Is there really a difficulty difference between med schools?

[Thego2guy]

I love the way this thread turned out and I have gained much more insight and points of view than I had wished for! You guys raised some really interesting points. I also don't mind how the topic branched off into quality vs. difficulty, difficulty vs. good/bad school, simple recall vs. deep thought of the material, boards vs. matching, boards vs. school quality vs. difficulty etc....

Admittedly I wasn't clear enough in my original post, but I was mainly asking IF med schools vary in difficulty (significant enough to measure while accounting for minor variables, since obviously there is always going to be a variation in hardness from school to school, and from person to person, and from class to class), and my secondary question was, what makes schools so different when accounting for location, hospital, and research opportunities. Honestly, even though I am more informed about this thanks to all of you, I have even more trouble coming up with a definitive answer for my main question. (However you guys did a good job showing me how multi-faceted the education experience can be at each school, despite the standardized classes and requirements)

One of the post that really impressed me was post #54 by SpectorGT; you sir, have an incredible point. As interesting as it was though, I still tend to agree with post #58 by willen101383. Obviously as med students you have more experience than me, but I feel like Downstate and Hopkins would both ask 3rd order questions. I doubt that there is much variation in such questions because the primary role of medical school education is to educate and foster a cerebral environment, from where true problem solvers come from (otherwise we would all just go to PA's). As a result of this universal common theme, I think that all questions are meant to test the reasoning more-so than the actual information - across all med schools. Hence my assumption about similar questions.

Ultimately, as you said spectorGT, "the only point was that we also cannot assume the other way that they are all the same. not knowing is not knowing.", I couldn't agree more!

You and Johnny had some really good points btw.

---

Members don't see this ad.

 

[SpecterGT260]

I think you are right. I think odds are there MUST be some variation, but to what degree, and where it is placed.... those are things that would be very difficult to answer. Some medical schools, WashU and Yale, for example, have anonymous tests so it doesn't really even matter how the questions are asked because students are held responsible for themselves. But in addressing what I said originally (that there MUST be some variation) this is in no way stating that harvard also MUST have more of the difficult question types vs any other school, just that in my experience we get mostly 3rd order questions and there are some gimmes, and therefore there is the ability to mix and match. (although I agree that the majority of schools will be very similar in this regard)

To that effect, without attending both schools, it would be unreasonable for someone to just assume that hopkins asks more integrative questions than downstate simply because it is a more competitive school. If you want a comparison on difficulty of curriculum look for ways to compare academic performance across schools. If you want a comparison on "matchability" look at match lists as Johnny said

 

[deleted103644]

And while match lists may pertain to a "better or worse" discussion, as proven by johnny they don't speak to difficulty. As per the OP question im still going w board scores

Have you taken Step 1 yet? It's all about USMLEWorld and First Aid, your preclinical classes will not help much (taught in too much depth, etc).

The USMLE is not a thinking test, it's a memorization test. While some of the material overlaps, I probably could have performed as well or better taking the test prior to medical school with 2 months and the right study materials (instead of 2 years + 1 month studying).

If you're looking for caliber of students,college GPA, SATs and MCATs are better.

 

[SpecterGT260]

No. Just Qbook so far. However it is going to take an act of god to get me to move from my position that memorization is compensation for lack of understanding. I've classically "memorized" very little in medical school and done quite well so far.

 

[deleted103644]

No. Just Qbook so far. However it is going to take an act of god to get me to move from my position that memorization is compensation for lack of understanding. I've classically "memorized" very little in medical school and done quite well so far.

The USMLE is not about understanding. It's not something you can reason out from first principles. Sadly, it is almost entirely rote memorization. A few physiology and statistics questions require some minimal reasoning, but it's mostly pattern recognition and memorization.

I agree with you on your opinion of memorization, and that's why I've been so adamant in my disagreement with you over the importance of board scores in comparison of medical schools. While there are things that can be memorized for the SAT or MCAT, you can do very well on those tests without specific test prep. The USMLE is not like that. You will need to memorize if you want to do well.

There are some great threads on preparation, I'd say bare minimum you need First Aid, Goljan pathology and USMLE World, but that's off topic for this thread.

 

[SpecterGT260]

Do you really think you could have stepped out of undergrad and spent 2 months with a first aid book and attained the same score on step1 that you would have with a traditional preclinical education? This is essentially what you are saying. Maybe I will agree once I get there..... but I really don't think so.

