Physiology is NOT precursor to medicine?

[nychila]

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I elected to enroll in several upper-level human physiology courses this year, but the content of those courses is rather different than what I had in mind. I thought that physiology would be the precursor to medicine; that is, one needs to understand how the body functions normally in order to understand it when it becomes dysfunctional and ultimately to treat it.

It seems to me that a large part of physiology is membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression, all of which seems very microscopic and unnecessary knowledge for a practicing doctor. Will these topics be heavily emphasized in medical school and discussed in detail?

 

[CrimsonKing]

That stuff is actually important; while it doesn't all need to be memorized, many of those proteins are targets for drugs. Even if you're not involved in research, you need to understand pharmacology and basic cell physiology to treat your patients in the best way possible.

Also, in certain specialties, alterations in cell-specific molecules can make a huge differente in treatment course. Hem-Onc is the big on in this respect.

You do need to know normal physiology to understand pathophysiology, and you'll get plenty of both in medical school.

There is absolutely no reason that an upper-level Physio course NOT taught by the med school should focus on the subject in the way it's relevant to medicine since that's not their focus. Believe it or not, all of science doesn't actually revolve around healthcare.

 

[Doctor Strange]

I elected to enroll in several upper-level human physiology courses this year, but the content of those courses is rather different than what I had in mind. I thought that physiology would be the precursor to medicine; that is, one needs to understand how the body functions normally in order to understand it when it becomes dysfunctional and ultimately to treat it.

It seems to me that a large part of physiology is membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression, all of which seems very microscopic and unnecessary knowledge for a practicing doctor. Will these topics be heavily emphasized in medical school and discussed in detail?

Wrong. How do you think drugs work? You can't expect to just see a condition, throw a drug at it, and have it magically go away. Drugs have different targets and mechanisms of action that act on proteins, substrates, and other downstream components. In order to understand the pharmacology, you need to have a basic understanding of physiology, which is essentially the biochemical mechanism of normal tissue function. I imagine "the heart beats at an average of 70 bpm and has an output of 5 L" is more along the line of what you were expecting, but, in reality, that's really just superficial data where physiology is concerned.

As an example, ACE inhibitors, ARBs and CCBs are all used to treat hypertension but in different ways. ACE inhibitors block a converting enzyme, ARBs block a receptor, and CCBs block an ion channel. You should learn about those enzymes, receptors, and channels in physiology so that you can apply them when you start learning about drugs.

 

[CodeBlu]

The Nobel prize is awarded in the following category... Physiology OR Medicine.

Membrane proteins and molecular physiology are vital. Electrophysiology and membrane currents. Pharmacology depends on physiology and vice versa.

Anatomy, biochem, micro/immunology and all that stuff feed into physiology for structure and function. Finally, pathology shows you how all those things that feed into physiology and cause disease.

Here's an example of a USMLE step 1 question which I admit is heavily focused on basic science... but you need those first principles to fully understand what is happening in medicine.


A 57-year-old man has crushing substernal chest pain for several hours. Upon admission to the emergency department, physicians diagnose him with acute myocardial infarction. Subsequent testing in the coronary care unit reveals that this patient has significant hyperhomocysteinemia, which may have contributed to his infarction. Chronic administration of which of the following will lower his serum homocysteine levels and possibly reduce his risk of subsequent infarcts?

A. Arginine
B. Vitamin B9 (Folate)
C. Vitamin A
D. Vitamine B1 (thiamine)
E. Vitamin B6 (pyridoxine)

The answer is B. Folate is vital for homocysteine metabolism. The biochemical pathway is really long and drawn out... with a folate trap and bla bla bla. But if you know how things work, then you know how to treat them when they go wrong.

Physiology can be extremely daunting. I've been around physiology for 5-6 years now. I can definitely say that med school has been considerably easier for me than some of my classmates. I still study because there are a lot of details to remember. I don't remember all the minute details of everything, but the way of thinking is there. So it makes it easier to think about problems.


Good luck. Keep at it. It will pay off.

 

[music2doc]

I elected to enroll in several upper-level human physiology courses this year, but the content of those courses is rather different than what I had in mind. I thought that physiology would be the precursor to medicine; that is, one needs to understand how the body functions normally in order to understand it when it becomes dysfunctional and ultimately to treat it.

