And best of all is the fact that a large chunk of it is either already wrong, will be proven wrong by the time you graduate/practice, or become obsolete knowledge by time you graduate/practice. Unfortunately you won't know whats wrong until you practice. Have fun knowing this.
I get what you mean. I felt this way about even undergrad courses. Grad school (for research that is) is about creating new knowledge to a degree or refuting or confirming the basics. (I know I'm over-simplifying this by the way, but it's to make a point). But the idea behind this process is that you wouldn't understand or appreciate the changes in high level learning unless you knew what the present widely accepted concepts were. You have to start somewhere.
Everyone knows that 'knowledge' rapidly becomes obsolete as new research is comes out every year. it's why guidelines are updated every few years. it's also why we have to attend (and sometimes even participate) in conferences etc. to stay on top of changes. but without knowledge of what things used to be, you can't know if changes others are proposing are "legit", are they going to cause harm etc. etc. you then have to decide for your own clinical practice, is the old way better, or is the new way an improvement that you should follow? For the sake of your patients, you need to be sharp about this. or it begs the question of what type of doctor are you wanting to be? is it about your convenience or is it about your patients? or is it the balance of things? I don't know! you tell me. it's a rhetorical question. how important is it to you to minimize the adverse reactions or avoid them for your patients? versus how much time do you have?
For instance, NOACs v.s. warfarin. there are cases where it's appropriate to use a NOAC, but there are still cases where it's more appropriate to stick with warfarin. (until further clinical trials are out). Now I'm waiting for other research to come out and tell me that other gold standard meds are crap. Like metformin is for chumps. But until that day comes.
One retired clinician used to tell us to learn medical history. Which I thought was frankly trivial compared to actual clinical or basic sciences we were being taught. then he said well,
how will you know where you are going if you don't know where you came from?
(I liked his quote, even though I'm probably still not going to start reading history books about the clinicians who discovered whatever particular disease in the 1800s/1900s. wikipedia maybe.)
I completely understand and appreciate learning most basic science, from the myriad of cellular structure and function, to ion channels, to oncogenes, to the heme degradation pathway, to lipid metabolism.. I enjoy learning all of that stuff, and can't imagine learning the clinical applications without those basics.
BUT, I will never understand for the life of me why we have to learn embryology in such extensive detail. I will never enjoy or see the purpose of most of it.
Haha. I didn't particularly enjoy studying embryology. was not my cup of tea as a student. Also many people told me that embryology was low yield too. And it is if you don't intend to do peds, o&g and some subspecialties later, however you will be in their territory on their rotations.
unfortunately, I realized on Peds rotation, particularly peds surg, it's uh really relevant. imagine telling them it's not important. you kinda have to consider that while you're on the rotation you are a 'peds student' or 'peds surg student'. you're going to get pimped. and boy, particularly the surgeons, will hand your ass to you if you don't know the relevant embryology to their particular surgery you're assisting with. you can't runaway in surgery, while scrubbed in, holding whatever it is, the sutures, a scope or the retractor. and they know it.
for instance, there were many surgeries i'd scrubbed in for which involved removing undescended testes. 9/10 times some surgeon would ask me if i knew what the embryological descent was for the testes and epididymis (maybe I'm exaggerating, like saying I used to walk 10 miles up hill to school everyday when it was actually like 5 mins on level ground..but it felt like a lot). I went through many 'oh ****' moments of scrambling to read up on embryology between cases on my phone or sneaky scrub pocket sized books. Occasionally what I'd read was completely confusing (because I'd skipped those lectures slides back in the day) and get steely stares from the surgeon later when I blurted out mangled version of the answer they were seeking.
I have no gripe with the basic sciences and understand the importance of knowing the fundamental concepts. My point is that the level of detail that is taught is useless because it can never be retained! In fact, I'd argue that the level of detail is counterproductive to learning the things we actually need to have a solid understanding of. I can't focus and hammer down a perfect understanding of concepts to the extent that I'd like because I have to move on to the next 50 slides of minutiae, and at the end of the day I will have forgotten all the minutiae while being less comfortable with the concepts than I otherwise would have been if I had more time to devote to the things that actually matter.
whoa.
hold your horses.
when your lecturers make their lectures, theoretically they are meant to be presenting a very condensed nugget to you about their field. Or whatever it is that they're teaching, which should be to your level too. unfortunately there are always going to be the overly enthusiastic that make 200 slides for a 60 minute lecture and prattle on about their research. generally, even the minutiae is already seen as part of the 'condensed version'. your job is to separate out the key basics and the finer points and find different ways to approach them, but in ways that both will still serve a purpose later on.
part of medical schools is not just learning the basic sciences as a foundation to clinical practice later. it's also about adapting your study habits and changing how you learn things for clinical practice later on. I knew as a student the learning never stops after school or residency. (i didn't fully understand what that meant then) with work taking up a lot of your time, you have to find the most efficient ways to stay on top of things. as said above, this field is changing constantly. we're always moving forward. we have to.
For medical school lectures at least - you create a skeleton or framework for yourself of what you know the basics are. then you learn those. or, use one of many resources that offer up that skeleton without your having to make one. things like First Aid or Pathoma. (if not those, there's always that notes-god or goddess that creates a tailored one to your class.) Pathoma for instance, is very good at teaching the very bare bone basics to pathology. Your lectures help you flesh out those bones.
For those finer detail things (or minutiae if you will), your lecturers aren't trying to waste everyone's time (most aren't anyway). You don't have to memorize by heart those details or spend copious amounts of time getting to know it well.
it's about exposure. when you come across it on rotations later, it will be familiar to you. maybe you don't know it well, but you will have seen it before. the information is easier to re-learn, it saves you time. you don't go through a deer in the headlights moment.
time is not on your side during rotations and during residency. by residency, hopefully, even the seemingly trivial things are easier to grasp and run with because you will have seen it in small doses over and over again over the course of 4 years of medical school. it's about efficiency over the long term, and being able to access information you'd thought you'd forgotten when it counts.
its exactly like the quote below:
It's not necessarily that we're meant to have long-term retention of all the minutiae, but we get exposed to the material and that contributes to our foundation in a subconscious way. It's not really something that I can prove, but I feel like learning these things changes our thought processes over time, and we approach a problem differently when re-exposure occurs.
(I get what you meant soverign0, by the way haha, and feel the same)
Don't ever forget that you're in medical school to be the best doctor you can for your patients, not to learn for the sake of learning or getting through exams (as important as exams are). It's not fair to say, it's the fault of your patients if they have a disease unfamiliar to you later on. You still have a duty of care and to provide the best care possible. at least you should be able to know which subspecialty is appropriate to refer to. I know these things are obvious. they were obvious to me as a student. as resident, once you make connections to some of your patients and their families, the last thing you ever want to do is let them down. or let your team down. for any reason.
It's hard as an MS1 or 2, when your learning is classroom based.
Things are easier to study for or read up on during rotations, when you're seeing patients and helping out with their care. Also you're constantly surrounded by clinicians and residents on the wards guiding your thought processes. the down side is that by then, you won't have the same time you used to to hit the books
