Hey thanks NYEMMED for taking the time to write that very informative and awesome response.
I have some questions for you BurlapSocks (sounds itchy). Could you please comment on what a typical day is like for a DPC student? I know it is a lot of independent study, but my question is really how does this work. I know you are presented with a case and you have "learning objectives", but then what? Do you just go home and read everything and anything you can about whatever it is you think the patient might have? I guess I'm just not really sure how you are supposed to approach this type of learning. I can definitely see the advantage of this pathway because you learn to learn, not just to memorize, but how do you know if you're reading enough or the right things? How much guidance do you get from faculty? Do you feel disadvantaged in any way or do you think you have the upper hand against lecture based students? How does your knowledge get tested? Do you feel like you study more than lecture based students?
I know, lots of questions. Any input would be helpful.
We have group three times a week, MWF, for two hours, and then have a clinical skills lab once a week for three hours. We also must attend the OMM labs and lectures, as well as anatomy labs and lectures with the lecture-based students. Often, we have OMM lab or anatomy lab before group, so the day will begin at 8AM (OMM) or 9AM (for anatomy), and will go until 3PM when group is concluded. Anatomy labs are 3 hours, while OMM labs are 2 hours. There may be a few hours in between the conclusion of OMM lab and group to reread or review.
As far as how group works, we are presented with a case, and will let the case guide us as far a how we will create learning issues that we will be learning about and discussing. For example, if the patient has an upset stomach, and has taken tylenol to ease the pain, we will go into the anatomy of the GI, histology of the stomach cells, pharmacology of tylenol, etc. Most of the group time is used to discuss these issues, and some time at the end is alotted to order tests. Based on this, we narrow down our differential diagnoses. The tests may also lead to learning issues. If a patient is breathing rapidly, we may wish to take a look at the respiratory system. If there are elevated red blood cells, we may make the histology of blood a learning issue.
After we decide on a few issues, I then proceed to read the textbooks until I am prepared to discuss these issues the next time we meet. It may be difficult at times to know that you are reading the correct things. You may come into group having read something that others have not, though this is a good thing and will generate discussion. You may learn that you have not read enough, and will have to open another book and re-examine the topic to get a good understanding of the material.
We have two faculty members who sit in, and are supposed to help us with maintaining the process of group discussion, but will not tell us if we are saying incorrect things in group, as that is the responsibility of the rest of the group. They may comment that a learning issue is not to their liking, but will more often than not say nothing when bad issues are chosen. You will find out how not to choose learning issues when you bite off more than you can chew. The quality of group discussion will reflect this.
I think that the information we do learn is cemented more effectively than if I were still in lecture. I say still, since we all took the introductory course together. For me, it takes twice as long per day to have a good grasp of the material, than I did when I had lectures during intro. We are tested on the learning issues that we come up with, twice a semester. There is a large test that combines multiple-choice questions, with fill-ins, and essays. In my opinion, it is more difficult than the exams I had during intro. Of course, we also take the anatomy and OMM exams, as well as the anatomy and OMM portions of the multiple choice exams the lecture students take. As there are fewer exams, there is less room for error, and one cannot hope to master the material one weekend, or even one week before an exam.
I think the biggest advantage to the DPC program is the clinical practicum, wherein we are placed into the offices of physicians in the middle of first year. I also think that having a large variety of cases and the process of creating learning issues makes it more interesting than sitting in a lecture hall, listening to the 15th hour of rheumatology lectures.