How would you change the med school curriculum so that it actually makes sense?

[cellsaver]

I mean, it's true that after second year, we're at the mercy of the hospital system we rotate at with minimal support and that most true learning is self directed. I skimmed over the slave stuff/etc. and suppose I didn't read the link.

If you did some research on the history of how the US Health Insurance Industry came to exist (WWII shortage of laborers, labor unions demanding employer sponsored health insurance, making a job look attractive while not offering decent wages ) and where we are today (Physician discontent vs CMS / Third Party Payers / Hospital business strategies), you will understand what you are about to enter as a young physician. The medcial business landscape is in total flux. Guess who is getting screwed?

Quite amusing to an MBA and / or CPA in charge of fiscal

Cada loco con su tema (each crazy has their issue)

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[Jabbed]

I mean, no offense, but when you post stuff like this...



...which revolves around a fundamental misunderstanding of how the medical team functions, I can't really take seriously any suggestions about what is or isn't a "waste of time" with regard to medical education.

Cherry pick quotes all you want. My original point was simply that a) pre-clinical years are important, but could be implemented better and b) undergrad adds very little to your practical knowledge or skillset. You seemingly agree with both of these.

I truly think that pre-clinical education should be central to clinical practice, it's just that most people don't retain much of it. I think implementing longitudinal retention studying and spaced repetition is the key to making it all worthwhile

And please don't feel any obligation to 'take my suggestions seriously'. It's an anonymous forum to offer perspectives from all steps of the medical training pathway. But if you prefer the ad hominem stuff by all means..

 

[VA Hopeful Dr]

I mean, it's true that after second year, we're at the mercy of the hospital system we rotate at with minimal support and that most true learning is self directed. I skimmed over the slave stuff/etc. and suppose I didn't read the link.

Minimal support and most of the learning is self directed? I'm pretty sure this just means your school abandoned you. My experience was nothing like that.

 

[raiderette]

Seriously. People are seriously ok with physicians who don't even understand basic functions of government?



And is it any more ridiculous that you'd think your dermatologist is more qualified because he took p-chem?

No. I have met too many physicians that can't speak to the public, can't empathize with patients or are simply boring and pedantic.

 

[WingedOx]

b) undergrad adds very little to your practical knowledge or skillset.

Eh, the random-ass classes I took along the way to my BA are probably as useful to me in the day to day practice of medicine than anything I took for my science education. Medicine isn't just applied sciences!

Minimal support and most of the learning is self directed? I'm pretty sure this just means your school abandoned you. My experience was nothing like that.

There's also the element of getting out what you put in.

 

[W19]

Eh, the random-ass classes I took along the way to my BA are probably as useful to me in the day to day practice of medicine than anything I took for my science education. Medicine isn't just applied sciences!

I call that bull...

 

[Affiche]

I think what's unfathomable to me is that we have such a grossly inefficient system, yet med students are so pressed for time they're often struggling to find time off for their own medical appointments, family events, holidays, etc. Like okay you're going to drag this out for 4 years, but then how do I only get one summer vacation in all that time? Drag it out and give me ample breaks or condense the curriculum and get me out fast.

 

[VA Hopeful Dr]

I think what's unfathomable to me is that we have such a grossly inefficient system, yet med students are so pressed for time they're often struggling to find time off for their own medical appointments, family events, holidays, etc. Like okay you're going to drag this out for 4 years, but then how do I only get one summer vacation in all that time? Drag it out and give me ample breaks or condense the curriculum and get me out fast.

I don't think the pre-clinical years are all that inefficient (I managed to make a twice-monthly allergy shot appointment both years). Its a staggering amount of information that you have to learn. Are some of the softer classes done poorly at times? Probably, but they were a fairly small part of total time spent so I'm not sure its worth getting rid of them just to save an hour or two every week.

Clinical years are a different story, mostly location dependent. Some of my rotations were very well done, I stayed busy and learned a great deal. Others much less so. Honestly, it all depends on how much a given department/attending actually wants to teach.

