New Curriculum -Step One 6 months early

[skillfullhello]

I go to a school that was one of a few that got some money from the AAMC to transform their curriculum. As a result i have been the lucky winner and my prize is taking step one 6 months early, late jan 2016. My mcat score also sucked bad. Im worried that i won't do well considering we are taking it 6 months early and standardized tests are not my "thing" , so i just wanted to gather some thoughts from you gunners on how to tackle this thing!

should i start looking at first aid right now or what? do practice questions?
We have NBME End of block exams too, will they help prepare me?

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[DermViser]

I go to a school that was one of a few that got some money from the AAMC to transform their curriculum. As a result i have been the lucky winner and my prize is taking step one 6 months early, late jan 2016. My mcat score also sucked bad. Im worried that i won't do well considering we are taking it 6 months early and standardized tests are not my "thing" , so i just wanted to gather some thoughts from you gunners on how to tackle this thing!

should i start looking at first aid right now or what? do practice questions?
We have NBME End of block exams too, will they help prepare me?

Sorry, I just had to laugh at the way the medical schools who got the grant are "accelerating change": http://www.ama-assn.org/sub/accelerating-change/grant-projects.shtml. What a complete waste of 11 million dollars by the AAMC. Not at all surprised that MedEd people would squander it.

I don't see how having a 1.5 year preclinical is some how transformative but whatever. NBME exams that your school administers will help gauge your progress. Use review books and Qbanks as you would in a 2 year preclinical.

 

[Jabbed]

Sorry, I just had to laugh at the way the medical schools who got the grant are "accelerating change": http://www.ama-assn.org/sub/accelerating-change/grant-projects.shtml. What a complete waste of 11 million dollars by the AAMC. Not at all surprised that MedEd people would squander it.

I don't see how having a 1.5 year preclinical is some how transformative but whatever. NBME exams that your school administers will help gauge your progress. Use review books and Qbanks as you would in a 2 year preclinical.

Shorter preclinical curriculum = longer clinical curriculum, additional elective rotations, and/or dedicated research blocks. A few big named schools do this already.

 

[SouthernSurgeon]

. Not at all surprised that MedEd people would squander it.

When the other students on the curriculum committee and I met with the PhD med-ed people, we were consistently shocked by how little they actually knew about our education/experiences. We had a meeting explaining to them for thirty minutes what the student's role is on a third year clerkship.

And yet these people are given power to determine our curriculum.

Sigh.

 

[DermViser]

When the other students on the curriculum committee and I met with the PhD med-ed people, we were consistently shocked by how little they actually knew about our education/experiences. We had a meeting explaining to them for thirty minutes what the student's role is on a third year clerkship.

And yet these people are given power to determine our curriculum.

Sigh.

Oh God yes!! I used to always wonder why our Curriculum committee could never get things right. I realize evaluations can sometimes seem like a cacaphony of different voices who complain about everything under the sun, but it seemed like year after year, the same complaints wouldn't be corrected but allowed to fester.

The MDs who are on the curriculum committee either a) don't care and are just doing it for their own motives, b) are too far away from medical school to know what changes would be actually effective and beneficial for students, or 3) are too scared to say anything of substance for fear of offending med school admins since they're shooting to go up the tenure track.

The PhDs on the committee tend to be the overzealous ones who don't want to change anything bc they're happy with things just the way they are or feel like they need to stick it to med students. One thing they can be assured of doing is that policy changes were never in the student's favor: adding required electives in MS-4, decreasing number of shelf retakes before having to repeat a clerkship, etc.

I guess it's gotten so bad with what MS-3s actually are doing on clerkships these days, with students being so unprepared when they start internship, that now the AAMC has released this: https://members.aamc.org/eweb/Dynam..._prd_key=E3229B10-BFE7-4B35-89E7-512BBB01AE3B, to actually have written down what students need to have mastered on Day 1 of residency.

 

[Psai]

It's shocking how dilute medical education is. The justification is that they need to teach their interns how to do everything but why don't they teach these things to medical students in the first place instead of having to bring their weak interns up to par? Why do I have to beg people to read my notes? Then the administration insults us by telling us that we need to write our med student notes in a format with a crappy layout that no one can read so they can get good family histories as part of their meaningless use mandate. Thanks for telling us that our only use is to update a part of the history that no one looks at

The few times I get to do stuff is usually when I'm with a strong upper year resident. I've been in surgeries where the attending does everything and only lets the chief resident suture at the end. Wtf?

