How much of step 1 is first year material?

[rodmichael82]

Is it safe to say USMLE step 1 is 80 % M2 material and 20 % M1?

Thanks!

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[JP2740]

Actually I have a good friend who counted every fact, it comes down to 74.839% year 2. I'm glad this has helped you to succeed and direct your studying

 

[Daodejing]

Actually I have a good friend who counted every fact, it comes down to 74.839% year 2. I'm glad this has helped you to succeed and direct your studying

😀

OP why does it matter...you should eat, sleep, and breathe basic science for both years. Now that's true prep for boards.

semi-srs.

 

[minwoo123]

From what i understand, the best way to prep for USMLE is to focus on learning the material really well and more importantly, use strategies to best retain that knowledge (e.g. Anki flashcards, taking an organized set of concise notes, teaching others etc.). I have the "How to study in medical school" book and basically it says, 1) Write really good, concise notes on each lecture. 2) Don't sleep before all notes are done. 3) Look things up if you don't know it 4) Review, review, review. 5) Teach/tutor others.

For the Anki strategy, there's an md/phd sdner, (forgot the website) who has a blogpost on how he used Anki for the first two years and for board prep.

There have been studies showing that you need to review the material like 5 times for it to really stick in your long term memory. so a lot of reviewing and regurgitation. that being said, knowing the answer to WHY this or that helps in memory retention.

So think about Step 1 prep as beginning on your first day of med school, work hard for two years, and you should be feeling pretty good about your knowledge when dedicated Step 1 prep comes along in second year. The only use of First Aid in the first two years is to give you an idea of the topics Step 1 focuses on and what topics are extraneous.

From my research on SDN, the recommended books are BRS Physiology by Constanzo, 5th edition, and BRS Pathology.

Hope this helps! =)

 

[rodmichael82]

From what i understand, the best way to prep for USMLE is to focus on learning the material really well and more importantly, use strategies to best retain that knowledge (e.g. Anki flashcards, taking an organized set of concise notes, teaching others etc.). I have the "How to study in medical school" book and basically it says, 1) Write really good, concise notes on each lecture. 2) Don't sleep before all notes are done. 3) Look things up if you don't know it 4) Review, review, review. 5) Teach/tutor others.

For the Anki strategy, there's an md/phd sdner, (forgot the website) who has a blogpost on how he used Anki for the first two years and for board prep.

There have been studies showing that you need to review the material like 5 times for it to really stick in your long term memory. so a lot of reviewing and regurgitation. that being said, knowing the answer to WHY this or that helps in memory retention.

So think about Step 1 prep as beginning on your first day of med school, work hard for two years, and you should be feeling pretty good about your knowledge when dedicated Step 1 prep comes along in second year. The only use of First Aid in the first two years is to give you an idea of the topics Step 1 focuses on and what topics are extraneous.

From my research on SDN, the recommended books are BRS Physiology by Constanzo, 5th edition, and BRS Pathology.

Hope this helps! =)

Are you in med school and have you taken step 1?

 

[tiedyeddog]

This is probably going to be really school specific. So, in general:

anatomy - not very big on step 1 compared to the amount of time spent on it in M1.
biochem - same deal

 

[Kaustikos]

Actually I have a good friend who counted every fact, it comes down to 74.839% year 2. I'm glad this has helped you to succeed and direct your studying

I think my friend got something similar... with 74.839 +/- 0.4% SD, CI 95% (74.5-75.12) p= 0.05...

 

[yehhhboiii]

when will premeds realize that they have nothing of value to offer us

 

[Pons Asinorum]

Lol at Rod and Min getting into a premed-on-premed-Step-1-advice pissing match. In the Allo forum, no less.

