Med School Faculty Seeking Anonymous PreMed Input on Curriculum

[MedSchoolProf]

We are members of the faculty at a well-respected, allopathic school. Senior faculty here are in the earliest stages of planning a new, preclerkship curriculum, and we are very much interested in hearing opinions from current premed students on the general proposals which are being discussed.

Our school currently has a traditional 2+2 schedule (i.e. 2 years preclerkshp, 2 years clerkship). The current curriculum is more complicated than this, but when simplified, courses fall into 3 categories:
1. Non-integrated, foundational basic science courses (e.g. biochem, genetics, cell bio, anatomy). Confined to first half of year 1.
2. A single, integrated course covering physiology, path, pharm, and histo. Taught ~2 half-days/week, from 2nd half of year 1 through end of year 2.
3. A single, integrated doctoring course (e.g. interview skills, physical exam, clinical reasoning, diagnostic test interpretation, procedures, ethics, nutrition, etc...). Taught 2 half-days/week, throughout all of years 1 and 2.

The proposals that are being discussed (which are, again, at a very early stage):
1. Creating more modularity in the curriculum by deintegrating #2 into distinctly separate courses on physio, path, pharm, and micro.
2. Redistributing some of the time spent in the doctoring course to "clinical skills boot camps" at the beginning of year 1 and just before clerkships start. (There would be some ongoing clinical experience throughout years 1 and 2, but much reduced in time/prominence)
3. Overall, there would be 2 separate tracks formed: A traditional 2 year track, aimed at students wanting to pursue clinical medicine. And a novel 3 year track, in which the same courses would be spread out over more time, aimed at students who want an opportunity for a more longitudinal experience in lab. The expectation would be that the 2 year and 3 year tracks would be roughly equal in popularity.

As you might imagine, these ideas have been very controversial among the faculty, and have generated much discussion. Since this would impact prospective students more than current students, we would love to hear the honest opinion of premeds here.

(Yes, we realize that a post on SDN is far from a scientific poll. This is meant as a first pass gathering of relevant opinions. And no, we are not at liberty to currently disclose our institution, and in the event you recognize the school, we would appreciate you holding back that info. Thanks!)

---

Members don't see this ad.

 

[Affiche]

Initial thoughts:
1. Reducing clinical time during pre-clinical years sounds like a plus to me. One of the biggest turn-offs to me in curriculum is having a large amount of required clinical time in years 1-2 that doesn't necessarily prepare students for third year but takes time away from pre-clinical studying.
2. I'm a little bit confused by the 3-year track and how that fits in with Step 1.

 

[Krupke]

Just to clarify: The 3 year track will be 5 years total? I would never add another year of med school loans. I applied to a school that has a competive stipend available to do a masters with research. Free tuition for the masters + $15K living stipend

Will you halve the tuition during 2 of the years since they are learning half the material in that time?

What is the benefit of adding another year of tuition rather than just taking a research year during school for free?

Plus, I been doing some reading on residency and it seems that more people are doing research years during residency. I wouldn't want to keep prolonging my training

 

[JessebenBenjamin]

Initial thoughts:
1. Reducing clinical time during pre-clinical years sounds like a plus to me.

Complete opposite. Remind me what I signed up for. I've also heard early clinical exposure helps tremendously to actually learn in your pre-clinical years.

 

[Affiche]

Complete opposite. Remind me what I signed up for. I've also heard early clinical exposure helps tremendously to actually learn in your pre-clinical years.

There's always plenty of opportunity to develop clinical skills though without it being mandatory. The less mandatory attendance during years 1-2, the better.

 

[Krupke]

I'm sorry to keep adding things, but, also, two of the schools I interviewed at require students to do a thesis project (which could be research if desired). Does a thesis not provide some longitudinal research? (Maybe a current med student could comment)

 

[lmn]

Weird to ask premeds imo, they haven't experienced any part of medical school and don't have a strong basis to say why they think certain things might be better or worse and what is useful for their training and prep for boards...

