How much pre-clinical information do you still remember, ie. Anatomy?

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RJGOP

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This question is directed more towards residents, fellows and attendings. I understand the answers will vary from to person, but I'm curious as to how much doctors typically retain pre-clinical material years later.

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This question is directed more towards residents, fellows and attendings. I understand the answers will vary from to person, but I'm curious as to how much doctors typicaly retain pre-clinical material years later.

I know a lot of anatomy.

But now I know it in the setting of a surgical practice.

I couldn't tell you the nerve roots for the brachial plexus for instance. Nor the esoteric layers of pelvic fascia that they expected us to memorize.

I know a lot of pathology and physiology (except the f**king kidney which remains eternally a black box of mystery to me)

I know a decent amount of pharmacology, but it's more of the "what drug do I use for this?" type than the detailed M2 type.

I know very very little biochemistry or embryology.
 
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Histology, Cell and Molecular Biology (I guess this would technically fit into Biochem) --- due to many diseases having an alteration in that area; Many drugs also work that way, Pathology, Pharmacology. (I still know Physiology but that's bc it was a great subject to try to understand - Physiology of the skin is usually not covered in medical school)

The problem with basic science education is that professors have no idea which specialty you will end up in. Does an Emergency Medicine really need to know histology? No. Should a pathologist know histology? Yes. Does a psychiatrist need to know Gross Anatomy? No, not really. Should a General Surgeon? Yes.

Intersting article on basic science education from a surgeon: http://skepticalscalpel.blogspot.com/2013/12/an-mds-thoughts-on-medical-education.html
 
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The problem with basic science education is that professors have no idea which specialty you will end up in. Does an Emergency Medicine really need to know histology? No. Should a pathologist know histology? Yes. Does a psychiatrist need to know Gross Anatomy? No, not really. Should a General Surgeon? Yes.

Hey now, I know there's some big thing in the skull that's important.
 
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Hey now, I know there's some big thing in the skull that's important.
That's Neuroanatomy, not Gross Anatomy. I could be very wrong, but most medical students find the brain very interesting, if even from a theoretical perspective, and thus enjoy Neuroanatomy/Neuroscience much more than Gross Anatomy, and learning about Camper's and Scarpa's fascia.

Psychiatry and Neurology are under the same certification board, I believe.
 
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Not a resident yet, but surprisingly more than I thought I would.

For anatomy, sometimes it takes a while to come back but much of the information is still there.

Also, its not like you stop reviewing anatomy once the clinical years start. For instance I was just on Anesthesia and we had to review a bunch of anatomy for spinals/epidurals (vertebrae and spinal cord), peripheral nerve blocks (extremities), central lines (neck and thorax), and intubations (airway).

The learning never ends in medicine.
 
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That's Neuroanatomy, not Gross Anatomy. I could be very wrong, but most medical students find the brain very interesting, if even from a theoretical perspective, and thus enjoy Neuroanatomy/Neuroscience much more than Gross Anatomy, and learning about Camper's and Scarpa's fascia.

Psychiatry and Neurology are under the same certification board, I believe.

Hmm, I actually enjoy gross anatomy quite a bit, I mean yeah memorizing layers of scrotal fascia is pretty annoying, but coming from an athletic background I've always had a keen interest in MSK and cardiovascular anatomy especially. Neuroanatomy on the other hand, makes me want to off myself. I guess I could just be the odd one out on this though.
 
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That's Neuroanatomy, not Gross Anatomy. I could be very wrong, but most medical students find the brain very interesting, if even from a theoretical perspective, and thus enjoy Neuroanatomy/Neuroscience much more than Gross Anatomy, and learning about Camper's and Scarpa's fascia.

Psychiatry and Neurology are under the same certification board, I believe.

Just dissected through my cadaver's Camper's and Scarpa's fascia. Getting a kick out of this thread, etc.
 
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Hmm, I actually enjoy gross anatomy quite a bit, I mean yeah memorizing layers of scrotal fascia is pretty annoying, but coming from an athletic background I've always had a keen interest in MSK and cardiovascular anatomy especially. Neuroanatomy on the other hand, makes me want to off myself. I guess I could just be the odd one out on this though.
I guess it depends which part of Neuroanatomy --- I can see how maybe different parts of the brainstem can do that, i.e. like the different cuts at different levels.
 
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Not a resident yet, but surprisingly more than I thought I would.

