarcasm. I think that many have been and will be, and at the end of the day, texts are still a standard part of curricula for a reason. By all means, add more visual-based learning things in; it can make a world of difference for some people on the trickier concepts, or for helping with memorization aids. But trying to cover everything with it is just as much folly as refusing to use it at all. These education techniques are tools. The beauty of having a diverse toolset is that you can use whichever one works best for the task at hand in order to be more effective and efficient overall.

I pulled my alternator this weekend, and it was damn near impossible for me to get past one part with my basic socket set; I had to go out and buy an L-wrench that fit the space I was working in better. But once I was past that sticking point, it was far faster and more efficient to use my basic toolkit for the bulk of the repair than it would have been to go out and buy an over-specialized tool for every step of the process. Learning is the same way.

And I'm glad that you've had a decent biostats and epidemiology course. Most people don't, in their lifetime. And even among medical students, the number who have taken Stats (barring a prereq at their particular medical school) is lower than you're insinuating. Plus, knowing the biostats does NOT mean that you will be good at reading and interpreting literature (honestly I haven't seen much correlation between the two...I've seen plenty of Stats students suck at evaluating literature, and plenty of people who are good at interpreting research who never took Stats). So a) I think you're oversimplifying what it means to be good at reading literature, b) I think you're overestimating the number of people who are truly comfortable with it, and c) if you don't think that it's a valuable skill for a physician to have we really DON'T have anything to discuss. I don't think it's the main argument for continuing to incorporate text-based learning, but I think it's a worthwhile consideration...medical students should have some level of comfort with text-based learning. You can't argue that it's incredibly simple for pretty much anyone to parse scientific texts and then in the next sentence state that we should stop making students rely so much on scientific texts to learn because it doesn't work for people.

 

[IslandStyle808]

And I'm glad that you've had a decent biostats and epidemiology course. Most people don't, in their lifetime. And even among medical students, the number who have taken Stats (barring a prereq at their particular medical school) is lower than you're insinuating. Plus, knowing the biostats does NOT mean that you will be good at reading and interpreting literature (honestly I haven't seen much correlation between the two...I've seen plenty of Stats students suck at evaluating literature, and plenty of people who are good at interpreting research who never took Stats). So a) I think you're oversimplifying what it means to be good at reading literature, b) I think you're overestimating the number of people who are truly comfortable with it, and c) if you don't think that it's a valuable skill for a physician to have we really DON'T have anything to discuss. I don't think it's the main argument for continuing to incorporate text-based learning, but I think it's a worthwhile consideration...medical students should have some level of comfort with text-based learning. You can't argue that it's incredibly simple for pretty much anyone to parse scientific texts and then in the next sentence state that we should stop making students rely so much on scientific texts to learn because it doesn't work for people.

Even with all of that let's face it, medical schools do a terrible job at integrating the interpretation of journal articles with the basic/clinical knowledge. It is not something that can be solved with undergraduate stats or epi, which are the barebones minimum need to interpret study design. There was even a time where SOAP note writing was only learned during 3rd year and not the 1st two years. The fact there is a large amount of students who cannot interpret the literature, that is the fault of the school curriculum and not the student.

However, I feel I am far better able to interpret the study design of the literature thanks to taking multiple epidemology class than if I didn't. The problem is that medical school hasn't given me the tools to be able to integrate basic science and clinical knowledge (however, I will hold back any full judgement until 3rd year).

 

[mehc012]

Even with all of that let's face it, medical schools do a terrible job at integrating the interpretation of journal articles with the basic/clinical knowledge. It is not something that can be solved with undergraduate stats or epi, which are the barebones minimum need to interpret study design. There was even a time where SOAP note writing was only learned during 3rd year and not the 1st two years. The fact there is a large amount of students who cannot interpret the literature, that is the fault of the school curriculum and not the student.

However, I feel I am far better able to interpret the study design of the literature thanks to taking multiple epidemology class than if I didn't. The problem is that medical school hasn't given me the tools to be able to integrate basic science and clinical knowledge (however, I will hold back any full judgement until 3rd year).