 

[TehTeddy]

So as I understand it, the 3 year track would add an extra pre-clinical year, correct? For a total of 5 years. When you say longitudinal experience in the lab, do you mean to make time for research during the regular year (i.e. while taking classes, like in undergrad)? How would this affect tuition for those years? Since the same amount of material would be covered in both the 2 and 3 year tracks.

I will say, as a pre-medical student, the idea of paying the normal yearly tuition for an extra year, for the same amount of covered material, would be a turn-off from that track (and the aim is for both to be roughly equal in popularity yes?). Granted, I would still prefer the normal 2+2 track even if the total tuition came to the same amount in the end, but I could see the appeal for certain students.

 

[MedSchoolProf]

2. I'm a little bit confused by the 3-year track and how that fits in with Step 1.

Step 1 could be taken either at the end of the 3rd year (i.e. last preclerkship year), or early within the first clinical year (i.e. not required prior to starting clerkships)

 

[MedSchoolProf]

Just to clarify: The 3 year track will be 5 years total?

Will you halve the tuition during 2 of the years since they are learning half the material in that time?

Yes, the 3 year track will be 5 years total. Discussions are very early at this point, but tuition would be adjusted such that the 3 year preclerksihp track wasn't dramatically different in cost (aside from housing and food, of course!)

 

[MedSchoolProf]

Weird to ask premeds imo, they haven't experienced any part of medical school and don't have a strong basis to say why they think certain things might be better or worse and what is useful for their training and prep for boards...

The reason to ask premeds about this is because the primary argument upon which these proposals are based, is that students applying to medical school are seeking greater flexibility with their coursework, to enable them to concentrate more on research. We are simply trying to see if that's the case. (i.e. if a 3 year preclerkship option would be desirable to a significant number of prospective students). The other changes mentioned (e.g. redistributed clinical exposure, reduced integration) would primarily be to support the ability to create two parallel tracks.

 

[Affiche]

Step 1 could be taken either at the end of the 3rd year (i.e. last preclerkship year), or early within the first clinical year (i.e. not required prior to starting clerkships)

I think the biggest concern is with paying tuition for an extra year to do more research. Right now, med students can take a year off and do research without paying extra tuition, so I dislike the 3 year track.

 

[Spector1]

Yeah any "extra" programs like research should either be stuffed to fit in the 4 year track or any additional years covered by grants/fellowship money (kind of how cleveland lerner does it but they are more generous)

 

[Affiche]

The reason to ask premeds about this is because the primary argument upon which these proposals are based, is that students applying to medical school are seeking greater flexibility with their coursework, to enable them to concentrate more on research. We are simply trying to see if that's the case. (i.e. if a 3 year preclerkship option would be desirable to a significant number of prospective students). The other changes mentioned (e.g. redistributed clinical exposure, reduced integration) would primarily be to support the ability to create two parallel tracks.

Is there scheduled time off for step 1 studying or will students be balancing studying with research?

How is the 3 year track different than a phd? To be honest, if I'm already putting in 5 years to do extra research it makes more sense to me to just do 2 more years and come out with an MD/PhD and have my tuition paid for plus the extra credentials of the second degree.

 

[Glazedonutlove]

We are members of the faculty at a well-respected, allopathic school. Senior faculty here are in the earliest stages of planning a new, preclerkship curriculum, and we are very much interested in hearing opinions from current premed students on the general proposals which are being discussed.

Our school currently has a traditional 2+2 schedule (i.e. 2 years preclerkshp, 2 years clerkship). The current curriculum is more complicated than this, but when simplified, courses fall into 3 categories:
1. Non-integrated, foundational basic science courses (e.g. biochem, genetics, cell bio, anatomy). Confined to first half of year 1.
2. A single, integrated course covering physiology, path, pharm, and histo. Taught ~2 half-days/week, from 2nd half of year 1 through end of year 2.
3. A single, integrated doctoring course (e.g. interview skills, physical exam, clinical reasoning, diagnostic test interpretation, procedures, ethics, nutrition, etc...). Taught 2 half-days/week, throughout all of years 1 and 2.