For anatomy, sometimes it takes a while to come back but much of the information is still there.

Also, its not like you stop reviewing anatomy once the clinical years start. For instance I was just on Anesthesia and we had to review a bunch of anatomy for spinals/epidurals (vertebrae and spinal cord), peripheral nerve blocks (extremities), central lines (neck and thorax), and intubations (airway).

The learning never ends in medicine.
I agree. Common misperception by med students is that most of the learning/book work is only in MS-1/MS-2. It's only a foundation which is why it is called "basic" science. It can get quite intricate when people have certain variations in anatomy -- i.e. the pathway of certain heart vessels. Of course pointing out on a cadaver, a plastic model, or an atlas picture is much different, than when you're putting a Glidoscope down someone's throat (and a huge, fat throat at that).
 
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This question is directed more towards residents, fellows and attendings. I understand the answers will vary from to person, but I'm curious as to how much doctors typicaly retain pre-clinical material years later.

A hell of a lot more than You might expect. Some of it I use regularly, some of it is just trivia floating around in my head. A lot of it falls somewhere in the middle: not used on a regular basis, but available for the odd occasion when it comes in handy.

Which is why I cringe a bit when first/second year med students whine about how useless it is to work so hard to memorize/understand "useless" things. Yes, there is some level of detail you may never have to encounter again in many subjects, but depending on the field you choose, many things will come back to haunt you if you didn't master it in medical school.
 
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A hell of a lot more than You might expect. Some of it I use regularly, some of it is just trivia floating around in my head. A lot of it falls somewhere in the middle: not used on a regular basis, but available for the odd occasion when it comes in handy.

Which is why I cringe a bit when first/second year med students whine about how useless it is to work so hard to memorize/understand "useless" things. Yes, there is some level of detail you may never have to encounter again in many subjects, but depending on the field you choose, many things will come back to haunt you if you didn't master it in medical school.
And for some reason, it's almost clockwork that the stuff that M1s always seem to pick is "useless", actually is used in clinical medicine. My belief is that it isn't the material that is the problem, but that it is taught very very poorly. =Unfortunately it requires a lot of resources for med schools to integrate clinicians well into the basic science curriculum (making up for lost RVUs by faculty coming in and lecturing), that many schools, just scrap the entire idea and just have PhDs teach everything.
 
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Let's just say there are certain parts of Gross Anatomy that I hate with the strength of a thousand suns. Another one - the layers of the scrotum: http://radiopaedia.org/articles/layers-of-the-scrotum-mnemonic

That's coming up in a few days, but have to do it on another groups cadaver due to gender differences. I've been fortunate so far as our group's cadaver has relatively little fat on her, and considering the age at which she died, probably lived a pretty healthy life (the heart and lungs are close to textbook ideal). The male cadaver next door is covered in fat, though. I foresee a not-so-pleasant dissection.
 
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They remember ALL of it. Pre-clinical material is extraordinarily value and one cannot possibly know what is and is not clinically relevant, because it's ALL clinically relevant. If you don't remember which spinal roots innervate the superior gemellus, or which transcription factors are responsible for osteoprogenitor differentiation then you are a terrible doctor and you should be ashamed of yourself because your knowledge deficit will undoubtedly harm a patient.
 
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They remember ALL of it. Pre-clinical material is extraordinarily value and one cannot possibly know what is and is not clinically relevant, because it's ALL clinically relevant. If you don't remember which spinal roots innervate the superior gemellus, or which transcription factors are responsible for osteoprogenitor differentiation then you are a terrible doctor and you should be ashamed of yourself because your knowledge deficit will undoubtedly harm a patient.
For someone who chose medical school as a non-traditional student, as a step up from where you were previously, you're particularly annoying.
 
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For someone who chose medical school as a non-traditional student, as a step up from where you were previously, you're particularly annoying.
Which transcription factors are responsible for forelimb and hindlimb development?
 
They remember ALL of it. Pre-clinical material is extraordinarily value and one cannot possibly know what is and is not clinically relevant, because it's ALL clinically relevant. If you don't remember which spinal roots innervate the superior gemellus, or which transcription factors are responsible for osteoprogenitor differentiation then you are a terrible doctor and you should be ashamed of yourself because your knowledge deficit will undoubtedly harm a patient.

