How will my first year studies contribute to my capacity to help patients?

[tdod]

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This question may sound silly, but hear my out:

I study diligently (I'm MS1), but I would like to refine the basis of my motivation. I am losing interest in my former sources of motivation - status, income, prestige, anxiety. I would like to replace them with altruistic motives, but I currently lack knowledge regarding the various ways in which academic excellence (as opposed to adequacy) in my first two years can enable me to confer greater benefit to my patients. Some possibilities are:

• greater mastery of Step 1 material → more effective practitioner?
• academic excellence leads to position of authority, enabling me to promote beneficial institutional changes?
• academic excellence enables me to obtain residency in a speciality and location that is ideal for me, which will enable me to invest more energy into my residency and future practice?
• other aspects I have not considered?

Any thoughts on this would be appreciated!

 

[Oso]

This question may sound silly, but hear my out:

I study diligently (I'm MS1), but I would like to refine the basis of my motivation. I am losing interest in my former sources of motivation - status, income, prestige, anxiety. I would like to replace them with altruistic motives, but I currently lack knowledge regarding the various ways in which academic excellence (as opposed to adequacy) in my first two years can enable me to confer greater benefit to my patients. Some possibilities are:

• greater mastery of Step 1 material → more effective practitioner?
• academic excellence leads to position of authority, enabling me to promote beneficial institutional changes?
• academic excellence enables me to obtain residency in a speciality and location that is ideal for me, which will enable me to invest more energy into my residency and future practice?
• other aspects I have not considered?

Any thoughts on this would be appreciated!

Lol they won't, sorry.

Also, you're saying your main motivations initially were status, income, and prestige, and you're NOW trying to develop altruistic motives?

 

[tdod]

Lol they won't, sorry.

Also, you're saying your main motivations initially were status, income, and prestige, and you're NOW trying to develop altruistic motives?

Yes, if I am to be honest. I understand such an admission opens me up to criticism. Feel free to criticize, but bear in mind that I am a medical student and I will be a doctor. I will have future patients, and providing me with constructive advice will enable me to better help my future patients. Criticizing me for my past behaviors is far less likely to do so.

In my experience, altruism and compassion must be cultivated over time. We are all tempted to deem ourselves perfectly selfless and altruistic, but I've found that selfishness is deeply embedded in the human mind. I have no problem admitting that I am selfish. In fact, I am happy to make this admission; if I convince myself otherwise, then I will have less motivation to deepen my commitment to the wellbeing of others.

 

[michaelrack]

This question may sound silly, but hear my out:

• academic excellence enables me to obtain residency in a speciality and location that is ideal for me, which will enable me to invest more energy into my residency and future !

Yes

 

[atomheart]

It is about learning to think as other physicians do. The first motivation is to know enough to not kill people with poor decisions (do no harm).

Once you've reached that level you can start to think about contributing to the science, building your business, or "helping people".

 

[Anti-PD1]

This question may sound silly, but hear my out:

I study diligently (I'm MS1), but I would like to refine the basis of my motivation. I am losing interest in my former sources of motivation - status, income, prestige, anxiety. I would like to replace them with altruistic motives, but I currently lack knowledge regarding the various ways in which academic excellence (as opposed to adequacy) in my first two years can enable me to confer greater benefit to my patients. Some possibilities are:

• greater mastery of Step 1 material → more effective practitioner?
• academic excellence leads to position of authority, enabling me to promote beneficial institutional changes?
• academic excellence enables me to obtain residency in a speciality and location that is ideal for me, which will enable me to invest more energy into my residency and future practice?
• other aspects I have not considered?

Any thoughts on this would be appreciated!

Re: preclinical studies, I'll share a story.

My guru Sattar taught me how fingernail clubbing occurs. In patients with lung cancer, interstitial lung disease, etc megakaryocytes are fragmented in the pulmonary vasculature, and these fragments accumulate at the farthest capillary beds, causing fingernail clubbing. So the theory is.

To me, that was rad. It stuck in my mind.

4th year, I'm taking a family med elective to prepare for Step 2 CS. Spanish speaking woman comes in complaining of chronic flu like symptoms, very vague, very blah. And she's speaking Spanish, so the valence of language is lost. Resident thought it was allergic rhinitis. As we left the room, I asked him if he saw her nails. To me, she had fingernail clubbing. We go back in and re-examine her. Did a Schamroth's window test. Social history: turns out she's worked at a glue factory for the last 10 years.

tl;dr remembering preclinical/Sattar/Step 1 earned this patient a workup for ILD she otherwise would have missed out on.

