How Would You Reimagine Med-School Education?

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Supergunner2.0

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Supergunner 2.0 here. I decided to ask this question because recently I've been thinking about medical education in the 21st century and I've been wondering a few things like...

1) I find the pbl format inefficient in teaching medical science (at least in the way I know - case in the beginning of the week, some lectures, talk about case later in week). I think it has many benefits for teaching soft skills (how to behave professionally, how to address peers in a way that is not demeaning, how to give presentations and sharpen public speaking skills). For soft skills, I think PBL is a great system but I can't help but wonder if it can be tightened just a bit.

2) Could live lectures be out of date, especially since video is so ubiquitous now? Personally, I think live lectures are very hit or miss. I was thinking that maybe recorded lectures should be a norm and that "lecture" time could be used for something else instead? Maybe Q&A sessions with faculty? Or something else?

3) Why doesn't the medical community change the requirements for medical school so that the structural sciences (gross, histology, embryology) are experienced during undergrad? It seems logical in that you would then free up a lot of time during medical school. Cut out Organic Chemistry and BAM, you have 1 year's worth of material to reassign. How much O-chem have I used? Seems its requirement is more for a right of passage than really for any sort of practical purpose.

Maybe there are better ways already implemented out there but my general sense is that most schools are shifting to a pbl format (with an "unknown" case being presented and then talked about) with live lectures for part of the day. These are some of the things supergunner 2.0 has been thinking while crushing medical school, but I am curious what some of you might be thinking.
 
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Just a warning, you're going to be banned again. Posting under a different handle is a violation of the TOS.

I'm also assuming the LCME wouldn't want to depend on undergraduate institutions to teach preclinical subjects because they wouldn't be able to regulate what was taught.
 
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That would be unfortunate because I'm asking a pretty relevant question.
 
That would be unfortunate because I'm asking a pretty relevant question.

I don't know how second chances work on SDN. It would be nice to shave a year off of medical school by essentially completing the courses in undergrad... but a year of medical school is probably equivalent to two years of undergrad, so I'm not sure it would be possible, even if somehow the LCME regulation thing wasn't an issue.
 
Just a warning, you're going to be banned again. Posting under a different handle is a violation of the TOS.

I'm also assuming the LCME wouldn't want to depend on undergraduate institutions to teach preclinical subjects because they wouldn't be able to regulate what was taught.
True, regulation would be important but I feel like those subject in particular are considered by most to be lower yield in terms of the material needed to be learned during medical school. Though I think they are very important, especially for framing understanding of pathology... which might be another reason to learn them earlier. They are also very set in terms of their known knowledge. They're not changing. The only thing that changes is the amount needed to be known which most med schools are minimizing. So if anything, people would over learn them if they were an undergrad requirement. I think they are encountered again anyways because they work their way into the pathology so they become reinforced after having learned them for say... the MCAT.
 
Supergunner 2.0 here. I decided to ask this question because recently I've been thinking about medical education in the 21st century and I've been wondering a few things like...

1) I find the pbl format inefficient in teaching medical science (at least in the way I know - case in the beginning of the week, some lectures, talk about case later in week). I think it has many benefits for teaching soft skills (how to behave professionally, how to address peers in a way that is not demeaning, how to give presentations and sharpen public speaking skills). For soft skills, I think PBL is a great system but I can't help but wonder if it can be tightened just a bit.

2) Could live lectures be out of date, especially since video is so ubiquitous now? Personally, I think live lectures are very hit or miss. I was thinking that maybe recorded lectures should be a norm and that "lecture" time could be used for something else instead? Maybe Q&A sessions with faculty? Or something else?

3) Why doesn't the medical community change the requirements for medical school so that the structural sciences (gross, histology, neuroanatomy, embryology) are experienced during undergrad? It seems logical in that you would then free up a lot of time during medical school. Cut out Organic Chemistry and BAM, you have 1 year's worth of material to reassign. How much O-chem have I used? Seems its requirement is more for a right of passage than really for any sort of practical purpose.