You wouldn't know clinically relevant medicine if it bit you on the backside
 
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They remember ALL of it. Pre-clinical material is extraordinarily value and one cannot possibly know what is and is not clinically relevant, because it's ALL clinically relevant. If you don't remember which spinal roots innervate the superior gemellus, or which transcription factors are responsible for osteoprogenitor differentiation then you are a terrible doctor and you should be ashamed of yourself because your knowledge deficit will undoubtedly harm a patient.

I hate to engage in schadenfreude (actually I don't hate it all that much), but after your history of douchey "manual labor is sooooooo much harder than anything medical school will offer" posts, I don't feel particularly bad when I read your current woe-is-me posts.

We've all suffered through the preclinical years. Some of it wont help us in the future, some of it will. Some of that you can identify, and some you can't yet. Offering a few specific examples of likely unimportant (to you) facts doesn't somehow prove your apparent point that med school lecturers are meanies. Drop out and become a PA or NP if learning all these things doesn't suit you.

If I have you mistaken for some other whiner, I apologize.
 
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You're killing your patients, bud. Hox genes are for segmentation. Which Tbx genes in particular.
If you didn't want to learn this stuff and think it's all unimportant, then why in God's name would you go to med school? You were a non-traditional student so in theory you actually thoroughly researched the amount of investment before you quit your job, unlike your typical traditional student.
 
If you didn't want to learn this stuff and think it's all unimportant, then why in God's name would you go to med school? You were a non-traditional student so in theory you actually thoroughly researched the amount of investment before you quit your job, unlike your typical traditional student.
I expected more of professional school. At times (most of the time) it feels like a graduate program in biology. Hopefully MS2 will be more interesting because MS1 sucks.
 
I expected more of professional school. At times (most of the time) it feels like a graduate program in biology. Hopefully MS2 will be more interesting because MS1 sucks.

Gotta learn to crawl before you walk.
 
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I expected more of professional school. At times (most of the time) it feels like a graduate program in biology. Hopefully MS2 will be more interesting because MS1 sucks.
MS-1 is the foundation to build upon when you enter MS-2 and things are segmented into organ systems. Many diseases have cellular/signal transduction dysfunction -- i.e. Neoplasia such as colon cancer.
 
I expected more of professional school. At times (most of the time) it feels like a graduate program in biology. Hopefully MS2 will be more interesting because MS1 sucks.

You've been in school for what, 3 months? And you've been complaining on this forum about how much it sucks for what, 2 months 29 days? You really should sit down and think about what you want because either a) you are just one of those people who complain about everything and never seem to be happy, in which case I'd suggest reevaluating your approach to life before you spiral into depression, or b) medical school thus far really has been that terrible for you and you should seriously consider quitting while your ahead. I'm apologize for being blunt, but you seem like a truly miserable person who should maybe seek some professional help to help you figure out what you want to do with your life (and there's nothing wrong talking to someone to get help!).
 
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This question is directed more towards residents, fellows and attendings. I understand the answers will vary from to person, but I'm curious as to how much doctors typically retain pre-clinical material years later.

Some?

Actually, other than knowing the approximate half lives of naloxone and heroin, along with knowledge of the concept of competitive inhibition, I probably didn't use much preclinical material overnight. There was some ECG stuff I first learned in the preclinical years. Honestly, for the clinically relevant stuff, it becomes difficult to recall what was learned in the preclinical years and what was built on from preclinical knowledge.
 
You've been in school for what, 3 months? And you've been complaining on this forum about how much it sucks for what, 2 months 29 days? You really should sit down and think about what you want because either a) you are just one of those people who complain about everything and never seem to be happy, in which case I'd suggest reevaluating your approach to life before you spiral into depression, or b) medical school thus far really has been that terrible for you and you should seriously consider quitting while your ahead. I'm apologize for being blunt, but you seem like a truly miserable person who should maybe seek some professional help to help you figure out what you want to do with your life (and there's nothing wrong talking to someone to get help!).
Longer than that and he already has.
 
And for some reason, it's almost clockwork that the stuff that M1s always seem to pick is "useless", actually is used in clinical medicine. My belief is that it isn't the material that is the problem, but that it is taught very very poorly. =Unfortunately it requires a lot of resources for med schools to integrate clinicians well into the basic science curriculum (making up for lost RVUs by faculty coming in and lecturing), that many schools, just scrap the entire idea and just have PhDs teach everything.