 

[Locrian]

Step 1 Topics High Yield to Low Yeild (Second Year Subject weighted)
1. Pathology – 2nd Year
1. Physiology – 1st Year
3. Pharmacology – 2nd Year
4. Molecular Bio/Genetics – (1st/2nd year)
5. Behavioral Sciences – 2nd Year
6. Microbiology – 1st Year
7. Neuroanatomy – 2nd Year
8. Gross Anatomy – 1st Year
9. Biochemistry – 1st Year
10. Embryology – 1st Year
11. Immunology – 1st Year
12. Histology -1st Year

 

[chronicidal]

From what i understand, the best way to prep for USMLE is to focus on learning the material really well and more importantly, use strategies to best retain that knowledge (e.g. Anki flashcards, taking an organized set of concise notes, teaching others etc.). I have the "How to study in medical school" book and basically it says, 1) Write really good, concise notes on each lecture. 2) Don't sleep before all notes are done. 3) Look things up if you don't know it 4) Review, review, review. 5) Teach/tutor others.

For the Anki strategy, there's an md/phd sdner, (forgot the website) who has a blogpost on how he used Anki for the first two years and for board prep.

There have been studies showing that you need to review the material like 5 times for it to really stick in your long term memory. so a lot of reviewing and regurgitation. that being said, knowing the answer to WHY this or that helps in memory retention.

So think about Step 1 prep as beginning on your first day of med school, work hard for two years, and you should be feeling pretty good about your knowledge when dedicated Step 1 prep comes along in second year. The only use of First Aid in the first two years is to give you an idea of the topics Step 1 focuses on and what topics are extraneous.

From my research on SDN, the recommended books are BRS Physiology by Constanzo, 5th edition, and BRS Pathology.

Hope this helps! =)

I am in med school; I haven't taken Step 1; I agree with this assessment; that SDNer is drwillbe http://drwillbe.blogspot.com/

 

[John Lannister]

From what i understand, the best way to prep for USMLE is to focus on learning the material really well and more importantly, use strategies to best retain that knowledge (e.g. Anki flashcards, taking an organized set of concise notes, teaching others etc.). I have the "How to study in medical school" book and basically it says, 1) Write really good, concise notes on each lecture. 2) Don't sleep before all notes are done. 3) Look things up if you don't know it 4) Review, review, review. 5) Teach/tutor others.

For the Anki strategy, there's an md/phd sdner, (forgot the website) who has a blogpost on how he used Anki for the first two years and for board prep.

There have been studies showing that you need to review the material like 5 times for it to really stick in your long term memory. so a lot of reviewing and regurgitation. that being said, knowing the answer to WHY this or that helps in memory retention.

So think about Step 1 prep as beginning on your first day of med school, work hard for two years, and you should be feeling pretty good about your knowledge when dedicated Step 1 prep comes along in second year. The only use of First Aid in the first two years is to give you an idea of the topics Step 1 focuses on and what topics are extraneous.

From my research on SDN, the recommended books are BRS Physiology by Constanzo, 5th edition, and BRS Pathology.

Hope this helps! =)

You also can overuse Anki. I certainly did for a while. It can be very inefficient.

 

[chronicidal]

You also can overuse Anki. I certainly did for a while. It can be very inefficient.

The trick is to realize your capacity for learning and retaining information is only like 100-200 facts a year for every minute per day you spend doing Anki cards. Spend an hour a day -> 6000-12000 facts a year. That's not that much, so you have to prioritize what you think is the most important knowledge.

Spaced repetition is for learning things that you want to maintain >90% retention of (as opposed to letting things decay exponentially, to maybe like 60% after a few months). Another way of thinking of how to prioritize is that something should only go into Anki if that fact will cost you more than a few minutes of your life (to look up, to correct a mistake you made, to achieve something you wanted) if you didn't know it at some point many months or years from now.

 

[rodmichael82]

Lol at Rod and Min getting into a premed-on-premed-Step-1-advice pissing match. In the Allo forum, no less.

I'm done with my 1st year not a premed dude.

I'm asking advice from folks that took the step 1 and I'm 100 % sure premeds haven't.