Maybe there are better ways already implemented out there but my general sense is that most school are shifting to a pbl format (with an "unknown" case being presented and then talked about) with live lectures for part of the day. These are some of the things supergunner 2.0 has been thinking while crushing medical school, but I am curious what some of you might be thinking.


Tell us more genius.
 
Well. I would go back to the article that I plagiarized (used to inspire) to write this question if I were you to find an answer to your wonderful question. Then hope someone doesn't flag you.
 
Well. I would go back to the article that I plagiarized (used to inspire) to write this question if I were you to find an answer to your wonderful question. Then hope someone doesn't flag you.
Before this turns into juvenile bickering and loses the significance of the thread... I was posing an honest question. There has been no plagiarizing. These are things I have thought of while progressing through med school. If you are currently going through it as well, then you must have had some thoughts about how things could be improved or maybe even revolutionized with the exponential increase in digital technology ---- like how groups coordinate things through Facebook now in medical school but no med school really formally acknowledges how essential that has become and still disseminates information through their own proprietary software.. But hey, if not, no worries. Not trying to inflame that side of you.
 
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Before this turns into juvenile bickering and loses the significance of the thread... I was posing an honest question. There has been no plagiarizing. These are things I have thought of while progressing through med school. If you are currently going through it as well, then you must have had some thoughts about how things could be improved or maybe even revolutionized with the exponential increase in digital technology ---- like how groups coordinate things through Facebook now in medical school but no med school really formally acknowledges how essential that has become and still disseminates information through their own proprietary software. But hey, if not, no worries. Not trying to inflame that side of you.



Word
 
Supergunner 2.0 here. I decided to ask this question because recently I've been thinking about medical education in the 21st century and I've been wondering a few things like...

1) I find the pbl format inefficient in teaching medical science (at least in the way I know - case in the beginning of the week, some lectures, talk about case later in week). I think it has many benefits for teaching soft skills (how to behave professionally, how to address peers in a way that is not demeaning, how to give presentations and sharpen public speaking skills). For soft skills, I think PBL is a great system but I can't help but wonder if it can be tightened just a bit.

Many would agree with you (I am tempted), but perhaps they lack perspective. Regardless, mention it to administrators and expect to be sacrificed to the dark lord cthulu.

2) Could live lectures be out of date, especially since video is so ubiquitous now? Personally, I think live lectures are very hit or miss. I was thinking that maybe recorded lectures should be a norm and that "lecture" time could be used for something else instead? Maybe Q&A sessions with faculty? Or something else?

Unless they redo video lectures every year, they will swiftly fall out of date. If they are going to do a video lecture, then a question hour, that just seems wasteful. The current system (provided you attend a school without required attendance) allows for the best of both worlds. If you get nothing from it, don't go (my approach around 50% of the time). Another hidden benefit of lecture is that it allows you to socialize a bit, and avoid becoming a total recluse.

3) Why doesn't the medical community change the requirements for medical school so that the structural sciences (gross, histology, embryology) are experienced during undergrad? It seems logical in that you would then free up a lot of time during medical school. Cut out Organic Chemistry and BAM, you have 1 year's worth of material to reassign. How much O-chem have I used? Seems its requirement is more for a right of passage than really for any sort of practical purpose.

I would say organic chemistry has hidden benefits. Mostly in that electron flow becomes significantly more intuitive. I think the type of O-chem could be significantly revised to reflect more biochemistry, but that's just me. You can't expect every university (or more accurately, every chem. dpt) to cater to pre-meds.

There is also the idea that perhaps we should expose some bright students to various sciences before they get trapped in medical school. If reading IR spec or NMR really got you off, maybe medicine would be less fulfilling than chemistry. And there is always the "culling" benefit: if you can force yourself to learn that stuff, you can probably force yourself to learn more interesting things.

Despite my personal distaste for biochemistry, I recognize that it is more important for some specialities (I believe oncology is one) than others. I've begun to realize that different basic sciences are the pinnacle of different specialties. It seems that physicians within those specialties tend to dispariage all sciences not directly related to their field of choice. Further along this line of thought, different pre-reqs are more important for some classes/basic sciences than others.