The proposals that are being discussed (which are, again, at a very early stage):
1. Creating more modularity in the curriculum by deintegrating #2 into distinctly separate courses on physio, path, pharm, and micro.
2. Redistributing some of the time spent in the doctoring course to "clinical skills boot camps" at the beginning of year 1 and just before clerkships start. (There would be some ongoing clinical experience throughout years 1 and 2, but much reduced in time/prominence)
3. Overall, there would be 2 separate tracks formed: A traditional 2 year track, aimed at students wanting to pursue clinical medicine. And a novel 3 year track, in which the same courses would be spread out over more time, aimed at students who want an opportunity for a more longitudinal experience in lab. The expectation would be that the 2 year and 3 year tracks would be roughly equal in popularity.

As you might imagine, these ideas have been very controversial among the faculty, and have generated much discussion. Since this would impact prospective students more than current students, we would love to hear the honest opinion of premeds here.

(Yes, we realize that a post on SDN is far from a scientific poll. This is meant as a first pass gathering of relevant opinions. And no, we are not at liberty to currently disclose our institution, and in the event you recognize the school, we would appreciate you holding back that info. Thanks!)

Cleveland clinic has a successful 5 year program (1 year for research thesis), but they pay for tuition. NYU has a program where they allow you to get an MD and master's in 4 years (though the curriculum doesn't allow for much vacation time). Some schools have an option to take off a year after 3rd year to do research or get an mph. I am interested in doing research in addition to studying medicine, so I applied to schools that have the integrated scholarship project. Some schools make this longitudinal--you would pick a project in first year, maybe do some work in the summer, and then there is additional time in 4th year. My question is what would draw students to pay for the extra year?
Someone mentioned above how it would be easier to just go for an MSTP, but I disagree--8 years vs 5 makes a big difference in my opinion.

 

[Slave to the Game]

1. Creating more modularity in the curriculum by deintegrating #2 into distinctly separate courses on physio, path, pharm, and micro.
2. Redistributing some of the time spent in the doctoring course to "clinical skills boot camps" at the beginning of year 1 and just before clerkships start. (There would be some ongoing clinical experience throughout years 1 and 2, but much reduced in time/prominence)

I'm a fan of #1. When I'm first exposed to new topics I learn better when they're compartmentalized, and the big picture (integration) can come into play after the intellectual groundwork has been laid out.
#2 also sounds good.

As for #3

3. Overall, there would be 2 separate tracks formed: A traditional 2 year track, aimed at students wanting to pursue clinical medicine. And a novel 3 year track, in which the same courses would be spread out over more time, aimed at students who want an opportunity for a more longitudinal experience in lab. The expectation would be that the 2 year and 3 year tracks would be roughly equal in popularity.

Splitting the class up into two distinct tracks might not be great for the student body as a whole. Not a fan. Also might create some in-group/out-group bias which jeopardizes the cohesive/collaborative nature of such a small student body. There may also be issues if the match results end up skewing in favor of one group.

These are my thoughts as a completely uninformed pre-medical student. I honestly think this would get better feedback at the allo forum.

 

[WedgeDawg]

I think it's more conducive to people wanting to enter academic medicine to take a research year if necessary rather than spacing classes out over 3 years and having lab time exist alongside classes. You're likely going to get a lot more done doing research full time+ over a year than doing it barely part time over 2ish years.

You could also consider doing what Duke and friends are doing with a 1 year preclinical curriculum and a built in research year after clinicals (so it goes 1. preclinical 2. clinical 3. research 4. electives/subIs). Or do a 1.5 year preclinical and give extra time for research after clinicals like Columbia/Penn/Yale do.

I think you'll get better responses from M4s or new residents than you will from premeds/preclinical students because these students will be able to comment on what worked in their curriculums, what didn't, and what they would change if they could. Premeds/M1s (myself included) have no idea what constitutes a good curriculum and what constitutes a nightmarish one. If you want, I can move this thread over to the Allopathic section where you might gather responses from people later in their training.

 

[Spinach Dip]

Weird to ask premeds imo, they haven't experienced any part of medical school and don't have a strong basis to say why they think certain things might be better or worse and what is useful for their training and prep for boards...