1. med school has caused me to drastically increase my information processing and handling abilities over undergrad
2. The memorization is facilitated with context - and only in-depth study lends context. Rote memorization of what is otherwise an arbitrary list of facts is much more difficult than memorizing out of a base of understanding.

I agree with you, that if we want to change the OP to discuss "better" med school, match lists are probably more relevant. However I still disagree with applying match lists to discussion on whether a school is more difficult in its curriculum. Based on all of the above conversation, I think we can agree that matching has essentially no bearing on how intense, in-depth, or integrated the material is for the preclinic years.

Also, no offense... you are an n=1. I know other people who would agree with you, and many who would not. In my own experience, our phys professor writes for USMLE. We get step1 questions on each phys exam - some of my classmates memorize the minutia (which bothers the crap out of me when I want to discuss concepts and I get a "well what does it say in the notes" response ), and others (myself included) do not memorize but arrive at our answers via reasoning and understanding of the concepts. I cannot say any more definitively than that until I take it, but I have a pretty strong inkling that I will maintain this attitude afterwards.

 

[deleted103644]

Do you really think you could have stepped out of undergrad and spent 2 months with a first aid book and attained the same score on step1 that you would have with a traditional preclinical education? This is essentially what you are saying. Maybe I will agree once I get there..... but I really don't think so.

Yes, although I started pretty well-prepared.

1. med school has caused me to drastically increase my information processing and handling abilities over undergrad
2. The memorization is facilitated with context - and only in-depth study lends context. Rote memorization of what is otherwise an arbitrary list of facts is much more difficult than memorizing out of a base of understanding.

I agree with you, that if we want to change the OP to discuss "better" med school, match lists are probably more relevant. However I still disagree with applying match lists to discussion on whether a school is more difficult in its curriculum. Based on all of the above conversation, I think we can agree that matching has essentially no bearing on how intense, in-depth, or integrated the material is for the preclinic years.

Also, no offense... you are an n=1. I know other people who would agree with you, and many who would not. In my own experience, our phys professor writes for USMLE. We get step1 questions on each phys exam - some of my classmates memorize the minutia (which bothers the crap out of me when I want to discuss concepts and I get a "well what does it say in the notes" response ), and others (myself included) do not memorize but arrive at our answers via reasoning and understanding of the concepts. I cannot say any more definitively than that until I take it, but I have a pretty strong inkling that I will maintain this attitude afterwards.

The level of deeper understanding you see in many pre-meds, medical students, and sadly doctors is usually not that great. If I'd had more faith in myself and cared less about a steady paycheck, I would have gone into something more conceptual like physics or systems biology.

Everyone has different studying styles. Past familiarity helps for studying, but none of the concepts you need to know for the USMLE are that deep, it's just the breadth of the knowledge that can be overwhelming.

My approach to medical school exams was similar to yours. It does not work for the USMLE, you just need to read test prep and take USMLEWorld questions.

 

[SpecterGT260]

I'm sticking to my guns here. I think you are seriously undervaluing and/or taking for granted what pre-clinical education has done for you.

*randomly open's Qbook from the nearby shelf*

Pseudogene are homologues of fucntional genes that lack promoters and are therefore part of the unexpressed DNA. It is thought that at least some of these were produced by reverse transcription of mRNA and insertion of the resultant cDNA into a chromosome by a virus. In addition to lacking a promoter and other regulatory elements, a pseudogene produced in this manner will also differ from the authentic gene in which of the following ways?
A. It will contain oncogenic mutation
B. It will contain nested genes for antibiotic resistance
C. it will have lost some coding regions
D. It will lack introns
E. It will require Shine-Dalgarno sequences

The answer is D. A virus will not have introns and typically do not undergo RNA splicing. I did not memorize at any point that viruses will not have introns, and honestly this is a new concept to me. However, it stands to reason due to the fact that the lifecycle of an RT virus results in packaged RNA that is later RT'ed and spliced into a host genome. There is no functional way for introns to survive more than 1 lifecycle of the virus - Even if they existed originally, they would be spliced out during host transcription, and the "offspring" virus would no longer have them post "packaging". I didn't look around for a good one here... this was literally the first question flipped open to.....

*flip again*

A hospitalized patient with dysuria and suprapubic pain is treated with ciprofloxin. What... uh... Ok, I'll give you this one. Pharm is rote memorization and that is why I hate it.

Try again....