 

[Goro]

Cherry pick quotes all you want. My original point was simply that a) pre-clinical years are important, but could be implemented better and b) undergrad adds very little to your practical knowledge or skillset. You seemingly agree with both of these.

And please don't feel any obligation to 'take my suggestions seriously'. It's an anonymous forum to offer perspectives from all steps of the medical training pathway. But if you prefer the ad hominem stuff by all means..

No. I have met too many physicians that can't speak to the public, can't empathize with patients or are simply boring and pedantic.

Eh, the random-ass classes I took along the way to my BA are probably as useful to me in the day to day practice of medicine than anything I took for my science education. Medicine isn't just applied sciences!
There's also the element of getting out what you put in.

I call that bull...

As Winged and Raiderette have alluded to, there's a reason why medical education is switching over to a competency-based model at both the med schools and graduate levels of training. This may come as a surprise to gunners, but scientific knowledge only counts for 1/6th of those competencies.

BTW, teaching and assessing of said competencies are now AOA + COCA and LCME + ACGME requirements.

 

[Stagg737]

Teach to step 1 so students get high scores. Then teach to step 2 so that students do well on shelf and step 2. Nothing else matters.

Then you may as well just go to a Carib diploma mill, as that is what their curriculum is based around (and they regularly churn out sub-par physicians).

You're 100% right, which is again why I think undergrad in general is just a waste of time and why I'm in favor of the 6 year model out of high school.

This comes back around to the immaturity of younger students. If you want 3 years UG --> 3 years of med school, that's a different argument. However expecting most 18 year olds to jump straight into a 6-year, med-school level curriculum and have the social skills to see patients is not realistic.

Cherry pick quotes all you want. My original point was simply that a) pre-clinical years are important, but could be implemented better and b) undergrad adds very little to your practical knowledge or skillset. You seemingly agree with both of these.

I've met too many med students and physicians who don't seem to understand the concept of "professionalism" to believe this. Unfortunately, teaching professionalism and social skills at some point is necessary in this field. Get rid or cut back on UG education too much and we'll need even more "BS, filler-courses" in med school than we've already got. No thank you. This is also relevant for other classes like finance, government, etc. I can't begin to count the number of financially idiotic physicians I've talked to, which imo is inexcusable given how intelligent they were overall.

 

[W19]

Then you may as well just go to a Carib diploma mill, as that is what their curriculum is based around (and they regularly churn out sub-par physicians).

Study shows that FMG/IMG grads provide comparable care....

Similar Outcomes for Care by Foreign vs U.S.-Trained Doctors

 

[Jabbed]

I've met too many med students and physicians who don't seem to understand the concept of "professionalism" to believe this. Unfortunately, teaching professionalism and social skills at some point is necessary in this field. Get rid or cut back on UG education too much and we'll need even more "BS, filler-courses" in med school than we've already got. No thank you. This is also relevant for other classes like finance, government, etc. I can't begin to count the number of financially idiotic physicians I've talked to, which imo is inexcusable given how intelligent they were overall.

Well those financially idiotic physicians likely graduated from US undergraduate institutions where they were required to take basic civics and finance classes..

Please realize that the rest of the medical world is on a 6 year system and isn't turning out Doogie Howser's. This whole "you aren't mature enough to become a doctor" argument is just simply not predicated in reality. We, as US grads, are the odd-balls here.

My first professionalism class in medical school was entitled "Empathy 101". Even as an utterly green med student, I realized that if you had spent the past 22 years on this planet as a human being and NOT developed the basic skill of empathizing with other human beings, it would be highly unlikely that a 30 minute powerpoint lecture on the subject was going to change anything.

 

[WingedOx]

This comes back around to the immaturity of younger students. If you want 3 years UG --> 3 years of med school, that's a different argument. However expecting most 18 year olds to jump straight into a 6-year, med-school level curriculum and have the social skills to see patients is not realistic.

It's not just the maturity of matriculants... it's the fact that applicant selection would involve 17-18 year olds... bad idea all around.

 

[Stagg737]

Study shows that FMG/IMG grads provide comparable care....

Similar Outcomes for Care by Foreign vs U.S.-Trained Doctors

There are also studies "showing" that NPs provide comparable care to physicians, guess that means we should just switch over to the same curriculum they use...

