The Pre-Medical Journey: More of a game than a useful learning experience

[PhillyMed777]

As I get deeper into my medical education, I’m realizing that the entire pre-med journey and selection process for medical school is highly irrelevant to preparing students for medical school. Often, “pre-med” becomes a check- off-the-box kind of process that includes things that don’t help students really get a preliminary feel for medicine.

Let’s face it. My bio degree, lab work, MCAT verbal and physical science scores, recommendations from people who know nothing about medicine recommending me for medicine, and countless hours spending time on “extracurriculars” didn’t do much in the way of closing the gap between me and the medical world. What do you all think? I was thinking it would be much more useful to have a pre-med do a customized "rotation" tailored to them. But I know it wouldn’t be easy to get much from it with no foundation.

Interested in input from all levels. What would you change as requirements? Or you think it’s perfect the way it is?

P.S. I kinda wish I could hear what Dermviser would say haha…

 

[cbrons]

What would you change as requirements?

Forbidding pre-meds like you from posting in allopathic. Because no one who has ever spent 30 seconds on a clinical rotation would think having an undergraduate rotate with them would be a sane or good idea.

 

[PhillyMed777]

Forbidding pre-meds like you from posting in allopathic. Because no one who has ever spent 30 seconds on a clinical rotation would think having an undergraduate rotate with them would be a sane or good idea.

Lol, I'm a med student. I'm not suggesting a full rotation. I'm suggesting spending more time in the clinic actually focusing on the medicine/job and one that is tailored to them, rather than doing random menial tasks

 

[TheRobin]

Lol, I'm a med student. I'm not suggesting a full rotation. I'm suggesting spending more time in the clinic actually focusing on the medicine/job and one that is tailored to them, rather than doing random menial tasks

You could shadow as much as you want, but would not come close to really understanding the field and what it demands of its trainees until you are actually in the thick of things.

 

[PhillyMed777]

Well i agree it's hard but it incoming students are soooo clueless. We had a meeting with the new first years and that made me think about all the time I wasted as a pre-med doing things that didn't help me now.

 

[TheRobin]

Well i agree it's hard but it incoming students are soooo clueless. We had a meeting with the new first years and that made me think about all the time I wasted as a pre-med doing things that didn't help me now.

But, was that supposed to be the point of the pre-med requirements? I don't think the pre-med requirements are there to "prepare" you for medical school so much as they are to play a gatekeeper type role.

 

[Señor S]

I didn't have much volunteering/shadowing and it definitely hurt me which, looking back on it, is laughable. Who dreams this stuff up?

 

[Psai]

Rotations would be a huge waste of time for a premed. You'd be walking around doing nothing and understanding even less. Premed is good to separate the wheat from the chaff

 

[md-2020]

I didn't have much volunteering/shadowing and it definitely hurt me which, looking back on it, is laughable. Who dreams this stuff up?

As an undergrad at a top IB target originally interested in banking, I found shadowing very helpful and interesting, and ultimately it was instrumental in my decision to forego my business degree/econ education + school pedigree to focus on medicine. I hold shadowing and clinical exposure in high regard as a result.


I can understand that "Day 1 pre-meds" would find shadowing boring/redundant though.

 

[operaman]

I never did the pre-med thing personally; kinda got lucky and managed to skate around it and still did well. I agree it probably isn't necessary, though I do find many of the basic science concepts to be woven into things. Perhaps it's such a basic underpinning and the concepts so general that we don't think about it, but it probably does help retain some of the basic medical knowledge. Even so, there's no reason those basic ideas can't be taught at the start of Ms1, but they do serve a valuable function as a weeding out tool (along with the MCAT).

Requirements I might add:

1) 2 years full time post-school work experience, preferably in the medical field. Not a tenable idea given the length of training as it is, but would be valuable and probably a lot more meaningful than simply shadowing 2x a month through undergrad.

2) Participation in a team sport. Can be intramural or community, but physical fitness and ability to play well with others are valuable traits. History of team sports has also been shown in studies to predict success as a resident.