Instead of implementing harebrained schemes to improve the curriculum they should just leave it as it is and give residents and attendings more time to teach med students stuff and look at our notes instead of endless rounding and writing their own notes all day long

 

[operaman]

I've yet to understand why there is such a push to shorten medical education when we live in an era marked by the greatest increase in scientific knowledge in the history of humanity. There are new drugs and new therapies today that weren't even there when I had pharm 1.5 years ago! I know there's a lot of minutiae that could probably be pared down, but I can't get past the cognitive disconnect of increasing scientific knowledge yet less time teaching science to doctors.

As for this lengthening clinical years...

Maybe @Ismet has some thoughts on this as well, but medical education has a lot in common with how we train musicians, or any artists really. No matter how prestigious the school, there are the handful of teachers who can really teach while the rest are average at best and dangerous at their worst. Lots of violin teachers at Julliard, but only one Dorothy Delay. Artists the world over have simply accepted this reality for what it is, but medical education seems determined to perpetuate this myth that everyone gets the same education. It just isn't true. Just like musicians, we all have the teachers and conductors/professors and attendings who inspire us and make us better, and we've all had those who do nothing or maybe even hurt us. It crosses all manner of school "ranking" as crappy teaching knows no bounds. Whether it's Julliard and Curtis or Harvard and Hopkins or any State U, there are the good and bad apples among them.

What this means is that any reforms are doomed to fail unless they do something to address this underlying issue. If 90% of the attendings were the kind who love to teach and are wholly invested in their students, then the students will learn and be better no matter what. If you have a bunch of attendings who just phone it in, you can throw billions of dollars at the problem with little to show for it but some new names on some old buildings. It's just rearranging deck chairs on the Titanic.

There's an adage in business that says: what gets measured, gets done. Until medical schools judge and pay their faculty by their teaching instead of by their RVUs, medical education will continue to hinge upon a patchwork of truly great teachers sprinkled among the mediocre and the terrible. Unless this problem is addressed, no meaningful change will ever happen.

 

[PL198]

oh my god, if I had to take step 1 in 3 months I'd be sh*tting my pants

 

[compstomper]

I've yet to understand why there is such a push to shorten medical education when we live in an era marked by the greatest increase in scientific knowledge in the history of humanity. There are new drugs and new therapies today that weren't even there when I had pharm 1.5 years ago! I know there's a lot of minutiae that could probably be pared down, but I can't get past the cognitive disconnect of increasing scientific knowledge yet less time teaching science to doctors.

As for this lengthening clinical years...

Maybe @Ismet has some thoughts on this as well, but medical education has a lot in common with how we train musicians, or any artists really. No matter how prestigious the school, there are the handful of teachers who can really teach while the rest are average at best and dangerous at their worst. Lots of violin teachers at Julliard, but only one Dorothy Delay. Artists the world over have simply accepted this reality for what it is, but medical education seems determined to perpetuate this myth that everyone gets the same education. It just isn't true. Just like musicians, we all have the teachers and conductors/professors and attendings who inspire us and make us better, and we've all had those who do nothing or maybe even hurt us. It crosses all manner of school "ranking" as crappy teaching knows no bounds. Whether it's Julliard and Curtis or Harvard and Hopkins or any State U, there are the good and bad apples among them.

What this means is that any reforms are doomed to fail unless they do something to address this underlying issue. If 90% of the attendings were the kind who love to teach and are wholly invested in their students, then the students will learn and be better no matter what. If you have a bunch of attendings who just phone it in, you can throw billions of dollars at the problem with little to show for it but some new names on some old buildings. It's just rearranging deck chairs on the Titanic.

There's an adage in business that says: what gets measured, gets done. Until medical schools judge and pay their faculty by their teaching instead of by their RVUs, medical education will continue to hinge upon a patchwork of truly great teachers sprinkled among the mediocre and the terrible. Unless this problem is addressed, no meaningful change will ever happen.

I worry that students in the 1.5 yr curriculums are responsible for the same amount of information as students in 2 yr preclinical programs, so that in essence, nothing is pared down. God help the person who's gonna tell these medical school PhD lecturers to cut out the portions of their lectures devoted to their obscure pet research projects.

 

[DermViser]

It's shocking how dilute medical education is. The justification is that they need to teach their interns how to do everything but why don't they teach these things to medical students in the first place instead of having to bring their weak interns up to par? Why do I have to beg people to read my notes? Then the administration insults us by telling us that we need to write our med student notes in a format with a crappy layout that no one can read so they can get good family histories as part of their meaningless use mandate. Thanks for telling us that our only use is to update a part of the history that no one looks at

The few times I get to do stuff is usually when I'm with a strong upper year resident. I've been in surgeries where the attending does everything and only lets the chief resident suture at the end. Wtf?