That is one of the reasons that I don't criticize my school anymore ... For an unranked school, there are some things they do right. For instance, having input of clinicians can make some of these classes a bit more interesting... I hate anatomy, but because anatomy is being taught by two professors (one with a PhD and an ER doc), it makes the class less boring and a little bit more applicable. We also have these two professors in the dissecting lab and the pathology professor on speed dial to come in to answer questions that the ER doc sometimes can't answer. Pharm and micro (second year) are taught by clinicians as well, a FM/PhD (pharmacology) and an IM/PhD (microbiology) respectively....
 
That is one of the reasons that I don't criticize my school anymore ... For an unranked school, there are some things they do right. For instance, having input of clinicians can make some of these classes a bit more interesting... I hate anatomy, but because anatomy is being taught by two professors (one with a PhD and an ER doc), it makes the class less boring and a little bit more applicable. We also have these two professors in the dissecting lab and the pathology professor on speed dial to come in to answer questions that the ER doc sometimes can't answer. Pharm and micro (second year) are taught by clinicians as well, a FM/PhD (pharmacology) and an IM/PhD (microbiology) respectively....
Yup, as much as USWNR rankings are criticized, they do have some validity. Just look at how Anatomy is taught. At Wash U for example, radiology residents help with helping students understand Anatomy by understanding how to look at imaging. Yet there are still medical schools in which students don't get exposed to imaging or learning how to read imaging in Anatomy, which is important at least, bc there are image questions on USMLE Step 1 - even if you look at the sample questions. Is it resource intensive, yes - that's why some med schools can't do it.

Having clinicians in basic sciences is important esp. since Step 1 has had a more clinical tilt, but it's also a money loser as well, with respect to that clincian not seeing the patients they're supposed to see during that time period - some can afford it, some can't. In theory, it would be great to have a Surgeon as the course director along with the PhD Anatomist, but that's pretty much impossible.
 
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You're killing your patients, bud. Hox genes are for segmentation. Which Tbx genes in particular.
Tbx 4 and 5 obviously. Everyone knows this. You might as well ask how many cells are produced by mitosis.
 
Gotta learn to crawl before you walk.

The_Wire_Clay_Davis.jpg
 
Yup, as much as USWNR rankings are criticized, they do have some validity. Just look at how Anatomy is taught. At Wash U for example, radiology residents help with helping students understand Anatomy by understanding how to look at imaging. Yet there are still medical schools in which students don't get exposed to imaging or learning how to read imaging in Anatomy, which is important at least, bc there are image questions on USMLE Step 1 - even if you look at the sample questions. Is it resource intensive, yes - that's why some med schools can't do it.

Having clinicians in basic sciences is important esp. since Step 1 has had a more clinical tilt, but it's also a money loser as well, with respect to that clincian not seeing the patients they're supposed to see during that time period - some can afford it, some can't. In theory, it would be great to have a Surgeon as the course director along with the PhD Anatomist, but that's pretty much impossible.
I just thought it was the norm to have input of clinicians in some of these major classes that I just said; I guess it is not... Heck! Even my 7 days genetics class was mainly taught by a M.D. geneticist...
 
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I expected more of professional school. At times (most of the time) it feels like a graduate program in biology. Hopefully MS2 will be more interesting because MS1 sucks.
Btw you know that role of Tbx and Hox genes are mediated by retinoic acid right? This is why retinoid drugs (like Acutane) are highly teratogenic.

BOOM clinical correlation.
 
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Um, who is that?

Senator Clay Davis from The Wire. There was an episode where he's advising/taking under his wing one of the main characters (a drug kingpin) on how to run for office, and the line he gave was something like "First you crawl, then you walk, then you run." I tried to find a video clip of the scene, but HBO seems to have done a good job getting scouring youtube for any trace of it. It's episode 8 of season 3, entitled "Moral Midgetry".
 
I expected more of professional school. At times (most of the time) it feels like a graduate program in biology. Hopefully MS2 will be more interesting because MS1 sucks.

You've been in school for what, 3 months? And you've been complaining on this forum about how much it sucks for what, 2 months 29 days? You really should sit down and think about what you want because either a) you are just one of those people who complain about everything and never seem to be happy, in which case I'd suggest reevaluating your approach to life before you spiral into depression, or b) medical school thus far really has been that terrible for you and you should seriously consider quitting while your ahead. I'm apologize for being blunt, but you seem like a truly miserable person who should maybe seek some professional help to help you figure out what you want to do with your life (and there's nothing wrong talking to someone to get help!).