The reason why I even bring this up is that during M1 year even though I did well I didn't take school too seriously. If I put in my all during M2 I should still do great on step 1 right?

 

[Stellar Clouds]

I'm done with my 1st year not a premed dude.

I'm asking advice from folks that took the step 1 and I'm 100 % sure premeds haven't.

The reason why I even bring this up is that during M1 year even though I did well I didn't take school too seriously. If I put in my all during M2 I should still do great on step 1 right?

It is not that you cannot do well, but a lot of the material learned during 2nd year requires a solid understanding of the material from 1st year. How can you understand when something goes wrong, if you don't understand how it functions when it is working correctly?

 

[rodmichael82]

Step 1 Topics High Yield to Low Yeild (Second Year Subject weighted)
1. Pathology – 2nd Year
1. Physiology – 1st Year
3. Pharmacology – 2nd Year
4. Molecular Bio/Genetics – (1st/2nd year)
5. Behavioral Sciences – 2nd Year
6. Microbiology – 1st Year
7. Neuroanatomy – 2nd Year
8. Gross Anatomy – 1st Year
9. Biochemistry – 1st Year
10. Embryology – 1st Year
11. Immunology – 1st Year
12. Histology -1st Year

Microbiology is taught in 2nd year to us, weird.

 

[VisionaryTics]

Step 1 is about seeing relationships across subjects. It's very integrative, so first year material is probably more important than "20% of questions are on anatomy/physiology/etc" makes it out to be.

 

[John Lannister]

Step 1 is about seeing relationships across subjects. It's very integrative, so first year material is probably more important than "20% of questions are on anatomy/physiology/etc" makes it out to be.

Excellent point. Plenty of questions use anatomy or biochem, but they are pathology questions. Even pharm questions, I find myself using biochem a lot to make sense of side effects... the problem is, it's not the level of depth taught in M1. So you need to know M1 really well but only @ a clinical level, not a biochem PhD or textbook level.

 

[Kaustikos]

Step 1 Topics High Yield to Low Yeild (Second Year Subject weighted)
1. Pathology – 2nd Year
1. Physiology – 1st Year
3. Pharmacology – 2nd Year
4. Molecular Bio/Genetics – (1st/2nd year)
5. Behavioral Sciences – 2nd Year
6. Microbiology – 1st Year
7. Neuroanatomy – 2nd Year
8. Gross Anatomy – 1st Year
9. Biochemistry – 1st Year
10. Embryology – 1st Year
11. Immunology – 1st Year
12. Histology -1st Year

I hope to god you're joking about behavioral sciences... I've seen way more questions on micro/biochem/neuro than behavioral...on uworld/nbme practice tests.

 

[Pons Asinorum]

I'm done with my 1st year not a premed dude.

I'm asking advice from folks that took the step 1 and I'm 100 % sure premeds haven't.

The reason why I even bring this up is that during M1 year even though I did well I didn't take school too seriously. If I put in my all during M2 I should still do great on step 1 right?

Yes, you can. I did the same thing, I'm in a P/F curriculum, and I P=MD'd my way through keeping my sanity and family loving our decision to go to med school. You will be fine following any of the many reasonable Step 1 strategies talked about damn near to death in the many threads here. Don't overthink, especially on stuff that you have no chance of changing. What if someone says "Nope, can't be done." What do you do with that? Are you going to change how you studies during first year? Why order the test if the results won't change how you treat the patient?

 

[rodmichael82]

Yes, you can. I did the same thing, I'm in a P/F curriculum, and I P=MD'd my way through keeping my sanity and family loving our decision to go to med school. You will be fine following any of the many reasonable Step 1 strategies talked about damn near to death in the many threads here. Don't overthink, especially on stuff that you have no chance of changing. What if someone says "Nope, can't be done." What do you do with that? Are you going to change how you studies during first year? Why order the test if the results won't change how you treat the patient?

I have searched study techniques and mostly found stuff for the focused prep in the last 2 months (6-8 weeks) before step 1 test date. Is there any thread that discusses a M2 year long passive studying plan? If so can you direct me to it. Thanks in advance.