Instead of implementing harebrained schemes to improve the curriculum they should just leave it as it is and give residents and attendings more time to teach med students stuff and look at our notes instead of endless rounding and writing their own notes all day long

Oh, they'll let you do tons of stuff - just on simulators and standardized patients:

http://www.kevinmd.com/blog/2013/08/intern-boot-camps-mandatory-medical-school.html
Comment: "All of the studies and literature about intern boot camps are fancy ways of voicing what most medical medical students already know: the majority of medical school is ineffective and a lot of valuable time is wasted on meaningless activities/tests/PBL's/TBL's/[insert buzzword of the day]. Let's just make it simple for everyone: medical school is relatively ineffective in preparing medical students for the next phases of training...therefore, things like intern boot camps are necessary. Makes this medical student wonder what kind of value he is getting for his 6-figure debt."

(The author of this article has drank the Kool-Aid)
http://www.kevinmd.com/blog/2014/05/medical-students-today-getting-richer-clinical-training.html
Comment:
"Goodness. I found myself so depressed reading this. The love of the RIA facility, the Big Brother computerized scoring system, the simulation lab and actors that probably cost a minor fortune... all of it a self-important display of what's wrong with medical education today as students are turned away from the bedside as they are crushed by medical school debt.
Why the resistance to seeing, talking to and interacting with real patients? It's as if there is some Utiopian dream we can simulate life and the psychology of all that illness entails. We need more students staring at patients, not actors; staring at people rather than computer screens; learning how to learn.
So I'm sorry I can't be as impressed as the author seemed to be. I see something different. As I walk through the wards and see many clueless residents held back by work hour restrictions that turn off their pagers as they head for home. There is little ownership of patient care any more. Instead, residents recite guidelines, click some buttons, and follow rubrics instead of appreciating the complexities of patient care. I can't help but think that our medical schools are living in LaLa Land as they forward their vision of how they'd like to see medicine rather than exposing medical students to the realities that will confront them as they leave their sheltered workshop. Computers won't fix these problems. Real live people will."

 

[DermViser]

I worry that students in the 1.5 yr curriculums are responsible for the same amount of information as students in 2 yr preclinical programs, so that in essence, nothing is pared down. God help the person who's gonna tell these medical school PhD lecturers to cut out the portions of their lectures devoted to their obscure pet research projects.

I believe they just cut out the redundancies (learning about apoptosis for the third time, for example). It's too bad that repetition helps solidify the information.

 

[SouthernSurgeon]

I worry that students in the 1.5 yr curriculums are responsible for the same amount of information as students in 2 yr preclinical programs, so that in essence, nothing is pared down. God help the person who's gonna tell these medical school PhD lecturers to cut out the portions of their lectures devoted to their obscure pet research projects.

My med school tried to make some pre-clinical curriculum changes while I was a student (not moving to a condensed pre-clinical, but trying to move to more of a systems model and restructuring the order of some of the courses/content, as well as changing the degree of emphasis for certain areas). The biggest roadblock they faced was that the PhD lecturers just wanted to keep giving their same canned content they'd been delivering for 10+ years, even if it was now supposed to be integrated with some other topic or given half the number of lectures to deliver it.

 

[DermViser]

I've yet to understand why there is such a push to shorten medical education when we live in an era marked by the greatest increase in scientific knowledge in the history of humanity. There are new drugs and new therapies today that weren't even there when I had pharm 1.5 years ago! I know there's a lot of minutiae that could probably be pared down, but I can't get past the cognitive disconnect of increasing scientific knowledge yet less time teaching science to doctors.

As for this lengthening clinical years...

Maybe @Ismet has some thoughts on this as well, but medical education has a lot in common with how we train musicians, or any artists really. No matter how prestigious the school, there are the handful of teachers who can really teach while the rest are average at best and dangerous at their worst. Lots of violin teachers at Julliard, but only one Dorothy Delay. Artists the world over have simply accepted this reality for what it is, but medical education seems determined to perpetuate this myth that everyone gets the same education. It just isn't true. Just like musicians, we all have the teachers and conductors/professors and attendings who inspire us and make us better, and we've all had those who do nothing or maybe even hurt us. It crosses all manner of school "ranking" as crappy teaching knows no bounds. Whether it's Julliard and Curtis or Harvard and Hopkins or any State U, there are the good and bad apples among them.

What this means is that any reforms are doomed to fail unless they do something to address this underlying issue. If 90% of the attendings were the kind who love to teach and are wholly invested in their students, then the students will learn and be better no matter what. If you have a bunch of attendings who just phone it in, you can throw billions of dollars at the problem with little to show for it but some new names on some old buildings. It's just rearranging deck chairs on the Titanic.