Well those financially idiotic physicians likely graduated from US undergraduate institutions where they were required to take basic civics and finance classes..

Please realize that the rest of the medical world is on a 6 year system and isn't turning out Doogie Howser's. This whole "you aren't mature enough to become a doctor" argument is just simply not predicated in reality. We, as US grads, are the odd-balls here.

My first professionalism class in medical school was entitled "Empathy 101". Even as an utterly green med student, I realized that if you had spent the past 22 years on this planet as a human being and NOT developed the basic skill of empathizing with other human beings, it would be highly unlikely that a 30 minute powerpoint lecture on the subject was going to change anything.

A few things that we're deciding to ignore in this whole debate. Many of those countries don't have just 6 years to complete their education. In countries like the UK, they have 6 years of med ed, then 4-7 years of residency (instead of 3-5 in the U.S.), followed by 2-3 more years of fellowship. So same length, just at different stages. In greece, all graduates have to do a 1 year rural medicine internship before starting their 3-7 years of residency. Additionally, in many countries doctors are considered "junior physicians" after completing residency for a few years before gaining full independent practice rights, so it's not just this shorter system where docs are out on their own that much earlier like you're suggesting.

Additionally, you can't compare U.S. culture to a lot of the countries you're talking about. In many of those countries, teenagers are seen as being mature enough to drink as teenagers. Can you imagine what would happen in the U.S. if we allowed 16 year olds to legally buy and drink beer or wine in the U.S. Does that sound like a good plan in our culture?

I also don't know what colleges require people to take finance classes, if you know of any science or pre-health programs which require that I'd be interested to find out where they are, but I've never heard of them. Include classes on government in that statement as well. I understand your point about professionalism and ethics classes in medical school, but can you honestly say that you don't have a number of classmates who don't have personality issues or flat-out don't know how to be professional? I honestly can't believe the number of things I've heard classmates say to faculty or written in e-mails that would make the average person stop and say WTF.

 

[W19]

There are also studies "showing" that NPs provide comparable care to physicians, guess that means we should just switch over to the same curriculum they use...

I did not know that NP take the same board exams with physicians and do a 3+ residency...

 

[Stagg737]

I did not know that NP take the same board exams with physicians and do a 3+ residency...

You implied that your study showed comparable care between Carib docs and US trained docs (which it doesn't) and I stated that there are studies between nurses and physicians that supposedly show the same even though they don't have a fraction of the training we do. I'm asking you why we should even bother with that training at all if the care is supposedly the same.

Your argument is also just terrible given it was based on a single study which wasn't even comparing US to Carib doctors and had numerous confounding factors (per the study itself). It makes me wonder if you even read the article or if you just saw the title and assumed it fit what you were saying.

 

[Stagg737]

I am being lectured by a DO student... Great!

Ad hominem attacks only show your arguments have no real value. If you don't like getting called out for making stupid statements and invalid arguments, I suggest you put actual thought into them in the future.

 

[W19]

@Stagg737 Let's see if the few schools that have transitioned into a 3-year curriculum will go back to 4. Then I will admit that my idea was misguided. Not going further with this argument...

You believe it will be bad idea for all med schools to transition to a 3-year curriculum (18 months + 18 months); I believe it won't affect the quality of physicians schools will put in the workforce...

 

[VA Hopeful Dr]

I am being lectured by a DO student... Great!

Wow, well done. Just great.

 

[VA Hopeful Dr]

@Stagg737 Let's see if the few schools that have transitioned into a 3-year curriculum will go back 4. Then I will admit that my idea was misguided. Not going further this argument...

You believe it will be bad idea for all med schools to transition to a 3-year curriculum (18 months + 18 months); I believe it won't affect the quality of physicians schools will put in the workforce...

Right because people love admitting they're wrong and making major and expensive changes.

Do you actually think before you post?

 

[W19]

Right because people love admitting they're wrong and making major and expensive changes.

Do you actually think before you post?

Nope doc...

So your argument is that people won't admit they make mistakes...

