Originally posted by pitman
Kimberli, that sounds like quite an indictment -- with PBL at the crux of the curriculum, it sounds like you got trained almost *in spite of* PBL, in which case you learned almost exclusively from rounds and independent studying(?) Did the groups help at least to find motivated students to study with?
Also, did you see any trend in the type(s)/background(s) of students who were ignorant/incompetent?
-Pitman
You are quite right. I've been fairly vocal about this in previous posts on this forum. I believe in the concept of PBL and was anxious to utilize it more (we had done so on to a small degree in grad school).
However, I found that the VAST majority of my learning was independent (which was not suprising - I expected it to be) or from clinical rotations. I believe PBL, at least the way it was taught when I was at Flinders, wholey inadequate for the teachings of basic science. Couple that with the fact that when we expressed concerns over our lack of basic science knowledge we would often be told that it wasn't necessary to have detailed knowledge as a practicing physician. Remind me of that when I struggle to analyze a metabolic or chemistry panel, when I try to remember (although I suppose it isn't called "remembering" when one never adequately learned in the first place) basic anatomy and physiology, or the various microbiological diseases and their treatments.
My experience is certainly not unique. It makes a difference what you do after graduation. In Australia, the senior medical students have a lot less responsibility, working hours and teaching than do US students. However, in Oz, in my observation, interns spent a lot more time learning the basics of practicing medicine - things I was already expected to know when I arrived in the US (ie, besides the above, ordering correct fluid and electrolyte replacement, drug dosages, pain management, writing orders, admit H & Ps, reading xrays independently, etc.)
I cannot comment on what the situation is now. But if you do choose a PBL curriculum, whether at Flinders or elsewhere, you must realize that the MAJORITY of your learning is YOUR RESPONSIBILITY and that it will not occur during PBL sessions. These are designed as a FRAMEWORK for your studies, not to be the basis of information/knowledge - that comes from reading independently, working on the wards, etc.
Those that did the best did so because they understood the above, worked hard outside of class, spent more time on the wards than was expected (which I should have done, I spent much more time in the OR - which benefitted my knowledge there, but not on ward managment), etc.
The only common denominator I could find with those that were less up to speed was that they were not science majors and had not taken the "US equivalent of pre-med coursework". At the time I was there, you were not required to to gain admission to a Aussie school. I think it definitely held those back that hadn't had the science background. Otherwise, students who spent more time partying and not studying on their own at home did less well.
This should not discourage you frm seeking an Australian medical education but rather as a note that while PBL is wonderful in its place (ie, teaching medical ethics, psychology, clinical case solving/differential diagnosis), I feel it falls far short of expectations for the first two years of basic science training. You must be willing and able to teach yourself in a PBL environment, or at least seek out the resources (which ARE there and available to you).