I feel like our school has done a decent job on that front...PBL curriculum lends itself to seeking out literature that's relevant to the 'patient' in each case, and we're required to have at least one mini-presentation on it each week. But yes, I agree, I'm simply using literature skills as an example of how it would be problematic to shift away from text entirely and allow students who "aren't comfortable" with learning from reading to completely ignore that it is a useful skill.

 

[IslandStyle808]

I feel like our school has done a decent job on that front...PBL curriculum lends itself to seeking out literature that's relevant to the 'patient' in each case, and we're required to have at least one mini-presentation on it each week. But yes, I agree, I'm simply using literature skills as an example of how it would be problematic to shift away from text entirely and allow students who "aren't comfortable" with learning from reading to completely ignore that it is a useful skill.

Wait you mean text book literature or journal article literature?

As a person who has been to demos and have friends who have done PBL, it doesn't really resolve the problem (not sure about your school). I'm asking in the context of if you had to choose between a "prospective cohort" journal article or "randomized clinical trial" journal article that both had different results, which would you rely on? Something along those lines. Not so much looking at the symptoms and then find a journal article that regurgitates the answer to the pathophysiology of the disease and drug treatment choice.

 

[mehc012]

Wait you mean text book literature or journal article literature?

As a person who has been to demos and have friends who have done PBL, it doesn't really resolve the problem (not sure about your school). I'm asking in the context of if you had to choose between a "prospective cohort" journal article or "randomized clinical trial" journal article that both had different results, which would you rely on? Something along those lines. Not so much looking at the symptoms and then find a journal article that regurgitates the answer to the pathophysiology of the disease and drug treatment choice.

Journal article literature...the formal presentation is only on one each week, but yeah usually people will pull clinical trial/cohort studies to discuss best treatment strategies. Sometimes people will have asked a question about pathophys or mechanism that goes beyond what's in the textbook and will throw back to basic science literature, but we're actually required, for the 'formal' literature pres, to analyze the strengths and weaknesses based on whether it's prospective, randomized, cohort, case studies, etc. and then relate it back to the case at hand. Aside from the required presentation, though, I usually answer 'treatment' or "why did this happen in this particular case?" questions by comparing several papers...or sometimes the patient will have a few disorders going on and I'll do an epidemiology search to figure out whether there's actually a correlation/linking mechanism between those things in reality, or whether it's just the school trying to jam in a few extra pathologies by having the patient come down with EVERYthing, lol. We don't do one-off PBLs, though, it's our entire curriculum, so it has space for that kind of exploration and literature utilization.

Not sure what kind of journal article would take a differential and turn it into a diagnosis and treatment...UpToDate isn't a journal yet!

 

[12glaucoma34]

Some of the responses in this thread make me wonder how on earth people made it past CARS or VR on the MCAT.

Again, another snarky common from the non clinician faculty, being critical of those who have performed well enough on the MCAT to actually get into medical school instead of just telling people how to do it without first hand experience.

Many of your responses make me wonder why you think you are such an authority figure on so much. Once you step outside the premed forums, we (meaning medical students) know more than you on nearly all topics.

 

[mehc012]

Again, another snarky common from the non clinician faculty, being critical of those who have performed well enough on the MCAT to actually get into medical school instead of just telling people how to do it without first hand experience.

Many of your responses make me wonder why you think you are such an authority figure on so much. Once you step outside the premed forums, we (meaning medical students) know more than you on nearly all topics.

Yeah, I'm falling over to listen to your advice over Goro's.
I may butt heads with him a lot, but a lot of what he says is sound, and he has a perspective that's worth listening to. Doesn't mean that he's always right, not by a long stretch, but I'd rather hear from the perspective of an administrator with years of watching students go through the process, and successful medical students, and doctors who know what's coming/what they're looking for in the hospital, etc...than have all of those diverse opinions get drowned out by an echo chamber of med students all assuring each other that they're right, with no other perspectives in the mix. Is everything he said here going to work for each person? Nah. But that's why it's one thread out of hundreds, and the only effective way to use the forum is to read enough of the threads that you can decide what take-home summary you think sounds like it will work best for you. I don't know why you have to be so damn bitter about it. Advice was offered; it's not like he was giving orders.

