So is med school pretty much a glorifed phonebook memorization marathon?

[Arkangeloid]

Because that's really what it seems like. Even our professors are making this clear to us: they never use the word "learn" in lecture, but they routinely tell us "You need to memorize X" or "You don't need to memorize Y."

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[ChartaBona]

Sometimes you just have to know the big picture concepts. Other things you just have to know, because there's no why, they just ARE.

 

[mcloaf]

Because that's really what it seems like. Even our professors are making this clear to us: they never use the word "learn" in lecture, but they routinely tell us "You need to memorize X" or "You don't need to memorize Y."

I'm not sure I understand the distinction. Did you expect to understand without having to memorize? Maybe it's a matter of perspective, I don't know. Outside of anatomy it hasn't really felt like that except for when we covered autonomic pharmacology, and even for anatomy I try to focus on learning how structures relate and interact in three dimensions so it doesn't feel like just rote memorization.

 

[Porfirio]

I have found the following:

Learning is mostly memorizing. Problem solving is mostly application of learned material. Research is mostly discovery through problem solving.

 

[Venko]

The clinical years is where you synthesize the memorized information. Physiology is the closest to a thoughtful class I remember from medical school. Its not a knock on it, but there are a lot of fundamentals that are necessary before beginning to synthesize and problem solve.

 

[Arkangeloid]

I'm not sure I understand the distinction. Did you expect to understand without having to memorize? Maybe it's a matter of perspective, I don't know. Outside of anatomy it hasn't really felt like that except for when we covered autonomic pharmacology, and even for anatomy I try to focus on learning how structures relate and interact in three dimensions so it doesn't feel like just rote memorization.

I knew there would be a lot of memorization, but I didn't expect that that would be pretty much all that I had to do. Also, I didn't expect that actually trying to learn stuff is detrimental to your success as a physician.

For example, for our last Immunology section, I asked for a tutor, who was an MD/PhD student, and he really did an excellent job teaching me Immunology and helping me learn the processes and what was happening. And then the exam came, and none of that stuff mattered, it just asked us about random (and rather arcane, if I say so myself) CD##s and stuff that I could have answered if I hadn't wasted time learning processes, and instead had just forced myself to memorize disjointed facts through brute force repetition.

I mean, I passed the exam anyways, but I scored much lower than the class average, and it left a sour taste in my mouth.

 

[Kahreek]

Nope, it is about knowing the right information in the right time.

 

[Planes2Doc]

Sounds about right. I stopped caring about things I once found interesting a long time ago.

 

[Renaissance Man]

The various CD numbers and cytokines aren't exactly esoteric knowledge, they are kind of important in immunology.

 

[VisionaryTics]

Feels that way sometimes, especially as an M1 and M2. Then once you get sick of memorizing the phonebook, you get sick of memorizing clinical science and "playing doctor".

Still, I have moments where I am legitimately shocked how much I've learned and changed over the last few years. It's always interesting to go tutor M1/M2s or have an M3 on the team because it blows me away that I was in their shoes just a year or two ago. Not saying I am some seasoned, weathered clinician. Just the opposite. I feel like a ***** all the time, but then I meet an M1 who shows me what 4 years of memorizing the phonebook and playing doctor have done to me.

 

[Arkangeloid]

The various CD numbers and cytokines aren't exactly esoteric knowledge, they are kind of important in immunology.

I knew most of them, and the ones involved in regulation, signaling, etc, there were just a few I didn't know. What bugged me was that I could have memorized the last few and matched the class average if I hadn't wasted time on other stuff like complement pathways.

 

[Apoplexy__]

I knew there would be a lot of memorization, but I didn't expect that that would be pretty much all that I had to do. Also, I didn't expect that actually trying to learn stuff is detrimental to your success as a physician.

Yes, there's tons of memorization but I never get the feeling that med school is even close to "all memorization". I could see Microbio, Pharm, and Anatomy being thought of that way, but all subjects have "logic shortcuts", where if you understand general principles by memorizing a few things, the rest of the memorization becomes so much easier. I'm sure you already know this, but it's worth emphasizing that you should seek out the logic in a seemingly "pure-memorization" fact whenever possible.