Yet the pre-med opinion is valuable because you don't want college juniors and seniors looking at your school's information and saying "they do X? I'm not applying there!"

 

[MedSchoolProf]

I think you'll get better responses from M4s or new residents than you will from premeds/preclinical students because these students will be able to comment on what worked in their curriculums, what didn't, and what they would change if they could. Premeds/M1s (myself included) have no idea what constitutes a good curriculum and what constitutes a nightmarish one. If you want, I can move this thread over to the Allopathic section where you might gather responses from people later in their training.

Thanks for the feedback. We are actually specifically seeking the opinions of premed students at the moment. The major motivation for these changes was because some faculty felt that our current curriculum was not accommodating enough for students entering med school with a desire to participate more actively in research. Thus, we are wanting to know whether or not premed students would see such changes (i.e. an option for 3 part-time preclerkship years instead of 2 full-time preclerkship years) as a advantage, and whether it would positively impact the decision to apply and/or matriculate to our institution.

 

[Spinach Dip]

And BTW, I have done the thought experiment of designing the curriculum *I* would like to see from med schools, and it goes something like this:

First 2 years:
-Standard didactic courses, including A&P, biochem, path, pharm, et al.
-A vast assortment of electives, including: clinic, research, and practical (non-science) things like medical spanish and personal finance/investing.

Last 2 years:
-Clerkships as normal.



In this way, those who want to get into the clinic/OR year 1 can do so, while those who would rather do research can go that route. And those who can't decide can do a little of each. The versatility would appeal to all potential students.



And in direct response to your first post, I think if you give students 4 and 5 year plans--both of which end in the same place--I envision very few choosing the 5 year path. IF, however, the 5-year path comes with a dual degree (MD/MBA, MD/MPH, MD/MS), it would be much more appealing to incoming students.

That's how I see it at least.

 

[moisne]

One of the biggest turn-offs to me in curriculum is having a large amount of required clinical time in years 1-2 that doesn't necessarily prepare students for third year but takes time away from pre-clinical studying.

It varies between people. I don't like to be forced to do things but my friend things the best way to learn is in clinic.

I'm sorry to keep adding things, but, also, two of the schools I interviewed at require students to do a thesis project (which could be research if desired). Does a thesis not provide some longitudinal research?

Any project (thesis, research, paper, etc) can be a longitudinal research

MSTP, but I disagree--8 years vs 5

It's really more than 7-13 years vs 5 years

our current curriculum was not accommodating enough for students entering med school with a desire to participate more actively in research. Thus, we are wanting to know whether or not premed students would see such changes

I went into med school thinking - "Yeah! I want research, research, research. I'll dedicate 10-20 hours a week to research!"
Now I'm like "online stream my class, work work, online stream some classes, step 1 step 1, oh... shoot, I forgot to go in for research this week, Ahhh I need to schedule my next clinic session."

 

[The Knife & Gun Club]

And BTW, I have done the thought experiment of designing the curriculum *I* would like to see from med schools, and it goes something like this:

First 2 years:
-Standard didactic courses, including A&P, biochem, path, pharm, et al.
-A vast assortment of electives, including: clinic, research, and practical (non-science) things like medical spanish and personal finance/investing.

Last 2 years:
-Clerkships as normal.



In this way, those who want to get into the clinic/OR year 1 can do so, while those who would rather do research can go that route. And those who can't decide can do a little of each. The versatility would appeal to all potential students.



And in direct response to your first post, I think if you give students 4 and 5 year plans--both of which end in the same place--I envision very few choosing the 5 year path. IF, however, the 5-year path comes with a dual degree (MD/MBA, MD/MPH, MD/MS), it would be much more appealing to incoming students.

That's how I see it at least.

TBH I think this sounds brilliant albeit probably alot more work for the administration. Medical Spanish and personal financial management sound like great classes for every med student.

I've often wondered if a class on "communicating medical information to people from limited educational backgrounds" could be made to work in med school. From what I've seen that is very needed in modern healthcare.

 

[Affiche]

You're likely going to get a lot more done doing research full time+ over a year than doing it barely part time over 2ish years.

