Systems-based curriculum and step I

[MedMan25]

Our school adopted the systems-based curriculum a few years ago and last year the 2nd year students (the first class to have experienced the new curriculum) had a dramatic drop in board scores. I know this might be attributed to the fact that the curriculum was brand new the year these students took step I but I am curious to know if there are other schools out there who have experienced the same drop, especially if this drop has been sustained for more than 1 year after implementing a systems-based curriculum. Anyone?

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[Tiger26]

Our school is just starting this, and I'm so glad I didn't have to go through it. I actually feel kinda bad for the new M1s having to take boards with this prep. I'm sure it works for some people, but I learned really well with the traditional curriculum.

 

[thesauce]

Our school adopted the systems-based curriculum a few years ago and last year the 2nd year students (the first class to have experienced the new curriculum) had a dramatic drop in board scores. I know this might be attributed to the fact that the curriculum was brand new the year these students took step I but I am curious to know if there are other schools out there who have experienced the same drop, especially if this drop has been sustained for more than 1 year after implementing a systems-based curriculum. Anyone?

That's especially bad considering the Step 1 average went up by 5 points last year.

Our school adopted a new system (pseudo system-based) and the following year scores went up. Then 2 years out, they went below previous levels. We really have no idea why.

 

[badasshairday]

ouch.

 

[Vonsmack]

I interviewed at UofA but that was awhile ago. As I remember, the curriculum is integrated system by system packing anatomy,phys,path all in one punch right? So the problem I see is that if you study cardio pathology Winter of your first year-you won't see any cardiovascular material again until boards.

With other traditional curriculums you would study anatomy/histo/phys first year, then micro/pharm/path second year of the same subject. So thats two passes for each subject, and during the second year you review first years material to understand pathophys, pharm etc.. So that seems like a disadvantage to me, that you only get one pass for each subject. You will have to find and make time to review important material throughout your second year to keep it somewhat fresh. That way when boards come, you aren't saying "I haven't seen musculoskeletal path in a year and a half, I don't remember anything!"

 

[Blesbok]

I liked the systems based approach. If it is done correctly it really integrates everything. I also used a systems based approach to board prep.

However, I would not like to be the test class just because a change in curriculum always has its bumps in the road.

 

[TMP-SMX]

Depends what you mean by systems-based.

At Wayne we had M1 as split by discipline and only physiology is system based. Anatomy was by region vs. system based which I think is a better way to learn relationships.

M2, Pathology is systems based but everything else is discipline-based. This works well because you take Micro and then see everything again with Pathophys which is the rest of the year. Also, we have pharmacology as its own class, see it again in every path organ system, and then have another integrated pharm unit at the end of M2 just prior to boards because Wayne's pharm knowledge was apparently not up to par.

 

[MedMan25]

I interviewed at UofA but that was awhile ago. As I remember, the curriculum is integrated system by system packing anatomy,phys,path all in one punch right? So the problem I see is that if you study cardio pathology Winter of your first year-you won't see any cardiovascular material again until boards.

With other traditional curriculums you would study anatomy/histo/phys first year, then micro/pharm/path second year of the same subject. So thats two passes for each subject, and during the second year you review first years material to understand pathophys, pharm etc.. So that seems like a disadvantage to me, that you only get one pass for each subject. You will have to find and make time to review important material throughout your second year to keep it somewhat fresh. That way when boards come, you aren't saying "I haven't seen musculoskeletal path in a year and a half, I don't remember anything!"

Yeah, everything is divided up into blocks by system. For example, we are in the cardio block now so we are learning all the biochem, path, pharm, phys, etc. of the cardiovascular system. Next block we do the same thing but for a different system.

I have mixed feelings about it. The one big problem I have is the fact that you can be terrible at one subject and still get by. For example, if biochem isn't your thing, there may only be 5 or 6 biochem questions on every exam within each block. So lets say you only get half of those biochem questions right. If you know the rest of your stuff you can still fair pretty well on an exam with 50 or so questions testing every subject. You could even honor if all you missed were about half the biochem q's.

Now lets say you continue this pattern for each block. At the end of two years, your competency in biochem is only about 50% what it should be. In a traditional curriculum, this would have meant failure and remediation of the biochem block. Instead, you've gotten through two years of med school with pretty decent grades (again, assuming you do well in the other areas). I realize that it wouldn't be hard for someone in this scenario to recognize their deficiency in biochem and do something about it before boards roll around but nonetheless I believe this system could easily give someone who got good grades in every block but failed the biochem questions a false sense of security.

 

[HPSPpayissues]

Our school is just starting this, and I'm so glad I didn't have to go through it. I actually feel kinda bad for the new M1s having to take boards with this prep. I'm sure it works for some people, but I learned really well with the traditional curriculum.

System-based courses don't help you master a given subject (ie physio or path). They help you incorporate most subjects into an overall clinical perspective, but doesn't give you in-depth teachings that you need to master each subject.

 

[Blesbok]

System-based courses don't help you master a given subject (ie physio or path). They help you incorporate most subjects into an overall clinical perspective, but doesn't give you in-depth teachings that you need to master each subject.

I am pretty sure I managed to master these subjects more than most people using a systems based setup. Unless you happen to have some research based evidence on the subject I don't think you can make a statement like this.

 

[The Angriest Bird]

The truth: Step I is much more about cramming and study on your own than anything else.

My school has a newly adopted system-based curriculum too. It's been there for maybe 5 years so it's not brand new. It doesn't matter. I was such a slacker in first two years. My rank was easily border-line 3rd-4th quartile. Then I crammed Step I hardcore for 6 weeks, read 11 books, did 7000 questions, and pulled off a 245.

 

[JDWflash44]

As discussed earlier systems based curriculum help you integrate different subjects together better and probably help you understand clinical medicine better. But I agree that doing well on Step 1 is more about how much YOU study and/or cram for the test and much less about your curriculum. I was in a systems based PBL program and did fine, but I studied A LOT on my own.