 

[rueby25]

I hope to god you're joking about behavioral sciences... I've seen way more questions on micro/biochem/neuro than behavioral...on uworld/nbme practice tests.

Behavioral science questions are "gimmes" on step 1 if you've prepared for them. That's what makes them high yield. They are also inevitable. Each block will have at least a few, much like each block will have one or two biostats questions. Neuro and micro are very important, but decidedly less high yield because of the nature of the questions.

 

[Pons Asinorum]

I have searched study techniques and mostly found stuff for the focused prep in the last 2 months (6-8 weeks) before step 1 test date. Is there any thread that discusses a M2 year long passive studying plan? If so can you direct me to it. Thanks in advance.

You don't need that, because the 6-8 weeks is plenty to get ready for Step 1. You have to just trust the process that has worked for everyone else. If you want to bump up your M2 retention, Pathoma is awesome to do alongside your second-year courses. Firecracker can be helpful (spaced repetition). These aren't secrets.

 

[Locrian]

I hope to god you're joking about behavioral sciences... I've seen way more questions on micro/biochem/neuro than behavioral...on uworld/nbme practice tests.

Sometimes it's hard to categorize all the questions you get into one clear cut subject. Many questions are integrated through subject.

(In the most oversimplified example):
Q:
Which of the following molecules does NOT promote lymphocyte apoptosis?
A. Bid
B. Caspase-8
C. FADD
D. FLIP
E. Glucocorticoid

(answer is D btw)

Is this a Immunology questions?
Is it a cell/molecular bio question?
Basic Path?

Would you maybe consider it an endocrine/cell receptor related question? if btw you didn't remember learning during phys that glucocorticoids can promote T cell apoptosis.

 

[Anastomoses]

Sometimes it's hard to categorize all the questions you get into one clear cut subject. Many questions are integrated through subject.

(In the most oversimplified example):
Q:
Which of the following molecules does NOT promote lymphocyte apoptosis?
A. Bid
B. Caspase-8
C. FADD
D. FLIP
E. Glucocorticoid

(answer is D btw)

Is this a Immunology questions?
Is it a cell/molecular bio question?
Basic Path?

Would you maybe consider it an endocrine/cell receptor related question? if btw you didn't remember learning during phys that glucocorticoids can promote T cell apoptosis.

I'm guessing if a lot of people kept tabs in physiology they'd have insider info on a lot more questions. good example.

 

[John Lannister]

Yes, you can. I did the same thing, I'm in a P/F curriculum, and I P=MD'd my way through keeping my sanity and family loving our decision to go to med school. You will be fine following any of the many reasonable Step 1 strategies talked about damn near to death in the many threads here. Don't overthink, especially on stuff that you have no chance of changing. What if someone says "Nope, can't be done." What do you do with that? Are you going to change how you studies during first year? Why order the test if the results won't change how you treat the patient?

Yeah, I feel like the Step 1 strategies have officially been beaten to death. My favorite is this post from a pre-med😱😳😕🙁 who starts M1 in a few months:

I have a fair amount of free time these days, which I've been filling with excessive TV, eating, and generally doing nothing. Of course, I've also been obsessing about starting med school this fall and reading SDN pretty regularly. I've thought a lot about how I plan on being successful at school, and lately I've turned my attention to Step 1. I know I'm thinking way in advance, but I was hoping I could get you guys' feedback on my "study plan." I think it seems fairly reasonable/not too excessive, but I need you all to tell me if I'm full of it, haha. My studying should be pretty open-ended until MS2. I just like to have some kind of plan of action. Anyways, here it is... Oh, and p.s., my school has a 1.5 year systems-based curriculum if that helps with anything.