 

[IslandStyle808]

Journal article literature...the formal presentation is only on one each week, but yeah usually people will pull clinical trial/cohort studies to discuss best treatment strategies. Sometimes people will have asked a question about pathophys or mechanism that goes beyond what's in the textbook and will throw back to basic science literature, but we're actually required, for the 'formal' literature pres, to analyze the strengths and weaknesses based on whether it's prospective, randomized, cohort, case studies, etc. and then relate it back to the case at hand. Aside from the required presentation, though, I usually answer 'treatment' or "why did this happen in this particular case?" questions by comparing several papers...or sometimes the patient will have a few disorders going on and I'll do an epidemiology search to figure out whether there's actually a correlation/linking mechanism between those things in reality, or whether it's just the school trying to jam in a few extra pathologies by having the patient come down with EVERYthing, lol. We don't do one-off PBLs, though, it's our entire curriculum, so it has space for that kind of exploration and literature utilization.

Not sure what kind of journal article would take a differential and turn it into a diagnosis and treatment...UpToDate isn't a journal yet!

Sounds like your school is doing a pretty good job, can't say the same for my school. We also look at the literature here and there, but we don't take it to enough depth. However, I would like to see curriculums allowing students to look at various sources and figure out which is the better one and why (ex. as mentioned with the prospective, retrospective, randomized, case studies, meta-analyses etc.). And take it further to ask should I be concerned about high blood pressure as a side effect or the drug by itself OR making sure it really is leading to an end clinical result such a a myocardial infarction. I feel these are some of the things missing in medical school education.

 

[12glaucoma34]

Yeah, I'm falling over to listen to your advice over Goro's.
I may butt heads with him a lot, but a lot of what he says is sound, and he has a perspective that's worth listening to. Doesn't mean that he's always right, not by a long stretch, but I'd rather hear from the perspective of an administrator with years of watching students go through the process, and successful medical students, and doctors who know what's coming/what they're looking for in the hospital, etc...than have all of those diverse opinions get drowned out by an echo chamber of med students all assuring each other that they're right, with no other perspectives in the mix. Is everything he said here going to work for each person? Nah. But that's why it's one thread out of hundreds, and the only effective way to use the forum is to read enough of the threads that you can decide what take-home summary you think sounds like it will work best for you. I don't know why you have to be so damn bitter about it. Advice was offered; it's not like he was giving orders.

I've conceded he does give good advice at times, but other advice isn't sound and remarks like the one in bold aren't necessary. Especially from someone who never took the MCAT.

 

[12glaucoma34]

Yeah, I'm falling over to listen to your advice over Goro's.
I may butt heads with him a lot, but a lot of what he says is sound, and he has a perspective that's worth listening to. Doesn't mean that he's always right, not by a long stretch, but I'd rather hear from the perspective of an administrator with years of watching students go through the process, and successful medical students, and doctors who know what's coming/what they're looking for in the hospital, etc...than have all of those diverse opinions get drowned out by an echo chamber of med students all assuring each other that they're right, with no other perspectives in the mix. Is everything he said here going to work for each person? Nah. But that's why it's one thread out of hundreds, and the only effective way to use the forum is to read enough of the threads that you can decide what take-home summary you think sounds like it will work best for you. I don't know why you have to be so damn bitter about it. Advice was offered; it's not like he was giving orders.

Also, the best advice I received in medical school wasn't from non clinician faculty, it was from other medical students. If I would have listened to the faculty at my school I would have went to class everyday and utilized their inefficient study methods and resources and not scored near as well as I did on my board exams. My school strongly strongly recommended taking a board review course that lasted one week that was eight hours per day, super thankful I didn't attend and know many people who did that reported it just set them back a week in studying.