There's an adage in business that says: what gets measured, gets done. Until medical schools judge and pay their faculty by their teaching instead of by their RVUs, medical education will continue to hinge upon a patchwork of truly great teachers sprinkled among the mediocre and the terrible. Unless this problem is addressed, no meaningful change will ever happen.

They'll just shunt them to residency programs and let them deal with any kinks and problems.

 

[SouthernSurgeon]

(The author of this article has drank the Kool-Aid)
http://www.kevinmd.com/blog/2014/05/medical-students-today-getting-richer-clinical-training.html
Comment:
"Goodness. I found myself so depressed reading this. The love of the RIA facility, the Big Brother computerized scoring system, the simulation lab and actors that probably cost a minor fortune... all of it a self-important display of what's wrong with medical education today as students are turned away from the bedside as they are crushed by medical school debt.
Why the resistance to seeing, talking to and interacting with real patients? It's as if there is some Utiopian dream we can simulate life and the psychology of all that illness entails. We need more students staring at patients, not actors; staring at people rather than computer screens; learning how to learn.
So I'm sorry I can't be as impressed as the author seemed to be. I see something different. As I walk through the wards and see many clueless residents held back by work hour restrictions that turn off their pagers as they head for home. There is little ownership of patient care any more. Instead, residents recite guidelines, click some buttons, and follow rubrics instead of appreciating the complexities of patient care. I can't help but think that our medical schools are living in LaLa Land as they forward their vision of how they'd like to see medicine rather than exposing medical students to the realities that will confront them as they leave their sheltered workshop. Computers won't fix these problems. Real live people will."

This commentor nailed it.

What is needed is to put the emphasis back on real clinical learning. Less marginalizing of students on the wards and glorified shadowing disguised as clinical clerkships.

The obsession with sim labs and SPs as a replacement for real clinical interactions with real patients with real pathology is the biggest problem in medical education.

 

[skillfullhello]

This is exactly how our lectures are. Filled with research dialogue! How can I make the most of my time ?

 

[DermViser]

My med school tried to make some pre-clinical curriculum changes while I was a student (not moving to a condensed pre-clinical, but trying to move to more of a systems model and restructuring the order of some of the courses/content, as well as changing the degree of emphasis for certain areas). The biggest roadblock they faced was that the PhD lecturers just wanted to keep giving their same canned content they'd been delivering for 10+ years, even if it was now supposed to be integrated with some other topic or given half the number of lectures to deliver it.

Yup. Bc the PhD lecturers already have their powerpoints made and set and sitting on a hard drive, and they would have to rearrange/redo their lectures in an integrated, organ systems based format. So sad. As a PhD I would be so embarassed personally if my lectures were so bad that a majority of the class didn't understand what I was lecturing on. Even in an "integrated" curriculum, it's not truly "integrated". It's just separate lectures talking about the same organ system but thru their specific basic science subject (Histo, Anatomy, Path, Phys) all taught in the same time block.

 

[SouthernSurgeon]

Even in an "integrated" curriculum, it's not truly "integrated". It's just separate lectures talking about the same organ system but thru their specific basic science subject (Histo, Anatomy, Path, Phys) all taught in the same time block.

Yes this was exactly what happened.

Fortunately for me I was already done with the preclinicals by the time they pulled this crap. I got to just have the plain old curriculum they'd been using for 20 years that seemed to work just fine.

 

[DermViser]

This commentor nailed it.

What is needed is to put the emphasis back on real clinical learning. Less marginalizing of students on the wards and glorified shadowing disguised as clinical clerkships.

The obsession with sim labs and SPs as a replacement for real clinical interactions with real patients with real pathology is the biggest problem in medical education.

Yes, that's Westby Fisher, another physician blogger with a social media presence. Love his comments and blog as well as that of Skeptical Scapel when it comes to discussing about the ridiculousness of medical education (and its exorbitant cost).

I think you'll like this one too: http://skepticalscalpel.blogspot.com/2013/12/an-mds-thoughts-on-medical-education.html (Got a kick out of "arbor vitae" as I remember memorizing that for neuroanatomy).

 

[PL198]

I believe they just cut out the redundancies (learning about apoptosis for the third time, for example). It's too bad that repetition helps solidify the information.

lol i've learned the innate immune response so many times that I feel like I could produce the cytokines telepathically

 

[SouthernSurgeon]

Yes, that's Westby Fisher, another physician blogger with a social media presence. Love his comments and blog as well as that of Skeptical Scapel when it comes to discussing about the ridiculousness of medical education (and its exorbitant cost).

I think you'll like this one too: http://skepticalscalpel.blogspot.com/2013/12/an-mds-thoughts-on-medical-education.html (Got a kick out of "arbor vitae" as I remember memorizing that for neuroanatomy).