As for putting histology, gross, and embryology in undergrad: hell to the no. I do not want my pathologist operating based off a god-damn undergrad. understanding of those subjects. Teaching gross alone in sufficient detail, at an undergrad pace, would take multiple years.


Maybe there are better ways already implemented out there but my general sense is that most schools are shifting to a pbl format (with an "unknown" case being presented and then talked about) with live lectures for part of the day. These are some of the things supergunner 2.0 has been thinking while crushing medical school, but I am curious what some of you might be thinking.

Answers above. Goodnight internet.
 
Lay off the amphetamines. Try out a nicotine patch in lieu of 50% of the dosage being abused is a great start.

Then find a local narcotic anonymous meeting.

Good night pal.
 
Answers above. Goodnight internet.
Hey, thanks for the thoughtful responses.

Many would agree with you (I am tempted), but perhaps they lack perspective. Regardless, mention it to administrators and expect to be sacrificed to the dark lord cthulu.
Ya, I agree with the last part. Although I am not saying it is pointless, just that it feels not as tight as it could be. Maybe if instead of doing a single case and tweezing it out... maybe something like when you prep for USMLE and you do questions with a small group of people. I think that type of quick fire pacing of questions and answering seems to generate more conversation than the single case format. Dunno.

Unless they redo video lectures every year, they will swiftly fall out of date.
Not really that fast and would be subject dependent. Plus, if you break up the recorded lecture so that you have sections individually recorded, then you can just tweak what you need every year and insert the new info wherever. The students would be responsible for looking at them before coming to the 1 hour "lecture" / Q&A session. The professor is there to answer any outstanding questions and/or to give questions they've written so that students know what types of questions (but his I mean wording) to expect on their exams... mostly this will allow students to understand how/on what the professors are going to ask questions and by alleviating this fear... they can focus more on what is more important, which is understanding the material and really honing in on what they need to know.

I would say organic chemistry has hidden benefits. Mostly in that electron flow becomes significantly more intuitive. I think the type of O-chem could be significantly revised to reflect more biochemistry, but that's just me.As for putting histology, gross, and embryology in undergrad: hell to the no. I do not want my pathologist operating based off a god-damn undergrad. understanding of those subjects. Teaching gross alone in sufficient detail, at an undergrad pace, would take multiple years.
Ya, i can agree with you on the understanding the electron flow part. Overall, i think you touch on that it's really more important to know biochemistry and by that, metabolic biochemistry... which isn't necessarily required. I think the amount of material taught in gross, histology and embryo (especially for medical school) could easily be taught at an undergrad level. I know this because I've seen it done and can say it's more than enough, if not even above what is necessary because there is more time to dedicate to these (I completely agree with you) very important subjects. The level taught at most med schools nowadays is not really that much purely because there is so much other stuff to teach now and they keep getting scaled back each year. So I think it's more than manageable and adequate, if not more so.
 
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Supergunner 2.0 here. I decided to ask this question because recently I've been thinking about medical education in the 21st century and I've been wondering a few things like...

1) I find the pbl format inefficient in teaching medical science (at least in the way I know - case in the beginning of the week, some lectures, talk about case later in week). I think it has many benefits for teaching soft skills (how to behave professionally, how to address peers in a way that is not demeaning, how to give presentations and sharpen public speaking skills). For soft skills, I think PBL is a great system but I can't help but wonder if it can be tightened just a bit.

2) Could live lectures be out of date, especially since video is so ubiquitous now? Personally, I think live lectures are very hit or miss. I was thinking that maybe recorded lectures should be a norm and that "lecture" time could be used for something else instead? Maybe Q&A sessions with faculty? Or something else?

3) Why doesn't the medical community change the requirements for medical school so that the structural sciences (gross, histology, embryology) are experienced during undergrad? It seems logical in that you would then free up a lot of time during medical school. Cut out Organic Chemistry and BAM, you have 1 year's worth of material to reassign. How much O-chem have I used? Seems its requirement is more for a right of passage than really for any sort of practical purpose.