 

[IslandStyle808]

Yeah, I'm falling over to listen to your advice over Goro's.
I may butt heads with him a lot, but a lot of what he says is sound, and he has a perspective that's worth listening to. Doesn't mean that he's always right, not by a long stretch, but I'd rather hear from the perspective of an administrator with years of watching students go through the process, and successful medical students, and doctors who know what's coming/what they're looking for in the hospital, etc...than have all of those diverse opinions get drowned out by an echo chamber of med students all assuring each other that they're right, with no other perspectives in the mix. Is everything he said here going to work for each person? Nah. But that's why it's one thread out of hundreds, and the only effective way to use the forum is to read enough of the threads that you can decide what take-home summary you think sounds like it will work best for you. I don't know why you have to be so damn bitter about it. Advice was offered; it's not like he was giving orders.

Of course, its not like we are totally ignoring his advice, its more like we are fine tuning the message to fit students. I agree with several of the things stated, but he is also seeing the forest and not the trees. However, on the converse we see the trees and not the forest. The important part is picking out what is relevant from Goro's advice as well as the advice from current medical students.

 

[cellsaver]

However, while our struggles are no where near as bad as those in those countries, we should still strive to be that 'squeaky wheel' to promote better change here as well. If you don't see the flaws in society no matter how small and change them, then greater progress cannot be made. We are what we are today because we complained about the things that our ancestors considered to be trivial.

While you may see yourself as the "squeaky wheel" to promote better change here as well, some of us just see you as squeaky wheels for the sake of squeaking.

Youve got it really good in America. Sadly you don't see it that way and feel everyone else has to change to accommodate your limited and dim view of life. You just might be part of the problem and not those who are trying show you the way

a sign of maturity is being introspective, self-analytical and seeing where you might be in need of learning from those who have gone before you because they are wiser and are trying to teach you the better way.

In the end the Third Party Payers, CMS, the hospital admins (MBA / CPA types), etc are going to eat you alive precisely because they know better about the current medical business landscape and you do not.

Choose your poison. It's on you.

 

[cellsaver]

Your inability to look beyond what works for you is, unfortunately, all too common in medicine. People with your line of thinking will be a major impediment to medical innovation (including education) in the years to come.

As a side note - you should watch the movie Midnight in Paris. It might speak to you.

Your hubris is sadly typical for your generation. Something about casting pearls before swine...but I really hate to insult that species.

ignored button applied. i'm here to learn from those people like Goro and others and enjoy the journey, not be lectured by someone who is clueless

 

[cellsaver]

If I want grief in my life, it's faster simply to punch the Dean.

I'm simply making suggestions here, not advising on the best use of Verapimal or treatments for steatorrhea.

your suggestions on Verapamil are more reliable than FA...as I already indicated a few days ago on how FA confuses Verapamil and Diltiazem.

Preach other Brother!

 

[Goro]

Yeah, I'm falling over to listen to your advice over Goro's.
I may butt heads with him a lot, but a lot of what he says is sound, and he has a perspective that's worth listening to. Doesn't mean that he's always right, not by a long stretch, but I'd rather hear from the perspective of an administrator with years of watching students go through the process, and successful medical students, and doctors who know what's coming/what they're looking for in the hospital, etc...than have all of those diverse opinions get drowned out by an echo chamber of med students all assuring each other that they're right, with no other perspectives in the mix. Is everything he said here going to work for each person? Nah. But that's why it's one thread out of hundreds, and the only effective way to use the forum is to read enough of the threads that you can decide what take-home summary you think sounds like it will work best for you. I don't know why you have to be so damn bitter about it. Advice was offered; it's not like he was giving orders.

Just a clarification : I'm not an administrator, I work for a living. I teach medical students!

 

[LittleFoot]

Of course, its not like we are totally ignoring his advice, its more like we are fine tuning the message to fit students. I agree with several of the things stated, but he is also seeing the forest and not the trees. However, on the converse we see the trees and not the forest. The important part is picking out what is relevant from Goro's advice as well as the advice from current medical students.