Yeah I read that when it first came out.

I'd tend to agree that 99% of the clinically relevant anatomy - the stuff I actually use regularly and can recall instinctively - I learned from surgery.

I do think that I got a pretty good knowledge base from my M1 anatomy course. It was intense but I thought it was one of the best taught courses at our school.

 

[DermViser]

Yes this was exactly what happened.

Fortunately for me I was already done with the preclinicals by the time they pulled this crap. I got to just have the plain old curriculum they'd been using for 20 years that seemed to work just fine.

I think every medical student realizes eventually (even the super perky ones who join the Curriculum committee) is that the best thing you can do is to graduate from medical school as soon as possible, before the med school admin screws your education any further with their new "transformative", "disruptive", or "innovative" ideas: http://www.ama-assn.org/sub/accelerating-change/grant-projects.shtml (If you see here it's nothing more than gobbledy gook that doesn't actual mean anything like "learner-centered", "competency-based"). Many times, the incentives and forces that act on medical schools aren't necessarily in line with the educational interests of medical students.

http://www.kevinmd.com/blog/2013/06/ama-significant-redesign-undergraduate-medical-education.html
Comment:
Indiana University School of Medicine - They want to create a health care system simulation with a simulated electronic medical record. By the time students graduate, the simulated EMRs will be obsolete. Then they'll need another $1 million to update it all?

Mayo Medical School - When Mayo throws out words like "innovative", "science", "teams", "communities", and "outcomes"; everyone says "oooh" and "aaah" in admiration. They're probably just going to have early clinical rotations or more simulations labs ("experiential learning"). They're also planning to spend some money on "wellness and resiliency resources". I suspect the focus will be resiliency >> wellness.

NYU School of Medicine - Students have a hard enough time getting through med school in four years, and they want to do it in three. Plus, they're going to teach the three-year students more than the four-year students. How? They're going to create a simulated medical environment that is somehow going to be "a real world clinical setting." Not only that, but they're going to develop an "ePortfolio" to push students through the three-year curriculum. (Putting 'e' in front of words is so 1990...)

Oregon Health & Science University School of Medicine - They're going to "develop and implement" something "innovative", but we don't know much about it other than that it will be "learner-centered", "competency-based", and "individualized" with "pre-determined milestones." They will also have some type of portfolio system to help students finish "in less than four years".

Penn State College of Medicine - They want to get basic science and clinical faculty to work together, as if they weren't already supposed to be doing that. Somehow, this new cooperative atmosphere will "prepare students to work within all aspects of the complex health system".

The Brody School of Medicine at East Carolina University - More innovation that isn't innovative. They say "rural and underserved populations will be featured". They're probably just going to send some students out to rural or high-crime sites to complete a rotation or two. Maybe the money will be spent on printing costs, because students get certificates for completing this program. (What happened to the practice of medicine being it's own reward?")

The Warren Alpert Medical School of Brown University - "We're going to give our students dual degrees. Give us money." ... "Uh, okay." ... How does that make sense? Maybe it's those buzzwords again, like "teamwork" and "leadership". They're also going to change the admissions process to include working with standardized patients... "We're going to make better doctors by making them learn medicine before they go to medical school."

University of California, Davis - Looks like a way to get students into residency without having to go through the match. Industry their say in the curriculum, and the school gets a million dollar grant. win-win.

University of California, San Francisco - Another "accelerated" program. "I do more in less time. You pay me money!"

University of Michigan Medical School - Med school RPG. There's a skills and knowledge tree. You get experience points that you can put into the "foundational 'trunk'". Once you've developed that enough, you can move on the "professional development 'branches'". You can choose your "developmental tracks" based on the character class you want to "cultivate" (like, family doctor or surgeon or anesthesiologist). You can track your stats in the "M Home" as you develop your "advanced skill sets within clinical domains".

Vanderbilt University School of Medicine - They plan to "embed students in the health care workplace", probably just early clinical rotations. Somehow "some students will be able to complete medical school in less than four years."

 

[DermViser]

@Arkangeloid should try to transfer!!!

I read the entire paragraph about Michigan's plan to accelerate change in medical education on the AMA website twice and I have still no idea what it means.

 

[username456789]

 

[PL198]

I think every medical student realizes eventually (even the super perky ones who join the Curriculum committee) is that the best thing you can do is to graduate from medical school as soon as possible, before the med school admin screws your education any further with their new "transformative", "disruptive", or "innovative" ideas: http://www.ama-assn.org/sub/accelerating-change/grant-projects.shtml (If you see here it's nothing more than gobbledy gook that doesn't actual mean anything like "learner-centered", "competency-based"). Many times, the incentives and forces that act on medical schools aren't necessarily in line with the educational interests of medical students.

http://www.kevinmd.com/blog/2013/06/ama-significant-redesign-undergraduate-medical-education.html
Comment:
Indiana University School of Medicine - They want to create a health care system simulation with a simulated electronic medical record. By the time students graduate, the simulated EMRs will be obsolete. Then they'll need another $1 million to update it all?