Do you think so? A big problem that I have as a clinical research coordinator is that the IRB slows everything down. I can see the benefit of having 3 years to do research vs 1 full-time, but the 3 year track proposed doesn't appeal to me.

The school I'll be matriculating at requires all students to have a research project throughout their 4 years, which I like. We're matched with a faculty mentor our first year and work with them until we graduate, plus there's funding available to do research full-time the summer between M1 and M2. This seems to work well for me because I can dedicate a lot of time to research without adding years onto my training without the added credentials. Perhaps it's just me, but if I'm adding any time onto this lengthy process then I want another degree to show for it lol.

 

[catie_jane]

Cleveland clinic has a successful 5 year program (1 year for research thesis), but they pay for tuition. NYU has a program where they allow you to get an MD and master's in 4 years (though the curriculum doesn't allow for much vacation time). Some schools have an option to take off a year after 3rd year to do research or get an mph. I am interested in doing research in addition to studying medicine, so I applied to schools that have the integrated scholarship project. Some schools make this longitudinal--you would pick a project in first year, maybe do some work in the summer, and then there is additional time in 4th year. My question is what would draw students to pay for the extra year?
Someone mentioned above how it would be easier to just go for an MSTP, but I disagree--8 years vs 5 makes a big difference in my opinion.

People are also forgetting that you have to continue to do post-docs with your PhD, so there is much more of a difference than 8 years vs 5 years when comparing the two

 

[Affiche]

People are also forgetting that you have to continue to do post-docs with your PhD, so there is much more of a difference than 8 years vs 5 years when comparing the two

You don't have to do a post-doc. The only reason I brought up the MD/PhD is because it's paid for. If I'm already paying for 5 years, why not commit to 7 and pay for none? I have no interest in a PhD though (that's my SO's area) so I'm biased lol.

 

[catie_jane]

You don't have to do a post-doc. The only reason I brought up the MD/PhD is because it's paid for. If I'm already paying for 5 years, why not commit to 7 and pay for none? I have no interest in a PhD though (that's my SO's area) so I'm biased lol.

Yeah, but in most cases to secure a good job you have to do at least one post-doc if not more (this is from my experience working with PhDs and post-doc fellows). And yeah I see your point. Most schools I looked into have a 5 year program which you can secure an extra degree and the extra year is tuition free. In those cases, for me at least, the 5 year track is worth it

 

[Krupke]

And in direct response to your first post, I think if you give students 4 and 5 year plans--both of which end in the same place--I envision very few choosing the 5 year path. IF, however, the 5-year path comes with a dual degree (MD/MBA, MD/MPH, MD/MS), it would be much more appealing to incoming students.

That's how I see it at least.

I agree that the degree option would be more attractive, but I think a lot of curriculums have been moving towards getting a 2nd degree/equivalent experience of a 2nd degree within 4 years. I still think it would be weird to move towards a 5 year degree with no financial incentives to get students to choose that programs over others.

 

[NotASerialKiller]

I'll vote for whichever one you want me to if you promise to accept me.

 

[lmn]

Yet the pre-med opinion is valuable because you don't want college juniors and seniors looking at your school's information and saying "they do X? I'm not applying there!"

If they are a "well-respect" MD program, I'm sure they don't have any deficit of highly qualified candidates in reality. You can definitely make your curriculum in a way that sounds attractive to premeds, but that doesn't mean that said curriculum will be good at providing a strong education, preparation for the clinic, and preparation for the step exams. How could any premed know what courses should be grouped together, or what courses can be shortened and which need more time? There are premeds in this thread saying they would want to skip clinic experience/standardized pts in the first two years to make more time for studying/w.e else, yet if you look in the allo section there are people talking about how a well run program in the first two years can give you invaluable preparation for 3rd year and experience and practice doing things that you will be graded on the wards. You can also find many med students who say that their clinic time was essential in keeping themselves grounded and sane while they were studying in the first two years, again this isn't something super obvious to a premed but may be really important to people who have been through it.