3) Participation and success in some sort of art form. Music, dance, writing, painting, drawing, whatever. A few years experience learning an art and having something to show for it would tell me more about someone than how many clubs they joined and served as secretary or treasurer. Medicine is very much an art and, more importantly, is learned in the same way you learn other arts. Just like your first second language is the hardest, so is your first art. The subsequent ones come much more easily. The entire model of arts learning - basic concepts, practical experience in a teaching setting, apprenticeship, and gradual mastery - mirrors medical education to a tee and for good reason. In the same paper that found team sports to predict good residents, musical experience was also approaching significance and would likely be so with a larger sample.

Not a comprehensive list, but a good start.

 

[Señor S]

As an undergrad at a top IB target originally interested in banking, I found shadowing very helpful and interesting, and ultimately it was instrumental in my decision to forego my business degree/econ education + school pedigree to focus on medicine. I hold shadowing and clinical exposure in high regard as a result.


I can understand that "Day 1 pre-meds" would find shadowing boring/redundant though.

That's fine if it worked for you, but as a requirement it's pretty lame. Many if not most people will have a good intuitive sense of what hospitals are like, and volunteering/shadowing doesn't give you any feel for what it's like to actually be a med student.

 

[Favoritefarm]

Your ideas are not new and have been discussed many times before. It's a weeding out process and a way to attempt to assess work ethic and project if the student will be able to handle the workload and pass the tests in med school.

This

 

[zeppelinpage4]

Growing a **** ton as a person over several years of college, having amazing life experiences and many ups and downs that shaped me into who I am now....that has helped tremendously.

I'm glad I got to experience college, rather than going straight to med school after high school like other countries do. But, that is a personal thing.

As far as pre-med coursework...I'm likely in the minority but personally I'm glad took them. I still rely on some basic physics, orgo, bio, and biochem concepts. The pre-med classes have way more depth than what I use in med school, but I'm glad I have the background. When an anesthesiologist explains how he factors in pressure changes, or when considering most of physiology, the physics concepts I learned helped. Biochem/Orgo background came in handy for understanding pharm drug mechanisms and things related to absorption of molecules. Bio def comes back, genetics, cell biology etc. Do I use this knowledge directly? No, I hardly think of it. But much of what I learned in med school and continue to learn has built upon basic understanding I gained over the years doing basic science classes in college.

I think pre-med can be shortened, and streamlined better. It def has it's flaws and a lot of it is a game (the MCAT, various volunteering and shadowing hoops etc.). But, it definitely wasn't useless for me.

 

[TheShaker]

This is why they say to focus on the experiences that you actually care about. I have a pretty extensive research experience from undergrad and that has definitely carried on to this point in my career. The checkbox volunteering? lolno

With that said, I feel like a lot of students are still in their premed days judging from the intensity of their massive, vascular erections every single time some kind of volunteering/leadership/resume padding club membership is mentioned. I mean, they probably care about it at some level but it seems to be that same compulsive resume padding for others.

 

[OnePunchBiopsy]

My undergraduate degree was catered to those seeking health professions, mostly prospective physicians and veterinarians. My undergraduate as a whole felt like it really helped me during first year and some of second year in medical school. The perspective of "learning for the sake of learning and being a competent physician one day" goes a long way.

Then you hit the wards in medical school, and you soon realize that nothing, not even medical school, as prepared you fully for the actual practice of medicine.

 

[takeurmeds02]

I suppose in a general sense, you could say the same for med students who are trying to match into really competitive residency programs. Depending on specialty, you may need to pick up extracurriculars along the way while still needing SLOE's/LOR's and top scores in a standardized test. Same is true for residents who are trying to move forward into top fellowships, places in academia, or prime locale places of employment, etc. There's always a similar hoop that needs to be jumped through all the way up the ladder; granted the process becomes more streamlined as you move up. It's all one big game with the hopes that you learn something about the world and yourself along the way.