Mayo Medical School - When Mayo throws out words like "innovative", "science", "teams", "communities", and "outcomes"; everyone says "oooh" and "aaah" in admiration. They're probably just going to have early clinical rotations or more simulations labs ("experiential learning"). They're also planning to spend some money on "wellness and resiliency resources". I suspect the focus will be resiliency >> wellness.

NYU School of Medicine - Students have a hard enough time getting through med school in four years, and they want to do it in three. Plus, they're going to teach the three-year students more than the four-year students. How? They're going to create a simulated medical environment that is somehow going to be "a real world clinical setting." Not only that, but they're going to develop an "ePortfolio" to push students through the three-year curriculum. (Putting 'e' in front of words is so 1990...)

Oregon Health & Science University School of Medicine - They're going to "develop and implement" something "innovative", but we don't know much about it other than that it will be "learner-centered", "competency-based", and "individualized" with "pre-determined milestones." They will also have some type of portfolio system to help students finish "in less than four years".

Penn State College of Medicine - They want to get basic science and clinical faculty to work together, as if they weren't already supposed to be doing that. Somehow, this new cooperative atmosphere will "prepare students to work within all aspects of the complex health system".

The Brody School of Medicine at East Carolina University - More innovation that isn't innovative. They say "rural and underserved populations will be featured". They're probably just going to send some students out to rural or high-crime sites to complete a rotation or two. Maybe the money will be spent on printing costs, because students get certificates for completing this program. (What happened to the practice of medicine being it's own reward?")

The Warren Alpert Medical School of Brown University - "We're going to give our students dual degrees. Give us money." ... "Uh, okay." ... How does that make sense? Maybe it's those buzzwords again, like "teamwork" and "leadership". They're also going to change the admissions process to include working with standardized patients... "We're going to make better doctors by making them learn medicine before they go to medical school."

University of California, Davis - Looks like a way to get students into residency without having to go through the match. Industry their say in the curriculum, and the school gets a million dollar grant. win-win.

University of California, San Francisco - Another "accelerated" program. "I do more in less time. You pay me money!"

University of Michigan Medical School - Med school RPG. There's a skills and knowledge tree. You get experience points that you can put into the "foundational 'trunk'". Once you've developed that enough, you can move on the "professional development 'branches'". You can choose your "developmental tracks" based on the character class you want to "cultivate" (like, family doctor or surgeon or anesthesiologist). You can track your stats in the "M Home" as you develop your "advanced skill sets within clinical domains".

Vanderbilt University School of Medicine - They plan to "embed students in the health care workplace", probably just early clinical rotations. Somehow "some students will be able to complete medical school in less than four years."

It's the idiots students fault. My school passes around votes for new tech stuff and it's like you haven't even explained to me what this vote is for or the effects of it, why would I ever agree to it? Meanwhile the average person just agrees to it because the word "simulation " sounds cool. That's so stupid, I have no clue if the passage of this thing would result in 2k extra in tuition a year, mandatory classes, or whatever, so why in the world would I vote for it?

 

[PL198]

I read the entire paragraph about Michigan's plan to accelerate change in medical education on the AMA website twice and I have still no idea what it means.

They don't either, that's the fun of it. 99 % of academia is making **** up as you go that sounds nice in a press release.

 

[DermViser]

It's the idiots students fault. My school passes around votes for new tech stuff and it's like you haven't even explained to me what this vote is for or the effects of it, why would I ever agree to it? Meanwhile the average person just agrees to it because the word "simulation " sounds cool. That's so stupid, I have no clue if the passage of this thing would result in 2k extra in tuition a year, mandatory classes, or whatever, so why in the world would I vote for it?

Of course! Simulation labs don't pay for themselves:

 

[PL198]

Of course! Simulation labs don't pay for themselves:

View attachment 185682

It's just a joke because I have no idea how you can support something without understanding the provisions behind it. Like they'll be like "alright so we're going to have a vote on simulation labs, who wants us to have new xyz installed," and it's like a 2 minute interaction where there's no information. Why would I ever vote for something I don't understand. It's like if someone gave me a piece of paper that said " Puppies Y or N?" Well I like puppies but if voting yes means I have to house 100 personally, then I'm not interested so I'm gonna vote no.