Exactly. This thread could have been a healthy debate to allow us to see both the forest and the trees, but it kind of turned into a flame war instead. Even so, there is a lot of valuable information in this thread (from both sides). I just think Goro could have been more accepting of disagreement from the medical students themselves, which is something I would expect from someone with 20+ years of experience working with medical students.

 

[IslandStyle808]

While you may see yourself as the "squeaky wheel" to promote better change here as well, some of us just see you as squeaky wheels for the sake of squeaking.

Youve got it really good in America. Sadly you don't see it that way and feel everyone else has to change to accommodate your limited and dim view of life. You just might be part of the problem and not those who are trying show you the way

a sign of maturity is being introspective, self-analytical and seeing where you might be in need of learning from those who have gone before you because they are wiser and are trying to teach you the better way.

In the end the Third Party Payers, CMS, the hospital admins (MBA / CPA types), etc are going to eat you alive precisely because they know better about the current medical business landscape and you do not.

Choose your poison. It's on you.

You must be fun at parties.

Well then, if you think I'm trashing what has worked for years lets look at your post that trashed what worked for centuries, the memory palace.

The videos of shepherds walking in the Egyptian desert with camels, associations with Staph aureus, birds in cages, animals at the zoo, Salmon fish on a plate... they were over the top. My husband saw them on youtube and he won't let it go. "best of the best, huh?" Louis Pasteur had it right: View attachment 222316

Here is a short story of its origins.

"The most common account of the creation of the art of memory centers around the story of Simonides of Ceos, a famous Greek poet, who was invited to chant a lyric poem in honor of his host, a nobleman of Thessaly. While praising his host, Simonides also mentioned the twin gods Castor and Pollux. When the recital was complete, the nobleman selfishly told Simonides that he would only pay him half of the agreed upon payment for the panegyric, and that he would have to get the balance of the payment from the two gods he had mentioned. A short time later, Simonides was told that two men were waiting for him outside. He left to meet the visitors but could find no one. Then, while he was outside the banquet hall, it collapsed, crushing everyone within. The bodies were so disfigured that they could not be identified for proper burial. But, Simonides was able to remember where each of the guests had been sitting at the table, and so was able to identify them for burial. This experience suggested to Simonides the principles which were to become central to the later development of the art he reputedly invented.[7]"

It was thanks to that technique that you so eloquently insulted that this man was able to give families piece of mind knowing who died in the accident. A lot of famous speakers in the past actually used similar techniques to give their speeches without the use of pen and paper. However, due to writing and the dependence of looking things up, we lost this technique to time.

Now we have people in this generation who are trying to bring back this technique into the fold, for example sketchy. There was also Mississippi medical student who won the world memory championship last year:
World Memory Champion is from Mississippi

I can draw up these palace from scratch even without sketchy and it has helped me especially with micro and pharm. I even believe it can help me in practice.

And yes I believe in my 'squeaky wheel' philosophy. Martin Luther King Jr. could have looked the other way when people of color were treated badly and just say to himself 'at least we are not slaves.' However, he didn't think this and that 'squeaky wheel' is what lead to revolution and lead people of various ethnicities to a better life in the US.

But hey you can choose to not study from sketchy, Uworld, pathoma, first aid and if studying from only textbooks works for you go for it. However, there is an importance to having the 'easier' resources and it has allowed us to improve and grow. Even now I read books from various academics and physician as to how to study better and hope to find techniques that can help people learn better. I don't believe my viewpoint is impeding progress but in fact improving it. That's fine if you don't believe it.

 

[T800'sThumb]

"People learn differently; you must find what works for you."

"Things like Sketchy work for me."

"No it doesn't! And, you must use all the textbooks."

 

[cellsaver]

You must be fun at parties.

a gathering of boring white anglos all busy on FB, Tindr and Twitter do momentarily stop their "partying" when they see a hot ravishing Latina walk into their safe space. Fortunately for me my husband is handsome, fun and hung, so it works for us

dont hate me

xoxo

 

[cellsaver]

Just a clarification : I'm not an administrator, I work for a living. I teach medical students!