 

[idm6]

Having worked in a few other fields before deciding to return to school to pursue a medical education, I have an appreciation for the clinical experience and shadowing requirements. In fields other than medicine, most people find the right career by bouncing around to different jobs until they find something they like. This is easy enough to do in most fields. If an econ grad realizes that his dream job in finance isn't everything he thought it would be, he can pretty easily go work in real estate development, research, city government, etc. Before I set my sights on medicine, my logic was "if you think you might like a particular career, go get a job doing it and see how it goes. If you like it, great. If not, move on."

That luxury doesn't exist in medicine. Unless you happen to have a few hundred thousand dollars you don't know what to do with, you can't become a doctor and then decide if you like it and move on if you don't. So you need to put way more effort into due diligence beforehand than you would for any other job. Shadowing and volunteering might not be perfect, but I can't think of any better way to decide if you like the field than being in a medical setting observing the work that is taking place.

As with most things in education, you get out what you put in. If you decide that your reason for volunteering is to check a box on your application, you probably won't get much out of your volunteer experience. If you decide that your reason for volunteering is to truly decide wether medicine is something you can see yourself doing for the next few decades and you seek out really meaningful opportunities, then you'll get a lot out of it.

With regard to the undergrad coursework and the MCAT: Medical school is all about completing difficult courses and showing what you've learned on standardized tests. Therefore, medical schools want to admit people who have shown that they can complete difficult undergrad coursework and then do well on a standardized test. Now, I'm just a premed, but that doesn't seem too unreasonable to me.

 

[cbrons]

As I get deeper into my medical education, I’m realizing that the entire pre-med journey and selection process for medical school is highly irrelevant

Yes it was a game. So is med school. A big inefficient game with lots of wasted time and non-sense. And administrators who make a lot of $ doing absolutely nothing useful. You are going through the rigmarole and paying for the DEGREE (not the quality of the education). The quality of the education is literally 0 at some schools.

Take this one school I know for example. Their tuition is like $11,000/month. Yet none of their clinical faculty draw a salary.

They are taught by virtually a fleet of all-volunteer faculty. Where does the money go? To the uneducated goons in the administration who couldn't get a job in a slop house if it weren't for academia and public sector unions.

But just remember, you are NOT paying for high quality education, you are paying the vigorish to enter the Guild. Paying for those two letters (M.D.)... most expensive letters in the alphabet.

 

[dgu334]

I'm a MS2 and not only do I think premed is a waste of time, med school is also a waste of time. We are going to forget everything we learn and we don't even learn anything that is useful in terms of how to treat a patient. For example, we just learned all about renal pathophysiology but if I see a patient with IgA nephropathy, I only know that the treatment should be steroids. I don't know specifically what steroids to give, the dosage, etc etc. Residency is where we actually learn how to do w/e job we pursue.

 

[Psai]

I'm a MS2 and not only do I think premed is a waste of time, med school is also a waste of time. We are going to forget everything we learn and we don't even learn anything that is useful in terms of how to treat a patient. For example, we just learned all about renal pathophysiology but if I see a patient with IgA nephropathy, I only know that the treatment should be steroids. I don't know specifically what steroids to give, the dosage, etc etc. Residency is where we actually learn how to do w/e job we pursue.

So you want to start running marathons when you've barely started to crawl? You're going to just jump into residency and learn about renal anatomy and physiology, start figuring out what a glomerulus is when you're trying to take care of 10 patients on the floor? You will be able to absorb mountains of information with no prior exposure or experience? Okay.

 

[Snoopy2006]

I'm a MS2 and not only do I think premed is a waste of time, med school is also a waste of time. We are going to forget everything we learn and we don't even learn anything that is useful in terms of how to treat a patient. For example, we just learned all about renal pathophysiology but if I see a patient with IgA nephropathy, I only know that the treatment should be steroids. I don't know specifically what steroids to give, the dosage, etc etc. Residency is where we actually learn how to do w/e job we pursue.

If you'd like to learn bare bones clinical skills without a deeper foundation or understanding of pathophysiology, then NP school is probably more appropriate for you.

Between this thread and the one about the guy who needed counseling after being asked a run-of-the-mill question on rounds ... I'm finally starting to get a better understanding of what "millennial attitude" means.