Maybe there are better ways already implemented out there but my general sense is that most schools are shifting to a pbl format (with an "unknown" case being presented and then talked about) with live lectures for part of the day. These are some of the things supergunner 2.0 has been thinking while crushing medical school, but I am curious what some of you might be thinking.

1) I think PBL works when it is done well. That means knowledgeable facilitators and knowledgeable classmates that work well together. If you're missing any of those elements, it gets all messed up esp. when you have to take multiple choice exams which you take alone. Really PBL works great to prepare you for medicine, which for all intents and purposes is becoming a "team" sport in which you have to work together in order to get things done. That's a lot of what MS-3 is - although it does have some individual things - patient presentations, NBME exams, etc. The problem is PBL works well if you have the information down first. 9 times out of 10 that doesn't happen. So it's this disorganized, chaotic BS of finding information. Real clinical medicine isn't, however, didactics where someone teaches you in lecture format. That's not how medicine is. So PBL is the best way to recreate how medicine is (Just as a note, I think PBL sucks, but in theory, the way it works, is a good idea)

2) Most med schools (at least the actual good ones) videotape all basic science lectures and podcast them in the first 2 years and don't have mandatory attendance. There are notable exceptions, I believe Emory for example, requires attendance, but they're also P/F in the first 2 years, so it's not that big of an issue.

3) There are some combined BS/MD programs but they just tend to decrease the undergrad part, if at all, keeping the med school part the same. It's more an early acceptance type of thing. I do agree with you, basic sciences would be much easier if they were spread out to where a med student could actually take the time to learn the material very well, without feeling like flying thru it. I think taking the Anatomies (gross, histology, embryology) over a longer period of time would be great, before heading into other basic sciences. The reason why O-chem is used as a requirement bc it allegedly provides good insight into how well you will handle med school material - as it tests both memorization and reasoning ability (mechanisms, etc.) There are very few classes that do that. That being said, I think a better class that would replace Organic is Biochem instead. Part of medicine is filtering out those people who wouldn't be able to handle the rigor in the first 2 years of medicine, and GPA and MCAT are the best things we have. If you can't handle introductory science courses, there is no way you will be able to handle basic sciences.
 
Preclinical years combined into one single year (a la Duke and Vandy) = MS1
Traditional 3rd year = MS2
Traditional 4th year+interviewing = MS3

Welcome to the 3-year medical curriculum. Faster, Sexier, and just as Expensive.
 
3) Why doesn't the medical community change the requirements for medical school so that the structural sciences (gross, histology, embryology) are experienced during undergrad? It seems logical in that you would then free up a lot of time during medical school. Cut out Organic Chemistry and BAM, you have 1 year's worth of material to reassign. How much O-chem have I used? Seems its requirement is more for a right of passage than really for any sort of practical purpose.

If gross, histo, embryology and other preclinical classes suddenly became premed requirements/tested on the MCAT in addition to all the other prereqs, everyone would basically have to be a biology major if they want to finish pre-med in 4 years. A college education at its purest, is meant to teach one how to learn and how to think, not to train for a specific trade (though this isn't always the case anymore).
 
Preclinical years combined into one single year (a la Duke and Vandy) = MS1
Traditional 3rd year = MS2
Traditional 4th year+interviewing = MS3

Welcome to the 3-year medical curriculum. Faster, Sexier, and just as Expensive.
When would you take Step 1? Right after MS1? Part of the reason that you have to take Step 1 later is bc it goes so ridiculously fast you need time to review it. Of course the official excuse is that so u can integrate it with MS-2. Also basic sciences is fast enough already, without cutting it down to 1 year. I think the people at Vanderbilt were idiots for switching to a 1 year basic science curriculum. Of course the only reason they can half getaway with that is bc it's Vandy. And of course, they're going to recruit people with high MCAT scores and GPAs, so the failings of the basic science curriculum don't show.
 
Your questions have been addressed before, both on and off these forums.
Every system of education can do with tweaking, no one disagrees with that.

The purpose of an undergraduate education isn't to teach you basic medical science. If that's what you prefer, you could always attend medical school in one of the many countries that accept students straight out of high school.
 