You really think students coming of Duke will be bad physicians...

 

[Jabbed]

There are also studies "showing" that NPs provide comparable care to physicians, guess that means we should just switch over to the same curriculum they use...



A few things that we're deciding to ignore in this whole debate. Many of those countries don't have just 6 years to complete their education. In countries like the UK, they have 6 years of med ed, then 4-7 years of residency (instead of 3-5 in the U.S.), followed by 2-3 more years of fellowship. So same length, just at different stages. In greece, all graduates have to do a 1 year rural medicine internship before starting their 3-7 years of residency. Additionally, in many countries doctors are considered "junior physicians" after completing residency for a few years before gaining full independent practice rights, so it's not just this shorter system where docs are out on their own that much earlier like you're suggesting.

Additionally, you can't compare U.S. culture to a lot of the countries you're talking about. In many of those countries, teenagers are seen as being mature enough to drink as teenagers. Can you imagine what would happen in the U.S. if we allowed 16 year olds to legally buy and drink beer or wine in the U.S. Does that sound like a good plan in our culture?

I also don't know what colleges require people to take finance classes, if you know of any science or pre-health programs which require that I'd be interested to find out where they are, but I've never heard of them. Include classes on government in that statement as well. I understand your point about professionalism and ethics classes in medical school, but can you honestly say that you don't have a number of classmates who don't have personality issues or flat-out don't know how to be professional? I honestly can't believe the number of things I've heard classmates say to faculty or written in e-mails that would make the average person stop and say WTF.

You have a remarkable ability to think like an administrator. Truly advanced for your stage of training.

"Students aren't mature enough. We must charge them more money and more time and place more requirements so that they can become mature. Because patient safety."

"Some fringe students have personality disorders and unprofessional behavior. We should mandate 100 LCME hours reinforcing professional behavior. Because patient safety."

Also, blaming our culture as a source of our "immaturity" was a nice touch.

 

[W19]

You have a remarkable ability to think like an administrator. Truly advanced for your stage of training.

"Students aren't mature enough. We must charge them more money and more time and place more requirements so that they can become mature. Because patient safety."

"Some fringe students have personality disorders and unprofessional behavior. We should mandate 100 LCME hours reinforcing professional behavior. Because patient safety."

Also, blaming our culture as a source of our "immaturity" was a nice touch.

Not only that, when people point out example of other countries that have 6-year curriculum, he/she went on a rant about residency in these places... No one was talking about residency!

 

[VA Hopeful Dr]

Nope doc...

So your argument is that people won't admit they make mistakes...

You really think students coming of Duke will be bad physicians...

Not at all, but I also think that they're likely to be smarter/faster learners/whatever compared to the average. It's like the kids who skip grades growing up - sure they turn out fine but the vast majority of kids wouldn't if they took the same path.

 

[VA Hopeful Dr]

You have a remarkable ability to think like an administrator. Truly advanced for your stage of training.

"Students aren't mature enough. We must charge them more money and more time and place more requirements so that they can become mature. Because patient safety."

"Some fringe students have personality disorders and unprofessional behavior. We should mandate 100 LCME hours reinforcing professional behavior. Because patient safety."

Also, blaming our culture as a source of our "immaturity" was a nice touch.

I don't recall seeing anything about charging more money or more time or anything like that.

What I do see is a system that works and has worked for a very long time an I would need very strong evidence as to why we need to change it.

That said, I think we can all agree that the tuition rate increases are ridiculous. But that has nothing to do with the way our medical education program is structured and is an entirely different conversation.

 

[W19]

Not at all, but I also think that they're likely to be smarter/faster learners/whatever compared to the average. It's like the kids who skip grades growing up - sure they turn out fine but the vast majority of kids wouldn't if they took the same path.

I don't know if you read my post... We spend time in med school doing things that are redundant and also there are classes that won't contribute that much to what I will be doing. was shocked that there are school out there that don't even teach histo and cell bio while my school spend 3 months in it... I was told LECOM has a 3 year PC program... so it's not like these students are among the elite... They pass COMLEX1/2 just like other DOs... NY university has it exactly the way I would design a 3-year med school curriculum.