 

[deleted158872]

yes, it is exactly a game and not learning experience since it doesn't matter what you major in in undergrad or your school's reputation. undergrad feels completely useless 'cause med school teaches you all you need to know

 

[Psai]

If you'd like to learn bare bones clinical skills without a deeper foundation or understanding of pathophysiology, then NP school is probably more appropriate for you.

Between this thread and the one about the guy who needed counseling after being asked a run-of-the-mill question on rounds ... I'm finally starting to get a better understanding of what "millennial attitude" means.

I didn't believe in it until recently

 

[dgu334]

So you want to start running marathons when you've barely started to crawl? You're going to just jump into residency and learn about renal anatomy and physiology, start figuring out what a glomerulus is when you're trying to take care of 10 patients on the floor? You will be able to absorb mountains of information with no prior exposure or experience? Okay.

The preclinical years of medical school are basically the same thing as premed. If anything, med school should just be 4 years of "3rd year."

Anyways, premed is absolutely useless. The U.S. Is one of the few countries that make kids go to college before medical school. Most countries have kids go straight from high school to med school (4 years).

 

[Psai]

The preclinical years of medical school are basically the same thing as premed. If anything, med school should just be 4 years of "3rd year."

Anyways, premed is absolutely useless. The U.S. Is one of the few countries that make kids go to college before medical school. Most countries have kids go straight from high school to med school (4 years).

You have to learn the basics of biology, chemistry and physics. College should teach you to be an intellectual. The preclinical years are much faster and more in depth than premed. They also cover different things. And if you've been through third year, you would not want 4 years of it. What would you even do with all that time?
Personally, I'd make it 2 years of science + whatever else in college then 1.5 years preclinical, 1.5 clinical years, then 4 years of residency. This is with excellent teachers and motivated students.

 

[Wordead]

The preclinical years of medical school are basically the same thing as premed. If anything, med school should just be 4 years of "3rd year."

Anyways, premed is absolutely useless. The U.S. Is one of the few countries that make kids go to college before medical school. Most countries have kids go straight from high school to med school (4 years).

Lol 4 years of M3

I hope you come back to read this after 3rd year so you can punch yourself in the face

 

[W19]

Growing a **** ton as a person over several years of college, having amazing life experiences and many ups and downs that shaped me into who I am now....that has helped tremendously.

I'm glad I got to experience college, rather than going straight to med school after high school like other countries do. But, that is a personal thing.

I think pre-med can be shortened, and streamlined better. It def has it's flaws and a lot of it is a game (the MCAT, various volunteering and shadowing hoops etc.). But, it definitely wasn't useless for me.

 

[W19]

The preclinical years of medical school are basically the same thing as premed. If anything, med school should just be 4 years of "3rd year."

Anyways, premed is absolutely useless. The U.S. Is one of the few countries that make kids go to college before medical school. Most countries have kids go straight from high school to med school (4 years).

It's actually 5 years in most countries plus 1 year intern... I think premed should be 3 years and med school should be another 3 years...

 

[compstomper]

As I get deeper into my medical education, I’m realizing that the entire pre-med journey and selection process for medical school is highly irrelevant to preparing students for medical school. Often, “pre-med” becomes a check- off-the-box kind of process that includes things that don’t help students really get a preliminary feel for medicine.

Let’s face it. My bio degree, lab work, MCAT verbal and physical science scores, recommendations from people who know nothing about medicine recommending me for medicine, and countless hours spending time on “extracurriculars” didn’t do much in the way of closing the gap between me and the medical world. What do you all think? I was thinking it would be much more useful to have a pre-med do a customized "rotation" tailored to them. But I know it wouldn’t be easy to get much from it with no foundation.

Interested in input from all levels. What would you change as requirements? Or you think it’s perfect the way it is?

P.S. I kinda wish I could hear what Dermviser would say haha…

There's more students who want to be doctors than there are slots in med schools, just like there are more med students who want to go into derm/ENT/Urology/Ortho than there are residency slots. Thus much of med school has nothing to do with actual medicine, just more hoops to jump through. Think salmon runs.