When would you take Step 1? Right after MS1? Part of the reason that you have to take Step 1 later is bc it goes so ridiculously fast you need time to review it. Of course the official excuse is that so u can integrate it with MS-2. Also basic sciences is fast enough already, without cutting it down to 1 year. I think the people at Vanderbilt were idiots for switching to a 1 year basic science curriculum. Of course the only reason they can half getaway with that is bc it's Vandy. And of course, they're going to recruit people with high MCAT scores and GPAs, so the failings of the basic science curriculum don't show.

Get preclinical down to 12 months.
After that, Step 1 prep for 1.5 months. (need 6 weeks added, see below)
Shorten the "required rotations" that are 8 weeks to 6 weeks.
Keep similar amount of electives/research as before for specialty exploration.
Keep protected holidays and residency interview time.

For example, at my school, shortening the 8-week to instead 6-week required rotations would save 8 weeks alone. Which would result in an extra 2 weeks to do something with (after adding in dedicated step 1 prep) -- that is without changing any other facets of the clinical years.
 
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If gross, histo, embryology and other preclinical classes suddenly became premed requirements/tested on the MCAT in addition to all the other prereqs, everyone would basically have to be a biology major if they want to finish pre-med in 4 years. A college education at its purest, is meant to teach one how to learn and how to think, not to train for a specific trade (though this isn't always the case anymore).
I truly believe it's good to have exposure to other subjects besides science. I agree it would be terrible to force everyone to be a biology major to have a chance at going into medicine. So it would have to be balanced to allow that to happen. But I do think these are very visual courses and so even the art minded of us would probably enjoy them.

Also basic sciences is fast enough already, without cutting it down to 1 year.

I kind of agree that truncating the material into a single year seems like a worse idea, because you really get no time to think. And I think it's proven that our biggest gains in insight happen when we're in a relaxed state, not a constantly panicked mode. This is why I suggested maybe some of these subjects should get shifted down to undergrad. Undergrads are totally capable of understanding these things. Take out the irrelevant subjects or emphasize certain ones less. How much physics do you really need to know for medicine??? be honest.

1) I think PBL works when it is done well. That means knowledgeable facilitators and knowledgeable classmates that work well together. If you're missing any of those elements, it gets all messed up esp. when you have to take multiple choice exams which you take alone. Really PBL works great to prepare you for medicine, which for all intents and purposes is becoming a "team" sport in which you have to work together in order to get things done. That's a lot of what MS-3 is - although it does have some individual things - patient presentations, NBME exams, etc. The problem is PBL works well if you have the information down first. 9 times out of 10 that doesn't happen. So it's this disorganized, chaotic BS of finding information. Real clinical medicine isn't, however, didactics where someone teaches you in lecture format. That's not how medicine is. So PBL is the best way to recreate how medicine is (Just as a note, I think PBL sucks, but in theory, the way it works, is a good idea)

I think we're in agreement with a lot of things. I would argue that it's true that once we hit the wards the learning is much more didactic, confusing...etc. But that's the ward and the point of classroom learning is to streamline the building of a language system of medical knowledge and clinical reasoning. I think the argument by admin would be that the simulation of the ward is a positive but I would argue it's a negative at this point because it hinders the learning process unnecessarily.

It's true that it can work great but there is too much room for human error by trying to standardize 30 groups of tutors and people. The student don't matter as much because they're all in it together and sure they might have different levels of knowledge but they're all focused on the same thing so they gain faster. The tutors on the other hand are usually in a career with families so there is less time for them to accelerate their learning and they end up knowing teaching a lot about some things and not so much about others. That's the weakness and always will be for the the PBL tutor run system.

Thanks all of your comments.
 
Your questions have been addressed before, both on and off these forums.
Every system of education can do with tweaking, no one disagrees with that.

The purpose of an undergraduate education isn't to teach you basic medical science. If that's what you prefer, you could always attend medical school in one of the many countries that accept students straight out of high school.

I agree but once you decide to enter medicine there are certain requirements you must take. So why not make these things that will have a dramatic impact once you actually start medical school. I think most of the requirements are sound but there are a few things that could be different as I've suggested. These subjects have been really whittled down in medical school so the amount of material could easily be taught in undergrad and reinforced again in medical school.