Wouldn't it be a lot better to have interviewees come and have current med students tell them how great the program is and how they changed it in ways that works extremely well for you to succeed in med school, and to have them say they made changes based on what med students said to help them excel further in boards, the clinic, and matching? I think great feedback and experience from students is far more important than looking attractive on paper, especially for an established MD school that doesn't really have to do things like that to attract good applicants. Plus I don't think anyone can give that great of feedback on what would be best if they aren't familiar with the particular school in question, so many aspects of this are school specific about what should be changed and what should be saved.

 

[Affiche]

If they are a "well-respect" MD program, I'm sure they don't have any deficit of highly qualified candidates in reality. You can definitely make your curriculum in a way that sounds attractive to premeds, but that doesn't mean that said curriculum will be good at providing a strong education, preparation for the clinic, and preparation for the step exams. How could any premed know what courses should be grouped together, or what courses can be shortened and which need more time? There are premeds in this thread saying they would want to skip clinic experience/standardized pts in the first two years to make more time for studying/w.e else, yet if you look in the allo section there are people talking about how a well run program in the first two years can give you invaluable preparation for 3rd year and experience and practice doing things that you will be graded on the wards. You can also find many med students who say that their clinic time was essential in keeping themselves grounded and sane while they were studying in the first two years, again this isn't something super obvious to a premed but may be really important to people who have been through it.

Wouldn't it be a lot better to have interviewees come and have current med students tell them how great the program is and how they changed it in ways that works extremely well for you to succeed in med school, and to have them say they made changes based on what med students said to help them excel further in boards, the clinic, and matching? I think great feedback and experience from students is far more important than looking attractive on paper, especially for an established MD school that doesn't really have to do things like that to attract good applicants. Plus I don't think anyone can give that great of feedback on what would be best if they aren't familiar with the particular school in question, so many aspects of this are school specific about what should be changed and what should be saved.

Here's are some of my thoughts:
1. My top choice coming into the cycle revealed a pretty drastic change at interview day. I knew within the first hour that I wouldn't attend that school no matter what. I ended up getting accepted there but have withdrawn my acceptance. I think this is what @Spinach Dip was referring to.
2. There are also plenty of medical students saying that they wish they had less required time scheduled during the first two years so they could study more. Also that clinical training during the the first two years didn't prove to be of much help for third year, save a few schools who do pre-clinical training really well. Not all schools do pre-clinical training really well and instead end up having their students participate in glorified shadowing for the first two years. I also think you can get in the clinical training outside of the classroom without it being a mandatory commitment every week, which plenty of schools do. And finally, I'm a non-trad student working clinically right now, so a lot of (not all) the clinical skills taught in the first two years are things I'm getting paid to do now, so I'd rather not take more time away from studying here.

 

[lmn]

Here's are some of my thoughts:
1. My top choice coming into the cycle revealed a pretty drastic change at interview day. I knew within the first hour that I wouldn't attend that school no matter what. I ended up getting accepted there but have withdrawn my acceptance. I think this is what @Spinach Dip was referring to.
2. There are also plenty of medical students saying that they wish they had less required time scheduled during the first two years so they could study more. Also that clinical training during the the first two years didn't prove to be of much help for third year, save a few schools who do pre-clinical training really well. Not all schools do pre-clinical training really well and instead end up having their students participate in glorified shadowing for the first two years. I also think you can get in the clinical training outside of the classroom without it being a mandatory commitment every week, which plenty of schools do. And finally, I'm a non-trad student working clinically right now, so a lot of (not all) the clinical skills taught in the first two years are things I'm getting paid to do now, so I'd rather not take more time away from studying here.

Ya I agree, that's why I'm saying I think the interview day and feedback from current students is much more important than how cool a different curriculum may seem when you look at a school's website.

And ya some schools have poorly run programs, which is why in that case I believe listening to your current students' feedback and making adjustment to the course to try to make it better and more effective is a better way to approach it than to just totally do away with the clinical experience. That's great if you are doing full interviews, getting experience doing physical exams, presenting, and writing up in your current job, but that is not a requirement and typical experience for incoming students to have, you would be an exception in this case, and schools shouldn't do away with very valuable training simply because a couple of students may already have that experience.