Lawd....are admins really that bad?

I like to think of them, with MD Degrees, of actually serving a higher purpose. I dont see mine as villains at all. But I could be wrong.

 

[Goro]

Lawd....are admins really that bad?

I like to think of them, with MD Degrees, of actually serving a higher purpose. I dont see mine as villains at all. But I could be wrong.

I stole the line from Stripes.

Sgt Hulka: You do this, NOW!
John: Yes, sir!
Sgt Hulka: Don't you call me sir! I work for a living! You call me sergeant!

The main functions of the administrators I have to deal with is their coming up with annoying and often irrational policies, often at a moment's notice.

 

[mehc012]

"People learn differently; you must find what works for you."

"Things like Sketchy work for me."

"No it doesn't! And, you must use all the textbooks."

Never said they didn't work; just that it'd be as much folly to make all curricula 100% visual learning as it would be to forsake those resources altogether. Implementing visual learning techniques is great because it allows people who learn that way to engage better, NOT because it's inherently better than text-based learning. Fixing one deficit by causing another isn't a solution; that'd be like giving your patients with Vitamin D deficiency only Vitamin D and removing all other nutrients from their diet; you'd cause more problems than you fix.

 

[JustSomePreMed]

a gathering of boring white anglos all busy on FB, Tindr and Twitter do momentarily stop their "partying" when they see a hot ravishing Latina walk into their safe space. Fortunately for me my husband is handsome, fun and hung, so it works for us

dont hate me

xoxo

Your posts get more cringeworthy by the day.

 

[dr zaius]

Apparently these days medical students don't want to go to lectures, or read books. They just go on and on about some group called UFAP. You know what we did in my day? We would go to lecture, read books, and also fap. Frequently. Suck it up, buttercups.

 

[cellsaver]

Apparently these days medical students don't want to go to lectures, or read books. They just go on and on about some group called UFAP. You know what we did in my day? We would go to lecture, read books, and also fap. Frequently. Suck it up, buttercups.

Check out the most recent edition of JAMA.

The Troponin Cascade
Cardiology | JAMA Internal Medicine

These physicians missed the important concepts in Robbins and Cotran, Pathophysiology of GI, and no doubt skipped the first two years of classes and relied on UFAP on a DIY basis.... while having time for reddit and FB. Who knew?!

The article describes ER physicians who misdiagnosed a patient, ran up costs with unnecessary diagnostics exams and admission to a Cardiac Unit with no hard evidence to support their decision making. None. Troponin was hardly noteworthy but the Cardiologists submitted the patient to excessive hospital length of stay and unnecessary procedures, and delayed resolution of problem. Then the Surgeons got a chance to throw the dice at the table and they belicosed and demanded further diagnostic procedures that were predicated on a false dx, before doing the cohlecystectomy on hospital day 4!

All of these physicians overlooked the clinical signs and symptoms of colelithiasis and relied instead on poor judgement. As Dr Sidhartha Mukhurjee might have said in his "Rules of Medicine", they lacked clinical intuition.

"A strong intuition is much more powerful than a weak test" Dr Siddhartha Mukherjee.


They totally blew over the epigastric pain that began after a meal, elevated liver enzymes and hx elevated cholesterol but ran with NSTEMI instead.

Simply breathtaking. I shook my head after the first paragraph and was appalled by the workup this poor patient endured. Such drama... just like SDN when Goro provides a guideline to help the cupcakes become fine physicians

At least the authors admitted, in part, they screwed over the patient.

We were told in first year of medical school that the patient walks into the office giving you the dx. You must have intuition though and that is not developed on an app or UFAP

 

[12glaucoma34]

I stole the line from Stripes.

Sgt Hulka: You do this, NOW!
John: Yes, sir!
Sgt Hulka: Don't you call me sir! I work for a living! You call me sergeant!

The main functions of the administrators I have to deal with is their coming up with annoying and often irrational policies, often at a moment's notice.