At least to me it seems like medical schools are struggling to contain the amount of info they need to teach so why not instead of squishing it down some more, just shed some of it to another level and reinforce it again with pathology.
 
Get preclinical down to 12 months.
After that, Step 1 prep for 1.5 months. (need 6 weeks added, see below)
Shorten the "required rotations" that are 8 weeks to 6 weeks.
Keep similar amount of electives/research as before for specialty exploration.
Keep protected holidays and residency interview time.

For example, at my school, shortening the 8-week to instead 6-week required rotations would save 8 weeks alone. Which would result in an extra 2 weeks to do something with (after adding in dedicated step 1 prep) -- that is without changing any other facets of the clinical years.

I do think that with the current amount of knowledge most students enter medical school with it would be difficult to teach all that material in a year and expect sound students to emerge. With the USMLE studying it might solidify most of that knowledge but I bet they would struggle a lot with using the lingo once they hit the ward. But it's an interesting thought.
 
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I do think that with the current amount of knowledge most student enter medical school with it would be difficult to teach all that material in a year and expect sound students to emerge. With the USMLE studying it might solidify most of that knowledge but I bet they would struggle a lot with using the lingo once they hit the ward. But it's an interesting thought.

I don't know the answer myself.

We would need a student from Duke or Vanderbilt to chime in and testify to if they are competent on the wards during their second year.
 
I don't know the answer myself.

We would need a student from Duke or Vanderbilt to chime in and testify to if they are competent on the wards during their second year.
That would be great!
 
Based on your responses, you haven't yet seen the value of a good, well rounded, undergraduate education.

giving you a complete answer would require more words than I'm willing to write right now 🙂, besides which, methinks you troll.
 
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Based on your responses, you haven't yet seen the value of a good, well rounded, undergraduate education.
I don't think I've hinted at devaluing a well rounded undergrad education. Nor am I suggesting overloading undergrads with so many hardcore sciences that they have no time for anything else. I'm suggesting substituting some for others and emphasizing these particular ones in undergrad because they are very set in their knowledge base and can be taught pretty standardly across the nation.

Personally, I really enjoyed my theatre courses and was a history minor because it allowed me to develop in ways that science courses allowed me to grow in others. But I think they could have comfortably coexisted side by side with requirements to get into medical school of gross anatomy, histology, and embryology. i think art majors would particularly enjoy the anatomy courses.
 
As if a Duke or Vanderbilt medical student is going to testify that they're incompetent on the wards.
Haha, true. It would really be more important to hear what clinicians think of them once they hit the wards as compared to a 2 year program... or whatever the comparison is. Even then, you would have a really small sample size with no significance.
 
As if a Duke or Vanderbilt medical student is going to testify that they're incompetent on the wards.

Sure, why not? SDN is anonymous.

It shouldn't be difficult to say "I have heard, as a class, that since we changed to the new curriculum our performance on the wards during second year has suffered."

Would that be mind boggling for someone to admit?

My school is a top 20* and rumor is that since our faculty pride themselves in "not teaching to the boards" our Step 1 scores are lackluster compared to the rest of the Top-20.

See how easy it is to be honest?

*Noted to demonstrate that there is nothing special about Top-20 schools (i.e. Duke/Vandy) that stop them from admitting truth on the internet.
 
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As if a Duke or Vanderbilt medical student is going to testify that they're incompetent on the wards.

LOLZ "yeah i'm actually a danger to the patients cause we had to breeze through all that preclinical stuff, but shhhhh don't tell anyone"
 
Sure, why not? SDN is anonymous.

It shouldn't be difficult to say "I have heard, as a class, that since we changed to the new curriculum our performance on the wards during second year has suffered."

My school is a top 20 and rumor is that since our faculty pride themselves in "not teaching to the boards" our Step 1 scores are lackluster compared to the rest of the Top-20.

See how easy it is to be honest?
They have no incentive to tell you this information. Look at medical school admissions tours now. They're done by the ***-kissers of the administration. Do you think they would want word getting around about how bad things are when they have yet to go thru the match?
 