 

[Affiche]

Ya I agree, that's why I'm saying I think the interview day and feedback from current students is much more important than how cool a different curriculum may seem when you look at a school's website.

And ya some schools have poorly run programs, which is why in that case I believe listening to your current students' feedback and making adjustment to the course to try to make it better and more effective is a better way to approach it than to just totally do away with the clinical experience. That's great if you are doing full interviews, getting experience doing physical exams, presenting, and writing up in your current job, but that is not a requirement and typical experience for incoming students to have, you would be an exception in this case, and schools shouldn't do away with very valuable training simply because a couple of students may already have that experience.

I agree that it should be improved instead of done away with, but personally I'd still prefer minimum mandatory attendance. People are coming in with different skills and learn in different ways and I don't want my time planned for me. I'm an adult, if I think I need to spend more time on X then I'll schedule to do that.

 

[lmn]

I agree that it should be improved instead of done away with, but personally I'd still prefer minimum mandatory attendance. People are coming in with different skills and learn in different ways and I don't want my time planned for me. I'm an adult, if I think I need to spend more time on X then I'll schedule to do that.

Ya I think the vast majority of people are very anti-mandatory attendance for classes/etc, but I feel like schools do really need to have solid "clinical" training and exposure component in the preclinical years, many students come in with little experience in clinic other than possibly from shadowing, and honestly a fair amount of people just need to be exposed to a "work"/non-school environment (primarily traditional students). Of course people can shadow, but like you said before, there is a big difference between watching and doing things yourself and I think it's in the best interest for a school overall to make sure they are setting up their students to do well come 3rd year (or whenever they start clinical training).

Ya that may at times mean an extra hour or two every once in awhile doing something you already know/are good at, but overall in the interest of all students and the school producing good doctors I think it's worth it. And honestly that small amount of time is really no big deal in the first two years, you'll have plenty of free time/time to study.

 

[FindMeOnTheLinks]

And BTW, I have done the thought experiment of designing the curriculum *I* would like to see from med schools, and it goes something like this:

First 2 years:
-Standard didactic courses, including A&P, biochem, path, pharm, et al.
-A vast assortment of electives, including: clinic, research, and practical (non-science) things like medical spanish and personal finance/investing.

Last 2 years:
-Clerkships as normal.



In this way, those who want to get into the clinic/OR year 1 can do so, while those who would rather do research can go that route. And those who can't decide can do a little of each. The versatility would appeal to all potential students.



And in direct response to your first post, I think if you give students 4 and 5 year plans--both of which end in the same place--I envision very few choosing the 5 year path. IF, however, the 5-year path comes with a dual degree (MD/MBA, MD/MPH, MD/MS), it would be much more appealing to incoming students.

That's how I see it at least.

Check out schools with "Scholarly Concentrations." University of South Florida has kind of what you are looking for as far as a few "elective" tracks that start during 1st year. If you want a more highly ranked school, Stanford does too. There might be another school but it's escaping me at the moment.

Also, your idea of getting in the clinic/OR as a first year is available at any school. If you want to do that, email a physician you're interested in shadowing and they will probably accommodate you as a medical student.

The thing about medical school, it's way easier to get involved in extra curricular activities than it is as a premed. As a premed you have to scratch and claw for every research, shadowing, and volunteering opportunity. In medical school it's much easier. If you want to do it, you do it, because there are fewer people vying for the same opportunities.

 

[Glazedonutlove]

Ya I think the vast majority of people are very anti-mandatory attendance for classes/etc, but I feel like schools do really need to have solid "clinical" training and exposure component in the preclinical years, many students come in with little experience in clinic other than possibly from shadowing, and honestly a fair amount of people just need to be exposed to a "work"/non-school environment (primarily traditional students). Of course people can shadow, but like you said before, there is a big difference between watching and doing things yourself and I think it's in the best interest for a school overall to make sure they are setting up their students to do well come 3rd year (or whenever they start clinical training).

Ya that may at times mean an extra hour or two every once in awhile doing something you already know/are good at, but overall in the interest of all students and the school producing good doctors I think it's worth it. And honestly that small amount of time is really no big deal in the first two years, you'll have plenty of free time/time to study.