Accelerated Three-Year MD at NYU School of Medicine | NYU Langone Health

 

[VA Hopeful Dr]

Not only that, when people point out example of other countries that have 6-year curriculum, he/she went on a rant about residency in these places... No one was talking about residency!

No, but if you're going to use their undergraduate system as a way to save time then it is not unreasonable to show that their residency system causes that time to balance out. If you cut the education time from somewhere it has to go somewhere else.

 

[W19]

No, but if you're going to use their undergraduate system as a way to save time then it is not unreasonable to show that their residency system causes that time to balance out. If you cut the education time from somewhere it has to go somewhere else.

The argument was about maturity to handle med school curriculum--unless you are saying that US students will still be immature after 3+ years postgrad training. I don't get it!

 

[ortnakas]

This thread is getting long so maybe I missed it-- but for those of you proposing a six year plan out of high school, how would it work for non-trads/career-changers?

 

[W19]

This thread is getting long so maybe I missed it-- but for those of you proposing a six year plan out of high school, how would it work for non-trads/career-changers?

To be honest, I don't think right out of HS would be a good idea. Heck, I would not be in med school right now since I am a non-trad student... But we can do it like pharmacy... prereqs + MCAT and 3-year med school...

 

[holdthemayo]

This thread is getting long so maybe I missed it-- but for those of you proposing a six year plan out of high school, how would it work for non-trads/career-changers?

I don't know about other countries, but most medical schools in the UK offer a 4-year graduate level degree designed for career-changes/non-trads.

I haven't started school yet (next week!), but based on how many "pre-meds" end up in non-medical fields, I think a large scale switch to 6yr BS/MD programs would lead to higher attrition and more unsatisfied doctors.

 

[VA Hopeful Dr]

The argument was about maturity to handle med school curriculum--unless you are saying that US students will still be immature after 3+ years postgrad training. I don't get it!

Ah, OK I see what you're getting at.

No, from that standpoint I don't think you'll see a huge difference between MD at 26 versus MD at 25. I'm sure there is some difference, but whether or not its significant is unclear.

 

[Goro]

@Stagg737 Let's see if the few schools that have transitioned into a 3-year curriculum will go back to 4. Then I will admit that my idea was misguided. Not going further with this argument...

You believe it will be bad idea for all med schools to transition to a 3-year curriculum (18 months + 18 months); I believe it won't affect the quality of physicians schools will put in the workforce...

My understanding is that these accelerated programs (like at UCD) are to generate Primary Care docs. Am I mistaken?

And you weren't merely being lectured by a DO student, but a fellow medical student.

 

[cellsaver]

And you weren't merely being lectured by a DO student, but a fellow medical student.

Wasn't this the thread where people argued about the maturity of 18 year olds versus 21 year olds in America, compared / contrasted with the maturity of European and Latin American medical students of younger ages?

Muy loco

 

[W19]

My understanding is that these accelerated programs (like at UCD) are to generate Primary Care docs. Am I mistaken?

And you weren't merely being lectured by a DO student, but a fellow medical student.

Lol... It was out of character. I apologize to @Stagg737

 

[Jabbed]

I haven't started school yet (next week!), but based on how many "pre-meds" end up in non-medical fields, I think a large scale switch to 6yr BS/MD programs would lead to higher attrition and more unsatisfied doctors.

Not really, the selection criteria for US premed vs Euro MD student are very different.

Premed is literally anyone in college that says "I want to be a doctor when I grow up!" Foreign MD candidates are often the cream of the crop of baccalaureate programs. While this doesn't reflect intentions or level of dedication necessarily, I think there's a big difference between students who think "I might like to be a doctor" vs "I am training to become a doctor".

And again, it works just fine in the rest of the world.

 

[Jabbed]

I don't recall seeing anything about charging more money or more time or anything like that.

What I do see is a system that works and has worked for a very long time an I would need very strong evidence as to why we need to change it.

That said, I think we can all agree that the tuition rate increases are ridiculous. But that has nothing to do with the way our medical education program is structured and is an entirely different conversation.