MS1

• Review First Aid (FA) and Rapid Review Pathology by Goljan concurrently with classes. Become familiar with these materials and use the information to help structure my studying and identify "high-yield" concepts.
• After finishing FA, start either the USMLE Rx or Kaplan QBank. This should potentially occur around spring break (i.e., 12 months before the designated study time) or during/after summer (having used the summer to finish reading FA). Annotate FA based on answers from the QBank. Annotate directly in the book or in a separate document--whatever I prefer.

MS2

• Continue reviewing FA and Goljan, annotating FA, and answering QBank questions alongside classes.
• At least four months before the designated study time, start using Anki cards to review FA. (Lower priority - may abandon)
• Upon the arrival of the designated study time, I should have read both FA and Goljan at least one time--ideally, I should have finished FA for a second time. I should also have completed the QBank and Anki cards.

Designated Study Time (6 weeks)

• Study FA and Goljan, annotating FA with the answers to the practice questions. Try to have FA and Goljan committed to memory two weeks before the exam so the remaining time can be spent doing practice questions and/or essential review.
• Start and complete USMLE World QBank.
• Assess my progress with the most recent NBME practice exams: Take one just prior to or at the very beginning of the designated study time to know my starting point. Take two more before the last week. During the final week, take the Free-150.
• Consider reviewing Microcards and Goljan audio.
• During the final week, review biochemistry, embryology, microbiology, and pharmacology, devoting a day to each topic. Also, carefully review the topics of incorrectly answered questions on the NBME tests.
• The day before the exam, do NOT study--relax!

Thanks!

 

[John Lannister]

Sometimes it's hard to categorize all the questions you get into one clear cut subject. Many questions are integrated through subject.

(In the most oversimplified example):
Q:
Which of the following molecules does NOT promote lymphocyte apoptosis?
A. Bid
B. Caspase-8
C. FADD
D. FLIP
E. Glucocorticoid

(answer is D btw)

Is this a Immunology questions?
Is it a cell/molecular bio question?
Basic Path?

Would you maybe consider it an endocrine/cell receptor related question? if btw you didn't remember learning during phys that glucocorticoids can promote T cell apoptosis.

lol, I don't even know what half those answer choices are.

 

[CDI]

lol, I don't even know what half those answer choices are.

Locrian invented them

 

[Kaustikos]

Sometimes it's hard to categorize all the questions you get into one clear cut subject. Many questions are integrated through subject.

(In the most oversimplified example):
Q:
Which of the following molecules does NOT promote lymphocyte apoptosis?
A. Bid
B. Caspase-8
C. FADD
D. FLIP
E. Glucocorticoid

(answer is D btw)

Is this a Immunology questions?
Is it a cell/molecular bio question?
Basic Path?

Would you maybe consider it an endocrine/cell receptor related question? if btw you didn't remember learning during phys that glucocorticoids can promote T cell apoptosis.

Bid BAD BAX (BID on getting BAD BACKS??) induces MAC
FADD is Fas associated
Caspase 8 - Well... Caspase is apoptotic
Steroids can be ruled out because of what you said.

All this is immune mediated.

FLIP I didn't know but all the others are

 

[John Lannister]

Bid BAD BAX (BID on getting BAD BACKS??) induces MAC
FADD is Fas associated
Caspase 8 - Well... Caspase is apoptotic
Steroids can be ruled out because of what you said.

All this is immune mediated.

FLIP I didn't know but all the others are

FADD / FLIP? BID? haven't seen those in any review books... FA? Uworld? Pathoma?

If it's not in one of those 3 sources, I'm pretty ok with not knowing it. FA/Uworld/Pathoma only cover about 1% of medicine. Opening it up to the other 99% could generate a variety on minutia or specialty level questions.

 

[mvenus929]

I have searched study techniques and mostly found stuff for the focused prep in the last 2 months (6-8 weeks) before step 1 test date. Is there any thread that discusses a M2 year long passive studying plan? If so can you direct me to it. Thanks in advance.

Study for your classes. If you study for your classes and understand the material well the first time, then when you're reviewing in your dedicated study time, you won't have to learn something from scratch.