Burkitt's lymphoma has a starry sky appearance? Makes sense, because upregulated c-MYC leads to increased cell turnover.
Testes drain to para-aortic nodes? Makes sense, because they descended from the abdomen (look to Embryo to explain Anatomy)
Chemo drugs cause bone marrow suppression, rashes, and GI disturbance? Makes sense, because those tissues have basal stem cells and a high rate of replication.

You get the picture.

I feel like a ***** all the time, but then I meet an M1 who shows me what 4 years of memorizing the phonebook and playing doctor have done to me.

I hope when you graduate, you change your title to "Dr. Steve Brule, class of 20__".

 

[Double A]

i think second year feels less like it. especially if you don't have path til second year

 

[ACSurgeon]

Because that's really what it seems like. Even our professors are making this clear to us: they never use the word "learn" in lecture, but they routinely tell us "You need to memorize X" or "You don't need to memorize Y."

While there is undoubtedly lots of memorizing in med school, that is a secondary goal. If you don't learn the big picture stuff, you'll find yourself struggling and stressing out more than you need to.

 

[neusu]

In the grander scheme of things, medical school is not entirely about knowing everything about everything. It is about knowing where to find something quickly because you have seen/heard about it previously and know (relatively) where you read it.

Yes, to do well on the tests, knowing the minutia is important. Does it make you a better doctor? No. Is there a better system, currently, to educate and determine who has the intellect and compassion required to do this job? No. Make it your life calling to find a better system, but until then, jump through the hoops and memorize that phonebook.

 

[Awesome Sauceome]

On Surgery? Memorize lots of anatomy. Know lots of music so you're ready when the surgeon pimps you on that too. Then memorize lots of IM for the shelf.
We can go on.

So ridiculously true. I was shadowing an ortho surgeon on tuesday and me, him, and the anesthesiologist got in an argument on how Rage against the machine became Audioslave when their lead singer left. Then we went on to a 20 minute conversation on Bruce springsteen, and then in the following surgery we talked about Dave Ghrol and the various bands that he has been a part of. I went in expecting it to be this super tense atmosphere and all it was was pimping me on my music knowledge haha

 

[NickNaylor]

Shirley you must be joking.

Rotations are essentially a routine in memorizing new facts about each rotation you're on.
On IM? Better read your pocket medicine so you know what the treatment algorithm is for Afib or what the most common causes of community acquired vs nosocomial pneumonia are and the treatments for each when you get pimped. Quick quick there M3.
On Psych? Diagnostic criteria for MDD, hurry up now. First line tx? Oh, a patient is having trouble falling asleep? Just pop some trazadone. Don't worry about why it's a sedative and an antidepressant, that's just what we do.
On Surgery? Memorize lots of anatomy. Know lots of music so you're ready when the surgeon pimps you on that too. Then memorize lots of IM for the shelf.
We can go on.

Yeah...

I agree with the principle of trying to memorize "logic shortcuts" as someone else mentioned above, but I've found those things are few and far between. The example about Burkitt's lymphoma: how the **** do you rationalize that a c-myc defect results in a starry sky appearance? Sure, you have a c-myc defect which leads to cellular instability and dysplasia, but how does that actually result in the starry sky appearance (as opposed to, say, another homogeneous mass of dark staining B cells)? I think the actual strategy is more "make **** up that kind of makes sense given what I know about the science so that I can maybe recall this correctly in the future."

That's where this whole thing is frustrating. A lot of the basics are common sense, but there are definitely things that do not fit within the realm of "common sense," particularly when it comes to memorizing branch 3 of the EBM algorithm for whatever disease you're reading about. The general principles of management often make logical sense, but for me at least I still struggle at times to memorize things in such a way that I can intuit them vs. point-blank memorizing them. In most cases it ultimately comes down to the latter.

I will say at least that doing this learning in the context of clinical encounters is helpful for me because I'm motivated to try and learn as much as I can. M1/M2 sucked because not only does a lot of what you learn have very little direct clinical relevance, but even the tidbits that are clinically relevant are often under-appreciated because you're not seeing patients. That said, I do find it easier to learn in M3 than the pre-clinical years. I don't want to be the guy that sees a patient and has no idea what's going on. The prospect of actually kind of caring for patients in about 18 months is also terrifying, which provides more motivation. But don't be fooled - if you were looking for something that isn't rote memorization, you're in the wrong field. That's been my experience thus far. General principles will take you so far, but in many cases you still have to memorize little details to distinguish among different disease processes and diagnoses.