LOLZ "yeah i'm actually a danger to the patients cause we had to breeze through all that preclinical stuff, but shhhhh don't tell anyone"
#1 rule in medical school - med students lie.

Always the good, top students of the class are brought to the front for potential applicants and the average/not so great/disgruntled are hidden from view. Residency interviews work the same way.
 
They have no incentive to tell you this information. Look at medical school admissions tours now. They're done by the ***-kissers of the administration. Do you think they would want word getting around about how bad things are when they have yet to go thru the match?

By "they" do you mean administrators?

You're right -- they don't have incentive to tell you that.

Again, a dose of honesty, rumor is that's why my school doesn't report it's Step 1 scores to US News -- because they aren't as impressive as the school's rep.

I have no problem admitting that as the students still match exceedingly well and are respected on the trail as individuals.

If a student on SDN from Duke or Vandy had heard that the 1 year preclinical curriculum has hindered their performance in the wards -- what's the problem with admitting it on here?

Is Duke suddenly going to be dropped from being highly regarded -- the applicants all shunned on the residency interview trail? No.
 
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Also, we diverted from the original question anyway. OP, in Post #23, posed the question of if the 1 year curriculum led to difficulty transitioning to the wards in regards to "lingo".

I used the word competent.

Reverting to the OP's question, I don't see what the problem is...
 
By "they" do you mean administrators?

You're right -- they don't have incentive to tell you that.

Again a dose of honesty, rumor is that is why my school doesn't report it's Step 1 scores to US News.

I have no problem admitting that as the students still match exceedingly well and are respected on the trail as individuals.

If a student on SDN from Duke or Vandy had heard that the 1 year preclinical curriculum has hindered their performance in the wards -- what's the problem with admitting it on here?

Is Duke suddenly going to be dropped from being highly regarded -- the applicants all shunned on the residency interview trail? No.
By "they", I mean med students giving tours.
 
Assuming that for the most part med students as a whole are in it for the good of humanity... are there other factors that we could change about the system in terms of education?

We seem to be veering to conversations regarding rank and perceived favoritism. These are issues too with their own values for discussion but not the intended purpose of this thread.
 
I truly believe it's good to have exposure to other subjects besides science. I agree it would be terrible to force everyone to be a biology major to have a chance at going into medicine. So it would have to be balanced to allow that to happen. But I do think these are very visual courses and so even the art minded of us would probably enjoy them.



I kind of agree that truncating the material into a single year seems like a worse idea, because you really get no time to think. And I think it's proven that our biggest gains in insight happen when we're in a relaxed state, not a constantly panicked mode. This is why I suggested maybe some of these subjects should get shifted down to undergrad. Undergrads are totally capable of understanding these things. Take out the irrelevant subjects or emphasize certain ones less. How much physics do you really need to know for medicine??? be honest.



I think we're in agreement with a lot of things. I would argue that it's true that once we hit the wards the learning is much more didactic, confusing...etc. But that's the ward and the point of classroom learning is to streamline the building of a language system of medical knowledge and clinical reasoning. I think the argument by admin would be that the simulation of the ward is a positive but I would argue it's a negative at this point because it hinders the learning process unnecessarily.

It's true that it can work great but there is too much room for human error by trying to standardize 30 groups of tutors and people. The student don't matter as much because they're all in it together and sure they might have different levels of knowledge but they're all focused on the same thing so they gain faster. The tutors on the other hand are usually in a career with families so there is less time for them to accelerate their learning and they end up knowing teaching a lot about some things and not so much about others. That's the weakness and always will be for the the PBL tutor run system.

Thanks all of your comments.