 

[GrabSlamBoot]

I have searched study techniques and mostly found stuff for the focused prep in the last 2 months (6-8 weeks) before step 1 test date. Is there any thread that discusses a M2 year long passive studying plan? If so can you direct me to it. Thanks in advance.

Look up dr. Willbe blog in google.

 

[rodmichael82]

Study for your classes. If you study for your classes and understand the material well the first time, then when you're reviewing in your dedicated study time, you won't have to learn something from scratch.

Review M1 material or study M2 material?

 

[Votaku]

Can anyone else also comment some more on Biostat on the step 1.

All but the simplest UWORLD Biostat questions seem beyond me (My course was horribly taught...and I hate Biostat). One of my school's advice people told us to read BRS, but I can't find the time in my schedule...

 

[NickNaylor]

Can anyone else also comment some more on Biostat on the step 1.

All but the simplest UWORLD Biostat questions seem beyond me (My course was horribly taught...and I hate Biostat). One of my school's advice people told us to read BRS, but I can't find the time in my schedule...

I personally found the behavioral sciences section of the First Aid for the Basic Sciences: General Principles text to be outstanding. It's nice and concise but provides way more information than what is in First Aid. I'm not sure that it would be worth buying ($60) for only that section, but it's something to consider depending on how desperate you are.

Sent from my SGH-M919

 

[Votaku]

I personally found the behavioral sciences section of the First Aid for the Basic Sciences: General Principles text to be outstanding. It's nice and concise but provides way more information than what is in First Aid. I'm not sure that it would be worth buying ($60) for only that section, but it's something to consider depending on how desperate you are.

Just found this text in my school library. Wow, it does seem pretty clear, thanks (I hope it's enough, god help me)

 

[NickNaylor]

Just found this text in my school library. Wow, it does seem pretty clear, thanks (I hope it's enough, god help me)

Outside of FA, it was the only source that I used for it and I felt pretty confident about my biostats knowledge.

Sent from my SGH-M919

 

[mvenus929]

Review M1 material or study M2 material?

As many people have already said, the material in M2 is built upon M1 information, so if you're studying for our M2 classes, you will likely also be reviewing M1. So, study for you classes, and worry about studying for step 1 when you are closer to you test date.

 

[Locrian]

FADD / FLIP? BID? haven't seen those in any review books... FA? Uworld? Pathoma?

If it's not in one of those 3 sources, I'm pretty ok with not knowing it. FA/Uworld/Pathoma only cover about 1% of medicine. Opening it up to the other 99% could generate a variety on minutia or specialty level questions.

Lol, are you serious?

There is a reason the increasing yield of "cell/molecular bio" questions are killing people on the boards these days.

I don't even know how you couldn't have come across this stuff?

4 different areas I came across those terms:
1. During CellBio/Biochem Block:
Lippincotts Cell and Molecular Biology Review (reviews these pathways)
HY cell and molecular Bio (reviews these pathways)
2. Endocrine/signaling systems during Physiology
3. During Immunology (even Basic Immunology by Abbas covers some of these pathways)
4. Intropath; don't you tell me Medium Robins, or RR Goljan doesn't talk about apoptosis and their mechanisms -.- even goljans audio.

You'd have to really try HARD to not have seen any of those words before.
Just like all the other people in my class that don't read books and depend on lectures, of course you miss A LOT of stuff lol.

 

[ijn]

Lol, are you serious?

There is a reason the increasing yield of "cell/molecular bio" questions are killing people on the boards these days.

I don't even know how you couldn't have come across this stuff?

4 different areas I came across those terms:
1. During CellBio/Biochem Block:
Lippincotts Cell and Molecular Biology Review (reviews these pathways)
HY cell and molecular Bio (reviews these pathways)
2. Endocrine/signaling systems during Physiology
3. During Immunology (even Basic Immunology by Abbas covers some of these pathways)
4. Intropath; don't you tell me Medium Robins, or RR Goljan doesn't talk about apoptosis and their mechanisms -.- even goljans audio.