Right--schools I applied to have patient interviewing/doctoring classes/standardized patients/simulators in pre-clinical and I think I will like that set up instead of just being buried in textbooks for 2 years. And if you go to a school with a good program, it does prepare you for third year (students on my interviews said it was helpful)

 

[Glandzburg]

Mandatory clinical obligations during your first and second years is one of those things that a lot of premeds seem to want in a medical school, but a majority of people end up changing their tone once they start the preclinical years. The reason is that you simply don't know enough to be of any real help yet. It's essentially shadowing, which you should have done before you started.

But, you do need some clinical experiences to learn how to interview, perform physicals, develop a plan, etc. These experiences would ideally be contained within the school's "doctoring" course.

The key is to find the right amount where students are learning basic skills, without eating into a huge chunk of necessary study time.

A lot of premeds think more clinical experience always = better, but this is only true to a point, and only if that clinical time is spent doing focused activities that develop pre-requisite skills for 3rd/4th year. Simply following a doctor around all afternoon is of marginal benefit.

EDIT: if you do want to shadow doctors, there are usually plenty of opportunities that are not mandatory.

 

[MedSchoolProf]

Thanks for everyone's input.

To clarify/answer a couple of questions:

1. We are very sorry, but we have no details to share regarding the tuition/funding for the 3 year preclerkship track, as compared to the 2 year one.
2. We appreciate students not wanting to do more shadowing experiences in the preclerkship years if they've already shadowed as premeds. The clinical experiences the preclerkship students get in our current doctoring course is not remotely like shadowing. It's very structured, hands-on, and practical.
3. Students who take the 3 year track would have the option of using that extra time to pursue an additional degree (e.g. MPH, MBA, etc...) instead of research, but those who use it specifically for basic science research would not have enough time to obtain another degree.
4. We agree that current medical students would be in a better position to remark on how these changes will impact training. However, the discussion about a new curriculum at our institution is partly being driven by a desire to make our school more appealing to premeds who hope to pursue basic science research. We are trying to gather very prelim data to get an idea as to how likely these changes will have that effect, as well as how likely they will turn off students who are primarily interested in clinical medicine.

 

[Ostallopathic]

We agree that current medical students would be in a better position to remark on how these changes will impact training. However, the discussion about a new curriculum at our institution is partly being driven by a desire to make our school more appealing to premeds who hope to pursue basic science research. We are trying to gather very prelim data to get an idea as to how likely these changes will have that effect, as well as how likely they will turn off students who are primarily interested in clinical medicine.

If you want to make your school more appealing to premeds who hope to pursue basic science research, then have a legit program that students can sign up for at will (without having to apply or anything annoying like that) so that they are automatically hooked up with a research lab in the summers.

Then, make a serious effort toward allowing students to be authors of the papers.

It might be hard to get it started, but if students start seeing that you can sign up for a program and actually contribute to a project in a meaningful way where you end up as a paper author, then they will be jumping at the chance to sign up if they have any interest at all in basic science research.

Also, you should check up with the PI's and the students to make sure that the students aren't stuck doing dumb stuff like spending 90% of the day organizing data in excel sheets or anything. I've heard some medical students get stuck doing that dumb stuff and it makes me really upset. Maybe make some unannounced visits because the PI's might be disingenuous and the students might not be forthcoming with information that could harm them. I actually have no idea. I just know that if you want students to sign up they have to be sure that they won't be doing dumb stuff.

Honestly, I think that most students would like research a lot more if there weren't selfish/lazy PI's who make their students do tasks any 6th grader could do.

The cool part about research is solving science problems. Figure out how you can encourage that most of all.

Honestly, though, why do you want MD basic science researchers so bad? What's wrong with PhD's?

 

[Cyberdyne 101]

I'm not sure if this has been mentioned, but Stanford has a 2 year pre-clinical track, with a required scholarly concentration, and roughly 60% of their students are on a 5 year track. The students actually get Wednesdays off during the first 2 years in order to pursue other interests. Obviously, this setup has worked very well for them.