It seems to me that a large part of physiology is membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression, all of which seems very microscopic and unnecessary knowledge for a practicing doctor. Will these topics be heavily emphasized in medical school and discussed in detail?

Those things you just mentioned are the BASIS upon which medicine is built. If Anatomy is moderately important to medicine, those are the core. The fact that you do not see that means you don't really understand what medications are doing. Many act upon those very proteins, receptors, signaling molecules, ionic balance, etc.

 

[Arbor Vitae]

I elected to enroll in several upper-level human physiology courses this year, but the content of those courses is rather different than what I had in mind. I thought that physiology would be the precursor to medicine; that is, one needs to understand how the body functions normally in order to understand it when it becomes dysfunctional and ultimately to treat it.

It seems to me that a large part of physiology is membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression, all of which seems very microscopic and unnecessary knowledge for a practicing doctor. Will these topics be heavily emphasized in medical school and discussed in detail?

So you don't think understanding these pathways is useful in pharmacology and prescribing medications?

 

[nychila]

Thanks for everyone's comments and advice. CodeBlu, that questions still seems very clinical to me and involves little microscopic knowledge.

I realize that membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression are crucial to modern medicine and I understand that doctors will need to understand them, but I'm hoping that medical school and thereafter won't require the memorization of multiple intra-cellular pathways involving 20 signalling factors in the correct sequence every time we talk about a disease. Maybe I'm naive, but I hope that the level of detail on a senior physiology or cell biology course midterm surpasses what's required in medical school...

 

[Charles_Carmichael]

Thanks for everyone's comments and advice. CodeBlu, that questions still seems very clinical to me and involves little microscopic knowledge.

I realize that membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression are crucial to modern medicine and I understand that doctors will need to understand them, but I'm hoping that medical school and thereafter won't require the memorization of multiple intra-cellular pathways involving 20 signalling factors in the correct sequence every time we talk about a disease. Maybe I'm naive, but I hope that the level of detail on a senior physiology or cell biology course midterm surpasses what's required in medical school...

No, it doesn't. Med school physiology is more in-depth.

Physiology is the foundation of medicine. You need to understand it well in order to learn/understand pathophysiology and pharmacology. You probably won't learn pathways + the 20 signaling factors in it, but you'll need to know the general idea/function of a good number of pathways. Depending on how clinically relevant they are, you might need to know some pathways in their entirety (as we currently understand them).

TL;DR -- Learn your physiology well. It's arguably one of the most important classes of med school.

 

[Arbor Vitae]

Thanks for everyone's comments and advice. CodeBlu, that questions still seems very clinical to me and involves little microscopic knowledge.

I realize that membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression are crucial to modern medicine and I understand that doctors will need to understand them, but I'm hoping that medical school and thereafter won't require the memorization of multiple intra-cellular pathways involving 20 signalling factors in the correct sequence every time we talk about a disease. Maybe I'm naive, but I hope that the level of detail on a senior physiology or cell biology course midterm surpasses what's required in medical school...

Are you kidding me? The amount of details you will have to memorize in medical will make you wish you were back in that class.

TL;DR -- Learn your physiology well. It's arguably one of the most important classes of med school.

it's also probably most important for MCAT bio section

 

[music2doc]

Thanks for everyone's comments and advice. CodeBlu, that questions still seems very clinical to me and involves little microscopic knowledge.

I realize that membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression are crucial to modern medicine and I understand that doctors will need to understand them, but I'm hoping that medical school and thereafter won't require the memorization of multiple intra-cellular pathways involving 20 signalling factors in the correct sequence every time we talk about a disease. Maybe I'm naive, but I hope that the level of detail on a senior physiology or cell biology course midterm surpasses what's required in medical school...