You'd have to really try HARD to not have seen any of those words before.
Just like all the other people in my class that don't read books and depend on lectures, of course you miss A LOT of stuff lol.

I personally thought your question was pretty low yield (and in non-step 1 format, they are forbidden from asking which of the following is NOT). And I ended up with a 269. Molecular biology can go suck a dick. There's little benefit outside of what's in FA.

 

[Locrian]

I personally thought your question was pretty low yield (and in non-step 1 format, they are forbidden from asking which of the following is NOT). And I ended up with a 269. Molecular biology can go suck a dick. There's little benefit outside of what's in FA.

Haha. You're right. It was a very oversimplified example and not in step format.

But let us all take a lesson from this. It's only important to know whats on step.
Thats what makes good doctors.

:Sigh:

 

[John Lannister]

Lol, are you serious?

There is a reason the increasing yield of "cell/molecular bio" questions are killing people on the boards these days.

I don't even know how you couldn't have come across this stuff?

4 different areas I came across those terms:
1. During CellBio/Biochem Block:
Lippincotts Cell and Molecular Biology Review (reviews these pathways)
HY cell and molecular Bio (reviews these pathways)
2. Endocrine/signaling systems during Physiology
3. During Immunology (even Basic Immunology by Abbas covers some of these pathways)
4. Intropath; don't you tell me Medium Robins, or RR Goljan doesn't talk about apoptosis and their mechanisms -.- even goljans audio.

You'd have to really try HARD to not have seen any of those words before.
Just like all the other people in my class that don't read books and depend on lectures, of course you miss A LOT of stuff lol.

Haha. You're right. It was a very oversimplified example and not in step format.

But let us all take a lesson from this. It's only important to know whats on step.
Thats what makes good doctors.

:Sigh:

First of, Ijn is probably 5x smarter than I am - and his opinion on this counts much more than mine.

Second off, my point wasn't that cell bio isn't important, but specially you're talking about: FADD / FLIP / BID, etc. At least Bcl-2 or BAX are in review books, but intermediates of intermediates? I don't think that's going to help anyone be a better doctor.

Clinical decision making has little to do with BID, FLIP, FADD and more to do with a presentation and understanding some pathophys... and you don't need that type of detail to understand pathophys. Look at a book like Step Up to Medicine. Pretty detailed and a decent background for IM - you wouldn't see any molecular pathways like that in there. Basically, the things you're talking about have nothing to do with being a good doctor.

 

[Locrian]

Remember you supposed to be a clinical scientist.

When you know only what your supposed to know/enough to get by, you're not really going to advance our field are you?

It's like when I talk to my fellow classmates about medicine, most of the time im literally standing their with a face like -.-... like yeah, hmm you have a fundamental misunderstanding of how the human body works when questioned, but you can recite goljan to me like their your own words because you memorized what you need to know for step. I'm so impressed.

 

[ijn]

Clinical decision making has little to do with BID, FLIP, FADD and more to do with a presentation and understanding some pathophys... and you don't need that type of detail to understand pathophys. Look at a book like Step Up to Medicine. Pretty detailed and a decent background for IM - you wouldn't see any molecular pathways like that in there. Basically, the things you're talking about have nothing to do with being a good doctor.

Yea you pretty much forget 99% of molecular biology a few weeks after that exam. I couldn't even tell you about high yield **** like g-coupled protein receptors anymore. Which I apparently knew okay at one point.

There's something to be said for basic science but after a certain point it has little to being a good doctor. I think more important questions are do you have a desire and self discipline to constantly learn new clinical science and do you have at least an average social IQ.

 

[Locrian]

Yea you pretty much forget 99% of molecular biology a few weeks after that exam. I couldn't even tell you about high yield **** like g-coupled protein receptors anymore. Which I apparently knew okay at one point.