And often these policies are pointless. From my perspective, administrators create committees and meetings for the sake of having committees and meetings that they must attend. It is like giving themselves busy work so the unnecessary position of assistant assistant assistant vice dean of osteopathic affairs who is a family practice doctor can keep cashing their 300,000 salary while only working 30 hours a week. And yes, I use the term "working" very loosely.

 

[12glaucoma34]

Lawd....are admins really that bad?

I like to think of them, with MD Degrees, of actually serving a higher purpose. I dont see mine as villains at all. But I could be wrong.

I think you are wrong, at least for the most part.

Yes, the higher purpose they are serving is themselves by taking advantage of the system by enriching themselves with bloated salaries they likely wouldn't earned if they worked outside of the academic setting. I encourage you to do a search of your schools administrators, deans, presidents, assistant deans, associate deans, vice presidents,....etc, count how many there are. Then ask yourself, what real purpose do they serve? Each of those get an administrative assistant with each of them getting several secretaries. They all create work for each other. I've noticed several medical schools now have a dean in charge of diversity, it is not necessary to employ someone for this, but i'm sure the dean or president of the university had a friend who needed a sweet job.

 

[sliceofbread136]

Check out the most recent edition of JAMA.

The Troponin Cascade
Cardiology | JAMA Internal Medicine

These physicians missed the important concepts in Robbins and Cotran, Pathophysiology of GI, and no doubt skipped the first two years of classes and relied on UFAP on a DIY basis.... while having time for reddit and FB. Who knew?!

The article describes ER physicians who misdiagnosed a patient, ran up costs with unnecessary diagnostics exams and admission to a Cardiac Unit with no hard evidence to support their decision making. None. Troponin was hardly noteworthy but the Cardiologists submitted the patient to excessive hospital length of stay and unnecessary procedures, and delayed resolution of problem. Then the Surgeons got a chance to throw the dice at the table and they belicosed and demanded further diagnostic procedures that were predicated on a false dx, before doing the cohlecystectomy on hospital day 4!

All of these physicians overlooked the clinical signs and symptoms of colelithiasis and relied instead on poor judgement. As Dr Sidhartha Mukhurjee might have said in his "Rules of Medicine", they lacked clinical intuition.

"A strong intuition is much more powerful than a weak test" Dr Siddhartha Mukherjee.


They totally blew over the epigastric pain that began after a meal, elevated liver enzymes and hx elevated cholesterol but ran with NSTEMI instead.

Simply breathtaking. I shook my head after the first paragraph and was appalled by the workup this poor patient endured. Such drama... just like SDN when Goro provides a guideline to help the cupcakes become fine physicians

At least the authors admitted, in part, they screwed over the patient.

We were told in first year of medical school that the patient walks into the office giving you the dx. You must have intuition though and that is not developed on an app or UFAP

Just curious, at what point of clinical training are you?

 

[P0ke]

I agree that being in medical school is a privilege, and I very, very much appreciate the supportive words cellsaver, but I also think that adult learners paying a mortgage for their education should be treated better than recruits in boot camp.

This is why I am appalled that there are med schools that require lecture attendance, and that there are faculty who treat teaching as this chore to get to so they can get back to their labs, or who teach their research and not what you need to know, or as mentioned above, merely teach by saying "read Chapters 10-30 of Harrisons (it's one thing to be a good self-learner..this is a very important thing, but we Faculty are paid to get you to a goal, and this is not done by merely pointing to the horizon and saying "start running"). We should never force learning, but rather, guide it.

Lastly, I despise those faculty who teach over your heads, as if you're residents!

The LCME needs to mandate something for optional lecture attendance. The people at the top of my school who make all the rules are all a bunch of pHDs and have no idea of the time constraints or amount of material a medical student has to get through. I believe they are of the thought "well that's how it's always been done here". Some of these same people who mandate the attendance are preclinical professors, and I think they don't want their egos to be hurt from lecturing to an empty classroom, so they care more about that than student wellbeing. It definitely hurt me during the first 2 years having to go to class every single day.