Not all of us who are "art minded" are visual. I would not trade my music major for any amount of science preparation in undergrad. I agree with a previous poster that the point of undergrad is not really to prepare you for a certain trade, but to teach you how to think, how to learn, and how to be yourself. I am very confident in saying that the rigor of my music degree prepared me for the challenges of medical school much more than most of my friends with science backgrounds. Especially those who did nothing but sciences (my school has a lot of 6 yr bs/md students who just took science classes in undergrad). And to your point about things like organic chemistry; it does seem like a rite of passage, but I think that's really the point. What is important from undergrad is not the material you learn, its the process and mindset.
About the curriculum in general, I wish my school did a li
 
I am very confident in saying that the rigor of my music degree prepared me for the challenges of medical school much more than most of my friends with science backgrounds. Especially those who did nothing but sciences (my school has a lot of 6 yr bs/md students who just took science classes in undergrad).

Why? How?
Just curious.
 
I know someone who goes to Duke that told me that they can take Step 1 any time after their first year, but most people take it after their second (which is a research/year off type thing that they still pay for!). He also told me their boards scores tend to be a bit lower than other schools at their level (although this is clearly hearsay). Not sure about clinical competence.

Personally, this would not be a system that I would fit at, but for people who have done the SMP + are interested in research it seems like a reasonable choice I guess.
 
Why? How?
Just curious.

For one, I feel that I had to study a lot harder and learn how to study better for music than for science classes. My last music theory class, especially the lab, is still the hardest course I have ever taken, even after a year of med school. What makes me confident in the fact that I was better prepared is mostly that this has all been pretty new material for me, and many of my peers have at least had some of this (the example that sticks out in my head is biochem), but on the whole, I (as well as the two other music majors in my class) have been outpacing most students with a science background. Obviously there are qualifiers in all of this; there are some science majors who are killing it to the nth degree, an some non-science majors (not music majors though) who are having to repeat the year. I also think part of it could be the quality of undergrad school- while I didn't appreciate it at the time, the fact that I went to a very rigorous undergrad school may be paying me more dividends now than if I had gone to a state school (I don't mean this as a knock on my state schools or any state schools, but I definitely think the quality of my undergrad contributed to this some). That's why I was very careful to say "the rigor of my music degree".
Also, being a music major has some awesome perks, like knowing great pump up music to listen to on the way to a test!
 
Lol med students in it for the good of humanity. Well I'll be one person that volunteers and says I am absolutely not an example of this. I don't recognize the good of others as a direct motivation to my actions.
 
Lol med students in it for the good of humanity. Well I'll be one person that volunteers and says I am absolutely not an example of this. I don't recognize the good of others as a direct motivation to my actions.

I took that as "for the good that I can do for humanity" not "because of humanity's goodness". ?
 
I took that as "for the good that I can do for humanity" not "because of humanity's goodness". ?

I don't look to directly do good for humanity. I look to provide a service for a fee, not do charity. If my actions happen to indirectly benefit humanity, I'm of course fine with that, but it's never my goal.
 
Hey, thanks for the thoughtful responses.

Miffed that you only showed parts of my answers :caution:
Just kidding 🙂

Anyway, there were some things I wanted to point out.

1. The chant with PBL always seems to be "if we could do it right." I think the concept of "intent to treat" is useful here. Even if a hypothetical surgery provides 100x better outcomes, if 99% of the patients die before they can be prepped, it doesn't matter much. In order to see the real numbers, we can't just look at patients who survived prep, we have to look at the patients who were supposed to be treated.

Similarly, maybe PBL could be awesome if only it could be properly implemented. But it rarely seems to be done. This is my main problem with PBL.
End rant.

2.
A number of our lectures in a specific course were cancelled and replaced with year-old podcasts. A surprising number of points needed to be revised in order to get the best information. I know it's anecdote, but I was mostly talking about my experience with the "yearly update" thing.

Having said that, there are certainly some good podcasts (especially embryo) that we got from previous years. These would likely have been the same, word for word, as last year.

3. The problem with undergraduate classes is the pace, quality control, and the way students are tested. While many of my undergraduate classes covered similar breath of material (over around 3x the time) as my medical school, what was tested was puny. Med. school tests suck, but they do seem to pick at a larger scope of material than undergrad. I appreciate that.
 
Ideally we would spend our entire lives in training -- at least that's the current trend with increased prerequisites for medical school admissions and the unwritten requirement of fellowship(s) after residency.
 
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