Yeah... that's naive. You're going to be memorizing pathways far longer than that in med school. Tests will sometimes just indicate a given structure, make a modification to that structure and then ask the systemic effects of that modification down the pathway. That said, that is more Biochem than Physio. Physio questions might include things like:

Which of the following is/are true...
Urinary K excretion is increased:
1. in metabolic alkalosis
2. in the presence of high plasma levels ofaldosterone
3. during massive diuresis induced by furosemide
4. in acute metabolic acidosis

Nicotine is able to stimulate contractions in isolated intestinal segments because it:
A. directly activates receptors on smooth muscle cells
B. activates postganglionic parasympathetic cholinergic neurons
C. activates postganglionic neurons of the sympathetic nervous system
D. prevents the degradation of acetylcholine by cholinesterase
E. causes the release of norepinephrine from adrenergic neurons

Case Study 91-4
A woman with a history of severe diarrhea has the following arterial blood values:
pH =7 PCO2 =2 [HCO3-] = 1

Venous blood samples showed decreased blood [K+] and a normal anion gap
A. She is hypoventilating
B. The decreased arterial [HCO3–] is a result
of loss of HCO3– in diarrheal fluid
C. The decreased blood [K+] is a result of
exchange of intracellular H+ for extracellular K+
D. The decreased blood [K+] is a result of decreased circulating levels of aldosterone E. The decreased blood [K+] is a result of decreased circulating levels of ADH

Those are all relatively easy questions, but they were the easiest to pull out of an old question bank of my school's...

 

[nychila]

You probably won't learn pathways + the 20 signaling factors in it, but you'll need to know the general idea/function of a good number of pathways. Depending on how clinically relevant they are, you might need to know some pathways in their entirety (as we currently understand them).

That would be fine, and I think that would be a lot more interesting than just memorizing a lot of pathways without really seeing the significance of it all, such as through treatment. I just hope that the basic science knowledge in medical school will be more interesting than undergrad.

 

[Doctor Strange]

That would be fine, and I think that would be a lot more interesting than just memorizing a lot of pathways without really seeing the significance of it all, such as through treatment. I just hope that the basic science knowledge in medical school will be more interesting than undergrad.

It's going to be the same and then some as others have already stated. I don't know why you're expecting anything different. Physio is physio is physio. Pathways are crucial, and a superficial understanding of physiology just doesn't cut it. You might not be using it all the time in clinical practice, but you will have to have an extremely detailed knowledge of how things work on a biochemical level for med school.

Sent from my Nexus 7 using SDN Mobile

 

[Geebeejay]

Thanks for everyone's comments and advice. CodeBlu, that questions still seems very clinical to me and involves little microscopic knowledge.
I realize that membrane proteins, receptors and channels, intra-cellular signalling, and genetic expression are crucial to modern medicine and I understand that doctors will need to understand them, but I'm hoping that medical school and thereafter won't require the memorization of multiple intra-cellular pathways involving 20 signalling factors in the correct sequence every time we talk about a disease. Maybe I'm naive, but I hope that the level of detail on a senior physiology or cell biology course midterm surpasses what's required in medical school...

Just like in the MCAT, learning microscopic trends and reasoning is more effective than rote memorization.

 

[nBeeDee]

That would be fine, and I think that would be a lot more interesting than just memorizing a lot of pathways without really seeing the significance of it all, such as through treatment. I just hope that the basic science knowledge in medical school will be more interesting than undergrad.

It just seems that your vision of physiology was a little off from the real thing prior to being exposed to it. This will sound like a pretty dumb statement... but it is what it is, and now you know.

Microscopic detail doesn't mean unnecessary. Physiology includes all the macroscopic AND microscopic/molecular info that relates to the normal functioning of living things. All of it is vital to understanding medicine and surgery. Sure, if you ask a practicing physician to draw you a certain metabolic pathway relevant to a certain drug they are prescribing, with all the intermediates, enzymes, etc. involved, they probably wont be able to. However, they should know that x drug inhibits the rate controlling step of said pathway, and that is why it works.

The basic science knowledge you are learning now will be exactly the same as medical school (relevant to humans), but the focus and amount of material and how it is presented will be different. The physiology of the human body isn't going to change because you're in medical school.

 

[Mdtichen]

That would be fine, and I think that would be a lot more interesting than just memorizing a lot of pathways without really seeing the significance of it all, such as through treatment. I just hope that the basic science knowledge in medical school will be more interesting than undergrad.

The human body works the same regardless of where you are learn it. Maybe you need to reconsider your career path.

 

[ScholarStud]

The human body works the same regardless of where you are learn it. Maybe you need to reconsider your career path.

Lol wow.

 

[CrimsonKing]

The human body works the same regardless of where you are learn it. Maybe you need to reconsider your career path.

While harsh, I'm going to give this a +1 👍

There is NO field in medicine where you can truly escape physiology. You've got to know it on the molecular level, on the cellular/organ level (Histo), and the macro level for systems physio.