Also, it's just satisfying to know why things work the way they work. I'm not happy until I know why.

 

[Iz_FtB]

Excellence is a habit. If you want to be great at the next stage, be great now. Doesn't matter how relevant or not your present responsibilities are to your future responsibilities.

 

[Goro]

This question may sound silly, but hear my out:

I study diligently (I'm MS1), but I would like to refine the basis of my motivation. I am losing interest in my former sources of motivation - status, income, prestige, anxiety. I would like to replace them with altruistic motives, but I currently lack knowledge regarding the various ways in which academic excellence (as opposed to adequacy) in my first two years can enable me to confer greater benefit to my patients. Some possibilities are:

• greater mastery of Step 1 material → more effective practitioner?
• academic excellence leads to position of authority, enabling me to promote beneficial institutional changes?
• academic excellence enables me to obtain residency in a speciality and location that is ideal for me, which will enable me to invest more energy into my residency and future practice?
• other aspects I have not considered?

Any thoughts on this would be appreciated!

It teaches you how to think, remember, and most importantly, to apply. You should also be having some courses in the actually doing of doctor stuff, like how to take a history, or where to place the stethoscope.

Also, your pre-clinical curriculum doesn't magically end with Step I. You take what you learn and apply it to Wards.

 

[sliceofbread136]

Re: preclinical studies, I'll share a story.

My guru Sattar taught me how fingernail clubbing occurs. In patients with lung cancer, interstitial lung disease, etc megakaryocytes are fragmented in the pulmonary vasculature, and these fragments accumulate at the farthest capillary beds, causing fingernail clubbing. So the theory is.

To me, that was rad. It stuck in my mind.

4th year, I'm taking a family med elective to prepare for Step 2 CS. Spanish speaking woman comes in complaining of chronic flu like symptoms, very vague, very blah. And she's speaking Spanish, so the valence of language is lost. Resident thought it was allergic rhinitis. As we left the room, I asked him if he saw her nails. To me, she had fingernail clubbing. We go back in and re-examine her. Did a Schamroth's window test. Social history: turns out she's worked at a glue factory for the last 10 years.

tl;dr remembering preclinical/Sattar/Step 1 earned this patient a workup for ILD she otherwise would have missed out on.

Also, it's just satisfying to know why things work the way they work. I'm not happy until I know why.

Step 1 knowledge has really no bearing on that, it’s a pretty basic clinical skill to always look for clubbing. That resident needs to work on a more thorough physical exam

 

[hamstergang]

Everything builds on prior classes. I found that earlier classes helped develop a deeper understanding of later classes. Occasionally you might want to pull on that knowledge, but generally it's easier to remember things better when you've had a good foundation.

 

[operaman]

I would argue that the concepts you learn in the preclinical years are vital to understanding the language and practice of medicine. Much of it fades into the background and you will retain those aspects that most relate to your clinical practice. The basics especially come in handy when things aren’t going well and you have to figure out how to move forward with a patient who is otherwise defying your usual algorithm.

 

[Tenk]

Every time I have to intubate someone, put in a chest tube, or even defibrillate them I just draw the Kreb cycle... and then my patient dies.

 

[CherryRedDracul]

Step 1 knowledge has really no bearing on that, it’s a pretty basic clinical skill to always look for clubbing. That resident needs to work on a more thorough physical exam

With the ridiculous amount of knowledge we're expected to possess, honestly, it helps to have some sort of framework to glue bits and pieces of knowledge onto.

Otherwise, I find it difficult to remember disparate chunks of information. Perhaps Step 1 knowledge doesn't have direct bearing to that situation, but it helped a medical student retain information that may have fallen out of his/her brain.

It stuck.

 

[sliceofbread136]

With the ridiculous amount of knowledge we're expected to possess, honestly, it helps to have some sort of framework to glue bits and pieces of knowledge onto.

Otherwise, I find it difficult to remember disparate chunks of information. Perhaps Step 1 knowledge doesn't have direct bearing to that situation, but it helped a medical student retain information that may have fallen out of his/her brain.

It stuck.

IMO of all the things to have memorized a full and robust physical exam is definitely one of them. That and your ABCs.