There's something to be said for basic science but after a certain point it has little to being a good doctor. I think more important questions are do you have a desire and self discipline to constantly learn new clinical science and do you have at least an average social IQ.

Hey that's good! Atleast you put in the work. And should you ever need to see that stuff again/read about it in research papers/drug action mechanisms, it will come back to you, or be easier for you to understand what they are saying. Vs. people im talking about that just gloss over whats not high yield -.- Just make everything harder for themselves later.

 

[Anastomoses]

Good doctor? I just wanna be a shot caller. Now tell me what to study...molecular or physio or what?

 

[rodmichael82]

Good doctor? I just wanna be a shot caller. Now tell me what to study...molecular or physio or what?

You better have Embryo down cold if you wana be a shot caller.

 

[chronicidal]

Hey that's good! Atleast you put in the work. And should you ever need to see that stuff again/read about it in research papers/drug action mechanisms, it will come back to you, or be easier for you to understand what they are saying. Vs. people im talking about that just gloss over whats not high yield -.- Just make everything harder for themselves later.

You point out an important choice facing medical students and how they approach their preclinical education.

What is the purpose of learning knowledge that is deemed "interesting" by PhD researchers or by subspecialist clinicians but is otherwise irrelevant to the current clinical practice of medicine or is not something that you can expect every good doctor in any field to know?

Is it that there is a small chance (and it's small, because it's low-yield) that this knowledge-for-knowledge's-sake may BECOME relevant later and that learning it NOW will be EASIER than learning it LATER?

I don't think that's worthwhile, in terms of efficiency. Rather than learning how BID functions in apoptosis now in case there is a cancer drug 20 years from now that targets it, I would rather learn it in 20 years, if and only if there is that drug, when I have significantly more perspective on how important knowing this stuff is to my area of clinical expertise. You COULD learn it once now, at considerable difficulty because it lacks certain relevance and meaning in your life, and then you let that memory decay exponentially without any added meaning or repetition for the next 20 years. It doesn't come up on boards (because it's low-yield), it doesn't come up on the wards (because the drug doesn't exist yet), it doesn't come up in your research (because you choose to specialize in an area that, statistically, is highly unlikely to deal with this one tidbit of minutia). Then 20 years from now, the strength of that memory trace is <1% of its initial strength. Now you read about this new miracle drug, you have to almost essentially re-learn the entire concept to get that memory from 1% to 100%. I would rather learn it (go from 0% to 100%) in 20 years because it will have an added layer of MEANING and relevance. When items of knowledge are elaborated with meaning, they stick in your memory better, i.e. they are easier to learn. Further, I'll know that the effort I'm putting into it is going to be worth it because it will be relevant, rather than just knowledge for knowledge's sake.

Preclinical medical education is not like a liberal arts education. They're not trying to get us to open our minds and think about things in new ways across different disciplines and learn knowledge for knowledge's sake. Preclinical medical education is professional school. It's about dumping a ton of knowledge in a single domain on us, forcing us to create declarative memories for everything, hoping some of it sticks and that we can apply it in the clinical context.

You might object, "Remember you supposed to be a clinical scientist." meaning we are supposed to be advancing the field and that we are a step above the mid-levels, nurses, PAs, technicians. I get that. I don't think teaching us a broad variety of esoteric KNOWLEDGE is the way to cultivate the SKILLS it takes to be a clinical scientist who can advance the field. We can only be experts in a small slice of medicine and forge ahead there, and our success in that endeavor will not be determined by how much of it we learned in the first two years of medical school. My ideal curriculum would pare down the content of first two years into the most clinically relevant things in order to create time for research. A few progressive-thinking schools are already doing this. Duke has had this idea for decades with its 1 year preclinical model. Vanderbilt is following in its steps. Many other schools have the 1.5 year, like Penn and Emory.

 

[Kaustikos]

Good doctor? I just wanna be a shot caller. Now tell me what to study...molecular or physio or what?

Teeth. You need to know teeth.

 

[Resapp]

I would say 30%.