Overload!

[deleted4401]

Here's my beef -

This block for head, neck, thorax, we learned so much stuff in Gross. Cranial nerve innervation, courses, lesion problems, nerve fibers in each ... Then we learned all the skull foramina and stuff, then all the freakin blood supply all over the face and head, and then all the venous drainage ... I am not complaining about the subject matter, I do like it.

But, here's my questions: how much will I remember when I am a doctor (or even two weeks from now)? will it make me a better clinician to know about the external nasal artery or that the posterior belly of the digastric and anterior belly of the digastric have different innervations? will someone tell me what (of this huge body of info) I will really need to keep in memory forever? would we be perhaps better off learning less stuff more thoroughly? how can we integrate across all disciplines more effectively so the messages/clinical apps will be more memorable (rather than being lost in the 600 term structure lists per block)?

I really love what I'm learning, but I just don't know what is very important, what is a little bit important, and what isn't important at all. I feel that anatomists think EVERYTHING is important, while physicians only think certain things are important?

Can any of our wise elders give some comments or advice? What do you use on a daily basis at work from anatomy class or histology or biochemistry? Do you think most of what you learned was important or is it just a rite of passage (and quite sadistic) sort of thing?

One more exam to go this Friday, and it is time to party like a rock star!

The coolest thing about Tulane is that when the block ends, you are in New Orleans, and you can party from noon Friday till the middle of next block!

Simul
Tulane Med '05

---

Members don't see this ad.

 

[AJM]

This is a tough question, and one that I can't give a simple answer to. What I think you're going through is the fact that EVERYTHING you're learning right now is brand new, since it's the first time you've heard this stuff. So if this is the only time you will learn this information, of course you will forget most of it. However, you will find over the next few years that the stuff that's really important for you to know will be brought up over and over again. I've heard several of my past attendings and professors use the number three rule: that is, if you only hear something once you forget it, you hear it again and then forget it, but if you hear it three times, you know that you have to remember it.

There's a lot of anatomy that I don't remember, but there's also a lot of anatomy that I do remember -- it's really based on what's reinforced in other classes and in your clinical rotations. It's also based a lot on what you're planning on going into. The classmates of mine going into radiology or surgical specialties remember much more anatomy than I do, but that's because they've taken more rotations which deal with that. On the other hand, I probably remember more biochem and maybe even histology than my surgery-bound classmates.

And last, to try to answer your question about whether this information is actually important, I think that these classes fall somewhere in between being just a rite of passage and teaching important information. Believe it or not, but you will figure out how to filter the information you get. That comes with experience -- once you've taken more classes, and learned about more clinical applications you will start to learn this skill.

Sorry I couldn't give a more specific answer!

 

[Mango]

ajm said exactly what I was going to say. You'll find that when you get to second year, and then third, that the important things are reiterated. They definitely stick better the second time around. And even if you forget the innervation of the digastric muscle, and which foramen each nerve passes through, you will remember the important info.

I am a discussion group leader (a TA-ish sort of job) for first year physiology this year, and I've found that as I review the information in preparation for teaching my weekly group, I am learning it even better than I did last year. It's "sticking" more this year, if you know what I mean.

So I guess what I'm trying to say is: don't worry, it will all be repeated several times. The road to independent practice takes so many years because of the volume of information that we must absorb. And any person, no matter how smart, needs to be reminded of things a couple times before they really sink in.

 

[Whisker Barrel Cortex]

I think almost all medical students understand your concerns and felt the same way. As a fourth year, I can say that I agree with the above two posts.

Depending on what rotation you're on and what specialty you enter, you will or will not need to know details of the first two years. The important points for a certain specialty will be reiterated in your rotation and residency and will be much more easily remembered the 2nd and 3rd time around. For example, your knowledge of head and neck anatomy will be essential if you go into ENT, but useless in cardiology. The details in biochem will be essential in endocrine, but useless in radiology. I think the reason so much info is taught in the first two years is twofold. One reason is that that knowledge is needed somewhere in some specialty so you have to have a vague recollection before seeing it again. The second reason is that it has been done that way since the start of modern medicine. Unfortunately, the amount of knowledge has increased more than 10-fold since then.

My advice to you is to just study the details expected of you and don't think too much about what the clinically important info is. You can review the info you need easily once you start clinicals.

 

[Cobragirl]

The buccinator lets you whistle...that's important, right? I will probably NEVER forget that it's innervated by the Facial AND Trigeminal just because it seemed like such an absolutely RIDICULOUS thing for me to remember...ironic huh?

 

[Spoondog]

Now hold on just a minute! Are you sure the buccinator is innervated by the trigeminal too? What are they smokin' down there in Florida anyway?!?

 

[SocialistMD]

Not motor, just sensory. Trigeminal only innervates branchial motor and muscles of mastication; the rest is sensory.

 

[Cobragirl]

Two nerves...like I said...

 

[Cobragirl]

Facial does motor to buccinator...trigeminal does sensory

 

[SocialistMD]

Yeah, that is what I meant. I guess I should have quoted spoondog to let everyone know I was replying to that particular post.

 

[Starflyr]

Ok...getting off of the buccinator discussion...

What Ive been told (and seen, to some extent) is that any information that you will need to know when you are an independently practicing physician will be repeated so many times that there is no way you will NOT remember it. On the other hand, though, if you become an ENT, its not likely that you could name the muscles innervated by the femoral nerve or point out the sensory distribution of the deep peroneal nerve. *shrug* I dont know. Im just glad Im done with Gross! (if you think head, neck, and thorax is a lot in one block, we got the whole body in 8 weeks - and the last 4 were head & neck (2 weeks), pelvis and perineum (1 week) and lower limb (1 week). ACK! But its better now, with MCT. At least Ive had this stuff before! (and whoever says that you dont need upper level bio classes is right - but it SURE makes it easier for me that I had biochem, embryology, molecular biology and genetics in undergrad). Anyways. Cheers!

Star