 

[DermViser]

It's just a joke because I have no idea how you can support something without understanding the provisions behind it. Like they'll be like "alright so we're going to have a vote on simulation labs, who wants us to have new xyz installed," and it's like a 2 minute interaction where there's no information. Why would I ever vote for something I don't understand. It's like if someone gave me a piece of paper that said " Puppies Y or N?" Well I like puppies but if voting yes means I have to house 100 personally, then I'm not interested so I'm gonna vote no.

The only reason medical schools do it is bc OTHER medical schools do it. How do you think podcasting and videotaping of lectures in the first 2 years started? Same for P/F grading.

 

[PL198]

The only reason medical schools do it is bc OTHER medical schools do it. How do you think podcasting and videotaping of lectures in the first 2 years started? Same for P/F grading.

While I'm against the concept of simulators being effective, at least give us an explanation. I have no idea if starting a simulation program means 2 of the things and it costs me 500 bucks/semester in tuition or 30 of them and I'm paying another 2-3k

 

[DermViser]

While I'm against the concept of simulators being effective, at least give us an explanation. I have no idea if starting a simulation program means 2 of the things and it costs me 500 bucks/semester in tuition or 30 of them and I'm paying another 2-3k

There is no explanation. It's a trend. Kind of like scrunchies and Trapper Keepers.

 

[Psai]

Of course! Simulation labs don't pay for themselves:

View attachment 185682

They look like *****s. I did a few sim lab exercises and they were complete garbage. I really don't understand why they can't just pay attendings to teach us instead of spending massive amounts of money on all these horrible standardized patients that can barely keep the script right. I'm here to see patients, not to futz around on fake patients, sim labs and poorly designed computer systems. Protip: if you need to force people into doing something it's probably an enormous waste of time

 

[DermViser]

They look like *****s. I did a few sim lab exercises and they were complete garbage. I really don't understand why they can't just pay attendings to teach us instead of paying all these horrible standardized patients that can barely keep the script right. I'm here to see patients not futz around on fake patients, sim labs and poorly designed computer systems. Protip: if you need to force people into doing something it's probably a massive waste of time

It's prob in response to MS-3 clerkships being ****. Rather than a culture change, it's just easier to keep students off the wards and practice in the game room.

 

[PL198]

It's prob in response to MS-3 clerkships being ****. Rather than a culture change, it's just easier to keep students off the wards and practice in the game room.

wait those are in place of M3 or to supplement....?

 

[DermViser]

wait those are in place of M3 or to supplement....?

To supplement.

 

[chronicidal]

University of California, Davis - Looks like a way to get students into residency without having to go through the match. Industry their say in the curriculum, and the school gets a million dollar grant. win-win.

Except the Match isn't going to allow an exception to the all-in policy...

 

[DermViser]

Except the Match isn't going to allow an exception to the all-in policy...

Yeah, I don't know how that works either - maybe like NYU? From the AAMC link above:
University of California – Davis School of Medicine
In partnership with Kaiser Permanente and UC Davis' residency programs, the proposal will create a three-year, competency-based medical school pathway called the Accelerated Competency-based Education in Primary Care (ACE-PC) program. UC-Davis medical students who enroll in the ACE-PC program will simultaneously be accepted into local primary care residencies (for a net total of six years of training). Students will be immersed in Kaiser's integrated health care system and patient-centered medical home model to promote seamless integration between medical education and clinical practice. Unique curricular content will include population management, chronic disease management, quality improvement, patient safety, team-based care and preventive health skills with special emphasis on diverse and underserved populations.

 

[Serous Demilune]

Sorry to necrobump. To people with this kind of curriculum, what do you do at the end of third year? My third year is ending next winter. Can I start away rotations early? I have all this extra elective time before residency applications go out and no idea how to spend it.

 

[cbrons]

This commentor nailed it.

What is needed is to put the emphasis back on real clinical learning. Less marginalizing of students on the wards and glorified shadowing disguised as clinical clerkships.

The obsession with sim labs and SPs as a replacement for real clinical interactions with real patients with real pathology is the biggest problem in medical education.

Sir, at our school they make you shadow well into 2nd year and then third year they just dump you on your own in patient rooms. Our students have absolutely no clue what they're doing, but I don't know what to tell them. It's not like they have an alternative way of learning, other than maybe watching some videos. Heh. Such a waste of money.

 

[mvenus929]

Sorry to necrobump. To people with this kind of curriculum, what do you do at the end of third year? My third year is ending next winter. Can I start away rotations early? I have all this extra elective time before residency applications go out and no idea how to spend it.

At my school, third year ended in February. We generally did Step 2 before most other people were finishing up third year (which made scheduling 10,000 times easier), and then did our AIs at our school, gathered up letters of recommendation, etc. For those who wanted to do away rotations, if you contact the place you want to do away rotations at, they generally allow you to do them early as well.