 

[Apoplexy__]

I agree with the principle of trying to memorize "logic shortcuts" as someone else mentioned above, but I've found those things are few and far between. The example about Burkitt's lymphoma: how the **** do you rationalize that a c-myc defect results in a starry sky appearance? Sure, you have a c-myc defect which leads to cellular instability and dysplasia, but how does that actually result in the starry sky appearance (as opposed to, say, another homogeneous mass of dark staining B cells)? I think the actual strategy is more "make **** up that kind of makes sense given what I know about the science so that I can maybe recall this correctly in the future."

I get what you're saying, but I think the fact that we as students can't answer "why isn't it this" doesn't invalidate the approach. Even if you make **** up as your logic, it still ties concepts together and solidifies them far better. And most of the time, the logic is either completely valid or difficult to prove wrong.

At its heart, yes, medical school is a bunch of memorization. Some things are so basic and one-step-logic that you can't do anything but senselessly cram it in. But in my experience, if you believe that ALL of medical school is pure memorization, and acronyms and brute-force reciting are your go-to strategy, you're doing it wrong.

 

[Venko]

Sounds like you all have it figured out.

this stuff works when the patients come in and have chief complaints of a disease. The synthesis occurs when you don't know the diagnosis, when you try and analyze the pattern of findings (after all what caused the a fib for this particular patient is not the same as what are the three most likely causes), and then when someone is getting worse with vague complaints and symptoms what do you do and why.

If it is simply memorization for you, you'll be a great nurse practitioner who has access to uptodate. Good for 85 to 90 percent, but not great at the rest.

Again, sounds like you all are confident about what you believe to be true…it may blind you from seeing what is really in front of you.

Everything involves memorization as a foundation and then when you have that down the synthesis occurs.

 

[Arkangeloid]

I will say at least that doing this learning in the context of clinical encounters is helpful for me because I'm motivated to try and learn as much as I can. M1/M2 sucked because not only does a lot of what you learn have very little direct clinical relevance, but even the tidbits that are clinically relevant are often under-appreciated because you're not seeing patients. That said, I do find it easier to learn in M3 than the pre-clinical years. I don't want to be the guy that sees a patient and has no idea what's going on. The prospect of actually kind of caring for patients in about 18 months is also terrifying, which provides more motivation. But don't be fooled - if you were looking for something that isn't rote memorization, you're in the wrong field. That's been my experience thus far. General principles will take you so far, but in many cases you still have to memorize little details to distinguish among different disease processes and diagnoses.

Heh, well, I probably am in the wrong field, and I've definitely made a poor career choice. Shoulda done CompSci in college. No matter though, I'm trapped here now, so I might as well make the best of it.

At least it gets better.

 

[Frazier]

From my [limited] experience thus far, med school sucks.

 

[mcloaf]

From my [limited] experience thus far, med school sucks.

 

[notbobtrustme]

eh, there's memorization, but it's not that bad.

Some blocks are worse than others and you will get sick of it, but keep a good attitude and know that it gets better (then it gets a whole lot worse )

 

[Planes2Doc]

From my [limited] experience thus far, med school sucks.

That's quite an understatement.

 

[Arkangeloid]

One thing that made me sad today was when we studied Neoplasia in Basic Path. This was something I had always been interested in and thought was pretty cool, but now I had lost all excitement for it, and was just trudging through the lecture like it was a chore. Med school has figured out a way to make even cool things become boring by the sheer volume of stuff they expect you to memorize.

 

[metopic]

Because that's really what it seems like. Even our professors are making this clear to us: they never use the word "learn" in lecture, but they routinely tell us "You need to memorize X" or "You don't need to memorize Y."

Yup, welcome to hell.

I like path and physio because at least some of it is actually logical/mathematical/uses critical thinking.

But even that has its limits.

Like the guy saying burkitt's should "logically" look like that. Sure bro. I'm sure if I told you the c-myc thing before that'd totally be the first thing you guessed.