A research physiologist is studying the effects of hypoxia on vascular resistance. An anesthetized animal is ventilated with varying partial pressures of oxygen, and the venous outflow from different organs is measured using Doppler. The graph above most likely represents which of the following? (graph is blood flow % =y, PO2(mmHg)=x, Quickly rises and tapers off around 60 mmHg and 100% blood flow. Direct relationship - not inverse relationship)
A. Brain
B. Kidney
C. Liver
D. Lungs
E. Spleen

Ok... so.. lets reason this one without having memorized hypothetical bloodflow curves. Most tissues will increase blood flow with increased hypoxia. Hypoxia bad. There is only 1 tissue that doesnt do this - because doing so would exacerbate the problem.... Lung. The answer is D. If the perfusion were to vary inversely as with most tissues, There would be a flood of deoxygenated blood that would escape the lungs. If the question were to test my memorization of this concept... they would ask me what the name of this response is.... I dont remember. I also didn't memorize direct vs inverse relationships for this particular comparison. The only thing I can be said to "memorize" is that perfusing lung sections with low oxygen content is bad. But even having "memorized" this fact, the inability to reason will leave you sunk in a hurry.

 

[SpecterGT260]

we are going to have to agree to disagree, i suspect... But I maintain that there isnt anything in first aid that you have memorized that doesn't have a coherent and rational explanation behind it. You can always ask "why", and I prefer to. Also, I don't think memorizing first aid will be all that helpful on step1.... UNDERSTANDING the concepts listed will be (and this gets into subtle nuance between what is meant by understanding vs memorized....)... but that requires a more fluid and malleable understanding of the concepts. I cannot really expect step 1 to test facts as listed in first aid. That last part is speculation, of course.... But everyone I talk to who has taken the test who claims to have memorized out of first aid... when asked, they do more than regurgitate lists.

 

[deleted103644]

we are going to have to agree to disagree, i suspect... But I maintain that there isnt anything in first aid that you have memorized that doesn't have a coherent and rational explanation behind it. You can always ask "why", and I prefer to. Also, I don't think memorizing first aid will be all that helpful on step1.... UNDERSTANDING the concepts listed will be (and this gets into subtle nuance between what is meant by understanding vs memorized....)... but that requires a more fluid and malleable understanding of the concepts. I cannot really expect step 1 to test facts as listed in first aid. That last part is speculation, of course.... But everyone I talk to who has taken the test who claims to have memorized out of first aid... when asked, they do more than regurgitate lists.

Of your three examples:

1) I would have been able to answer this in high school, and anyone who has taken biochemistry should be able to answer it as well. I suppose some people don't take that until medical school, but they are the exception.

2) There is a lot of pharm and ID on the boards that is rote memorization as you admit.

3) I had already conceded physio and statistics. These do not make up the bulk of the exam.

Assuming a conceptual grasp of everything tested by the MCAT, I stand firm by the assertion that a reasonably intelligent person could get >250 on the USMLE with just First Aid, USMLEWorld, and a few additional references (Goljan, etc).

I think we agree on what is valuable in education, you just give the USMLE way too much credit.

 

[SpecterGT260]

Well... it is what it is. My point is that my first weapon will be reason and my 2nd will be memorization. For anything you know, there will always be a component "memorized" (I had to memorize the process of RT viral infection), but where we go from there is reasoning. I doubt many highschoolers would offhandedly know that question. I admit that I had to think about it - to figure out what concept they were testing. "lacks" introns is no inherently obvious. Sure, you could have memorized it as a trivial factoid. I like my approach. Can you honestly say you understood WHY RT viruses don't have introns? Maybe you can, but many cannot. Same thing I used on B and T cell rearrangement. Many of my class just memorized that the heavy chain in B cells rearrange once and the lights go many times. Some went futher and memorized that it is "because" we do not want to kill off cells with disfunctional IgL because IgH is a heavy-loss process to begin with. However, others (and I am in this catagory) looked at it from a different perspective. the DJ arrangement always happens first and excises the in-between DNA which is destroyed. Then V arranges to this particular DJ with a similar byproduct. At this point, I dont give a damn what the cell or body "wants" to do - if it is advantageous to allow plasticity with IgL... the genome no longer contains any more D segments.... All D segments in front of, and behind, the one that was originally recombined are gone and destroyed from the cell's GENOME. It physically cannot undergo another rearrangement because it lacks the genes, not, as it is often presents, that it is simply blocked from doing so (or some phantom process of "it just doenst"). From this perspective it is equally appropriate to say that a single IgH rearrangement is a coincidental byproduct of the IgH loci structure, and not some greater evolutionary mechanism to increase efficiency of selection and pre-BCR passing.