"Barely working, better not fix it" might as well be the VA's slogan.

There are so many logical inconsistencies with our training pathway that it seems silly to pretend that there isn't room for improvement:
-Out of the 15 years that it takes to become a glorified plumber that pipe cleans arteries, only 1 of those years is spent pipe cleaning arteries!
-How can medical school cost upwards of 200k yet still mandate that your education be autodidactic?
-Why do I have to know ANYTHING about Sn1 reactions??
-Why do we spend so little time on each service in M3/M4? Why not spend 2-3 months on a service and really learn how to run it and make a meaningful experience out of it? Choosing a specialty at this point is like deciding what you want to buy for dinner by just LOOKING at the sample platter.
-Why do I have to know ANYTHING about Sn2 reactions???

 

[Stagg737]

@Stagg737 Let's see if the few schools that have transitioned into a 3-year curriculum will go back to 4. Then I will admit that my idea was misguided. Not going further with this argument...

You believe it will be bad idea for all med schools to transition to a 3-year curriculum (18 months + 18 months); I believe it won't affect the quality of physicians schools will put in the workforce...

We've been over this earlier. I don't have a problem with looking into a shorter curriculum. I agree that as a whole 4 years of undergrad is more than is necessary, and shortening medical school slightly isn't something that I'm against looking into. What I am opposed to are implementing 6 year programs on a larger scale as I've already mentioned several problems with them. I realize you're not necessarily stuck on that format, but other posters have been and I was addressing that.

At least with a 3 year UG --> 3-4 year med school program students will have lived on their own and had some experience with what it means to be an adult before they apply to medical school. I don't think there's a significantly greater degree of maturity between a 21 and 22 year old. However, there is a significant difference in maturity between a 18 and 21/22 year old imo.

My understanding is that these accelerated programs (like at UCD) are to generate Primary Care docs. Am I mistaken?

And you weren't merely being lectured by a DO student, but a fellow medical student.

Duke is actually a 4 year program, but they condense the typical 4 years into 3 and made 3rd year a research year. They're also one of the best schools in the country, so the students who train there are capable of completing a ridiculously accelerated curriculum (which I don't believe the average med student could do). The LECOM program is specifically meant to train family physicians in 3 years. Same with the NYU program W19 posted. They actually go so far as to make the 3 years conditional in the sense that they basically sign a contract with residency programs before they even begin medical school. They may choose to enter the actual match later, but are then required to participate in the regular 4 year program according to their website. I can't speak for UCD or other purely 3 year programs.

You have a remarkable ability to think like an administrator. Truly advanced for your stage of training.

"Students aren't mature enough. We must charge them more money and more time and place more requirements so that they can become mature. Because patient safety."

"Some fringe students have personality disorders and unprofessional behavior. We should mandate 100 LCME hours reinforcing professional behavior. Because patient safety."

Also, blaming our culture as a source of our "immaturity" was a nice touch.

I never said we should charge students more money or dump more money into requirements and training. As VA Hopeful said, that's a totally different argument. All I said was that based on the large number of med students and even physicians I've met, it's clear that many are lacking in any professionalism training or even basic common sense.

If the options are to either overtrain our physicians and cause them an inconvenience in order to ensure patient safety/proper standard of care or undertrain our physicians let those with personality issues and professionalism problems which will lead to worse outcomes, which are you going to choose?

Not really, the selection criteria for US premed vs Euro MD student are very different.

Premed is literally anyone in college that says "I want to be a doctor when I grow up!" Foreign MD candidates are often the cream of the crop of baccalaureate programs. While this doesn't reflect intentions or level of dedication necessarily, I think there's a big difference between students who think "I might like to be a doctor" vs "I am training to become a doctor".

And again, it works just fine in the rest of the world.

That sounds an awful lot like you're suggesting med school candidates in other countries are more mature than their U.S. counterparts...

 

[DropMets]

I think a 3 year (18 mo + 18 mo) may possibly be feasible if the first 2 years of medical school:

1) Cut out a decent amount of unnecessary material. Some will argue that absolutely all is valuable, but I think some people will simply argue this just to have an argument. If you really, reasonably and rationally think about it, there's a decent amount that is just bogus.