This x 1000

CV, every time I read your posts I wonder if your medical career is going to end very, very poorly. Everyone complains on SDN, especially about M1, but you take it to another level of miserable. I hope it's just exaggerated frustration, but if not you should really re-evaluate if medical school is right for you. You're only a semester in.
 
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Btw you know that role of Tbx and Hox genes are mediated by retinoic acid right? This is why retinoid drugs (like Acutane) are highly teratogenic.

BOOM clinical correlation.
No, I didn't know that. Putting that one little fact into the lecture would have made it more interesting.
 
Yup, as much as USWNR rankings are criticized, they do have some validity. Just look at how Anatomy is taught. At Wash U for example, radiology residents help with helping students understand Anatomy by understanding how to look at imaging. Yet there are still medical schools in which students don't get exposed to imaging or learning how to read imaging in Anatomy, which is important at least, bc there are image questions on USMLE Step 1 - even if you look at the sample questions. Is it resource intensive, yes - that's why some med schools can't do it.

Having clinicians in basic sciences is important esp. since Step 1 has had a more clinical tilt, but it's also a money loser as well, with respect to that clincian not seeing the patients they're supposed to see during that time period - some can afford it, some can't. In theory, it would be great to have a Surgeon as the course director along with the PhD Anatomist, but that's pretty much impossible.
Ironically, my clinician professors in biochem and physiology were the absolute worst. I feel that MD/PhD's do the best job by far.

Honestly though, I don't see why it's so difficult for a PhD to make a clinical lecture. Sprinkle in a few facts from UpToDate and explaining the pathogenesis would keep the vast majority of med students happy imo.
 
Ironically, my clinician professors in biochem and physiology were the absolute worst. I feel that MD/PhD's do the best job by far.

Honestly though, I don't see why it's so difficult for a PhD to make a clinical lecture. Sprinkle in a few facts from UpToDate and explaining the pathogenesis would keep the vast majority of med students happy imo.
Clinical facts are too pedestrian.
 
No, I didn't know that. Putting that one little fact into the lecture would have made it more interesting.
So then now that you know, why don't you have at least a little faith in the system, and have a little introspection that you don't know everything about what is relevant and what will be relevant.
 
No, I didn't know that. Putting that one little fact into the lecture would have made it more interesting.
Do you really spend that much time in embryology? Our Anatomy exams usually has 3-4 questions of embryo and most people I know usually read the PP slides a couple of hours before the exam... Most of us have figured out that it is not an efficient use of our time to master 5-6 chapters in that Langman's book to answer 3-4 questions correctly, which is not even guaranteed.
 
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Clinical facts are too pedestrian.
A PhD doesn't have the ability or skill set to give a clinical lecture. The same way an MD doesn't necessarily have the ability to give a basic science heavy cellular biology lecture.
 
Btw you know that role of Tbx and Hox genes are mediated by retinoic acid right? This is why retinoid drugs (like Acutane) are highly teratogenic.

BOOM clinical correlation.

uh I fail to see any possible way for any of the information in my preclinical courses to possibly have any clinical correlation. obviously they're just wasting my time, why else would they force me to go through this hazing called medical school if not for the sole purpose of making me miserable?
 
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Do you really spend that much time in embryology? Our Anatomy exams usually has 3-4 questions of embryo and most people I know usually read the PP slides a couple of hours before the exam... Most of us have figured out that it is not an efficient use of our time to master 5-6 chapters in that Langman's book to answer 3-4 questions correctly, which is not even guaranteed.
It's a small portion of our grade, but we still have to devote time to go through the horrible ****ing abortions that are embryology lectures.
 
It's a small portion of our grade, but we still have to devote time to go through the horrible ******* abortions that are embryology lectures.
Have you gotten to neuroanatomy yet? Neuroanatomy only seemed intuitive to me after reviewing embryology.

Minus pharyngeal arches. **** pharyngeal arches.
 
It's a small portion of our grade, but we still have to devote time to go through the horrible ******* abortions that are embryology lectures.
I see... It is a VERY small portion of my anatomy class. Most people that I talk to in my class don't really spend time on it that much... Then again, I heard one student went to administration and complain about that; I hope they don't change anything about the # of embryo questions they put on these exams...

Med school can have some weird people... I know a MS2 student that went and complain to administration because of a high average (I heard it was 88) in a pathology exam... He said the exam was too easy... This guy and his girlfriend study 14-16 hours/day according to people who know them...
 
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