Most of my class had met all the requirements for fourth year by Match day, or within 1-2 weeks of Match day, so were able to spend the rest of fourth year figuring out logistics of starting intern year. Or they went on vacation. Or both.

 

[AuerRod]

Hey friends,

I also go to a school with a shortened curriculum for first and second year. Our classes end in a couple weeks actually and boards are expected by April. Things have been hit or miss, but just a couple things that I've learned.

Keep up resources as you go along in school. For example during heme do the pathoma sections, learn the stuff in the first aid section, watch the sketchy micro videos for bugs that get mentioned, and check out the first aid general principles. This all along with studying hard for class will keep you afloat and cover your bases for boards. Hope this helps!

Also it all turns out okay in the end so don't stress!

 

[Raryn]

Except the Match isn't going to allow an exception to the all-in policy...

There's an easy way out of that. You just make a separate "track" in your residency (call it the accelerated learners track or something) and don't interview anyone other than your intended people in it. That way they're guaranteed the spots.

The problem you're going to run into is there's no way to stop the students from applying to other programs. Unless you basically just sabotage their applications.

 

[chronicidal]

There's an easy way out of that. You just make a separate "track" in your residency (call it the accelerated learners track or something) and don't interview anyone other than your intended people in it. That way they're guaranteed the spots.

The problem you're going to run into is there's no way to stop the students from applying to other programs. Unless you basically just sabotage their applications.

Looks like the NRMP policies are protecting students at the potential risk for programs, yes?

 

[PL198]

At my school, third year ended in February. We generally did Step 2 before most other people were finishing up third year (which made scheduling 10,000 times easier), and then did our AIs at our school, gathered up letters of recommendation, etc. For those who wanted to do away rotations, if you contact the place you want to do away rotations at, they generally allow you to do them early as well.

Most of my class had met all the requirements for fourth year by Match day, or within 1-2 weeks of Match day, so were able to spend the rest of fourth year figuring out logistics of starting intern year. Or they went on vacation. Or both.

did you get no time off after step 1 and during 3rd year or how did they swing this?

 

[Raryn]

Looks like the NRMP policies are protecting students at the potential risk for programs, yes?

Kind of. Now that I've been pondering a bit, I can think of all kinds of ways the programs can stop students from going somewhere else. For example, if they were required to sign some kind of agreement stating they'd be on the hook for any tuition assistance if they decided to go elsewhere. Like, sure, you can apply to a different specialty... and pay us back a hojillion dollars. Or just write the students a crappy deans letter stating that they were already committed to XYZ.

 

[tnara]

did you get no time off after step 1 and during 3rd year or how did they swing this?

2nd year classes end in December, Step 1 required to be completed by early-to-mid February, 3rd year clerkships start early March, finish clerkships in late February, take Step 2 whenever before December-something. We could take Step 1 any time between December and February, so we could take as much or as little time off as we could swing. I think we were required to have it done a week before the 2-week transition course started, so I think most people took at least a short vacation before 3rd year.

 

[Serous Demilune]

2nd year classes end in December, Step 1 required to be completed by early-to-mid February, 3rd year clerkships start early March, finish clerkships in late February, take Step 2 whenever before December-something. We could take Step 1 any time between December and February, so we could take as much or as little time off as we could swing. I think we were required to have it done a week before the 2-week transition course started, so I think most people took at least a short vacation before 3rd year.

What did you do after third year was over until October, if you don't mind me asking?

 

[tnara]

What did you do after third year was over until October, if you don't mind me asking?

I studied and took Step 2 in April, then took a short break. I didn't know what specialty I wanted to go into, so I did a few electives in the fields I was interested in and did my sub-I. After I decided on my specialty and got my letters, I just took electives in fields I liked and thought would be useful/interesting.

 

[mvenus929]

did you get no time off after step 1 and during 3rd year or how did they swing this?

We actually got 5 weeks off during third year, but it was all concentrated in the fall... A week for Thanksgiving and four for Christmas. They broke it up for the class below us because they realized that making us go 9 months without a vacation was just mean. But yeah, what tiara said... We finished second year in December and had to take Step 1 before the first week in February, then started clerkship orientation and were on the wards in March. Did a full year in the wards, then a two-eek health policy course, then we were free to make our schedules however we wanted.

I started mine out with my AI, then did a month of Ped ID (to get another letter), then took 2 weeks to do step 2, then did a bunch of random electives. Most of my class took 2-4 weeks off in March/April to study for step 2, then started on their AI or other rotations intended for letters. Those who weren't sure which field they wanted had plenty of chances to do an AI in separate fields.