2) Taught by "high quality" instructors/doctors, and not by people without experience (...many PhDs) or those who simply aren't good at teaching. That being said, some of my best professors have been PhDs. I'm simply saying that most professors I've had would make Lecture 1.5-2x longer than needed, and over 2 years, that really adds up. We could cut out a lot by having efficient and higher quality instruction.

Of course, these things would need to be standardized/regulated, and the feasibility of this happening is a whole new topic that I'm not touching.


Sent from my iPhone using SDN mobile

 

[Goro]

"Barely working, better not fix it" might as well be the VA's slogan.

There are so many logical inconsistencies with our training pathway that it seems silly to pretend that there isn't room for improvement:
-Out of the 15 years that it takes to become a glorified plumber that pipe cleans arteries, only 1 of those years is spent pipe cleaning arteries!
-How can medical school cost upwards of 200k yet still mandate that your education be autodidactic?
-Why do I have to know ANYTHING about Sn1 reactions??
-Why do we spend so little time on each service in M3/M4? Why not spend 2-3 months on a service and really learn how to run it and make a meaningful experience out of it? Choosing a specialty at this point is like deciding what you want to buy for dinner by just LOOKING at the sample platter.
-Why do I have to know ANYTHING about Sn2 reactions???

On the Sn1/2 reactions...that has nothing to do with med school. But that's not the point. The point is to select for people who can deal with intense and complex conceptual learning. That's why Orgo is a weeding course. But you're hijacking the thread which is about medical education, not pre-med. And in that vein, again, remember the required competencies. We need pre-meds to learn these as well. That's why none of us are fans of the 6-year Euro model of medical education.

 

[DropMets]

"Barely working, better not fix it" might as well be the VA's slogan.

There are so many logical inconsistencies with our training pathway that it seems silly to pretend that there isn't room for improvement:
-Out of the 15 years that it takes to become a glorified plumber that pipe cleans arteries, only 1 of those years is spent pipe cleaning arteries!
-How can medical school cost upwards of 200k yet still mandate that your education be autodidactic?
-Why do I have to know ANYTHING about Sn1 reactions??
-Why do we spend so little time on each service in M3/M4? Why not spend 2-3 months on a service and really learn how to run it and make a meaningful experience out of it? Choosing a specialty at this point is like deciding what you want to buy for dinner by just LOOKING at the sample platter.
-Why do I have to know ANYTHING about Sn2 reactions???

Sent from my iPhone using SDN mobile

 

[Jabbed]

On the Sn1/2 reactions...that has nothing to do with med school. But that's not the point. The point is to select for people who can deal with intense and complex conceptual learning. That's why Orgo is a weeding course. But you're hijacking the thread which is about medical education, not pre-med. And in that vein, again, remember the required competencies. We need pre-meds to learn these as well. That's why none of us are fans of the 6-year Euro model of medical education.

The orgo comment was clearly a joke, the remainder of my comments were related to higher medical education.

 

[Jabbed]

That sounds an awful lot like you're suggesting med school candidates in other countries are more mature than their U.S. counterparts...

Simply extrapolating that the decision to become a doctor has more weight than just entertaining the idea.

 

[deleted407021]

I kind of like it the way it is. I also kind of have to lol

This may be school-by-school, but I find some basic science material to be a bit superfluous -- teach us like we're student physicians, not PhD candidates.

 

[DropMets]

That sounds an awful lot like you're suggesting med school candidates in other countries are more mature than their U.S. counterparts...

Well, I think overall not necessarily true, but coming from personal experience (immigrant), I see that they may reach the needed maturity for medical school, on average, a bit earlier than here in the U.S. That's not to say we don't catch up, but there's no denying cultural differences that result in many of these countries having majority of their applicants ready (in a multitude of ways) earlier than here in the U.S.


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[VA Hopeful Dr]

"Barely working, better not fix it" might as well be the VA's slogan.

There are so many logical inconsistencies with our training pathway that it seems silly to pretend that there isn't room for improvement:
-Out of the 15 years that it takes to become a glorified plumber that pipe cleans arteries, only 1 of those years is spent pipe cleaning arteries!
-How can medical school cost upwards of 200k yet still mandate that your education be autodidactic?
-Why do I have to know ANYTHING about Sn1 reactions??
-Why do we spend so little time on each service in M3/M4? Why not spend 2-3 months on a service and really learn how to run it and make a meaningful experience out of it? Choosing a specialty at this point is like deciding what you want to buy for dinner by just LOOKING at the sample platter.
-Why do I have to know ANYTHING about Sn2 reactions???

Barely working? We produce the best physicians in the world. Everyone tries to come here (doctors and patients both), we produce most of the original research, and have the best outcomes.

Now to your points:
- You want a doctor working on you, not a technician. A technician can do the procedure, a doctor knows why and can manage the complications. Besides, doesn't a general surgery residency have a good bit of vascular training?
- I would love for school to be cheaper. And my school wasn't autodidactic. There is an unexceptable amount of variation in med schools, but that's not the argument.
- I spent 2 months on most of my rotations. FM, IM, peds, surgery, OB, psych. Did you not? All electives were at least a month. But aren't you trying to shorten education?
- Goro addressed that one.

Anything else?

 

[Goro]

The orgo comment was clearly a joke, the remainder of my comments were related to higher medical education.

Remember, humor travels poorly over the electrons!

 

[Jabbed]

Barely working? We produce the best physicians in the world. Everyone tries to come here (doctors and patients both), we produce most of the original research, and have the best outcomes.

Now to your points:
- You want a doctor working on you, not a technician. A technician can do the procedure, a doctor knows why and can manage the complications. Besides, doesn't a general surgery residency have a good bit of vascular training?
- I would love for school to be cheaper. And my school wasn't autodidactic. There is an unexceptable amount of variation in med schools, but that's not the argument.
- I spent 2 months on most of my rotations. FM, IM, peds, surgery, OB, psych. Did you not? All electives were at least a month. But aren't you trying to shorten education?
- Goro addressed that one.

Anything else?

Truly didn't mean to knock the VA clinical training, was referring to administrative issues.

Was referring to interventional cardiology. YMMV, but all of the (community) interventional guys that I have met are of the opinion that there are two types of problems in the world: 1. problems that they can stent and 2. who gives a **** about a problem that you can't stent?

Most of my rotations were 6-8 weeks, but I would rarely be on any one service for longer than 4 weeks. Not sure when you graduated, but the responsibilities and duties of M3/M4 have significantly diluted. Writing notes, entering orders, and being primary on a patient are all exceptions rather than the rule. This is a widely echoed sentiment.

There is a way to shorten education while increasing clinical exposure

 

[VA Hopeful Dr]

Truly didn't mean to knock the VA clinical training, was referring to administrative issues.

Was referring to interventional cardiology. YMMV, but all of the (community) interventional guys that I have met are of the opinion that there are two types of problems in the world: 1. problems that they can stent and 2. who gives a **** about a problem that you can't stent?

Most of my rotations were 6-8 weeks, but I would rarely be on any one service for longer than 4 weeks. Not sure when you graduated, but the responsibilities and duties of M3/M4 have significantly diluted. Writing notes, entering orders, and being primary on a patient are all exceptions rather than the rule. This is a widely echoed sentiment.

There is a way to shorten education while increasing clinical exposure

The VA in my username is for Virginia - was in undergrad there when I joined SDN.

I graduated med school in 2010, so not all that long ago. If what you say is true - no notes, no orders, essentially shadowing then that is very concerning.

 

[DropMets]

The VA in my username is for Virginia - was in undergrad there when I joined SDN.

I graduated med school in 2010, so not all that long ago. If what you say is true - no notes, no orders, essentially shadowing then that is very concerning.

Can confirm, at least at my institution. Sometimes we get to write lots of notes, but I've been on rotations where I wrote few/zero notes for 4+ weeks. Often, we just shadow residents because clinic is too busy, and each resident has only 1-2 allocated rooms, so you are a glorified observer. Never even touched orders. Certainly diluted from what it seems like.


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