Usefulness of years 1 and 2... really.

[OmahaMX80]

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As I sit here studying for my respiratory system final, I can't help but think about all the things I learned, and then forgot, last year... not to mention the stuff from the previous systems I've learned and forgotten this year.

And all that got me wondering... what, really, is the usefulness of the stuff we learn in years 1 and 2 beyond step 1? I know the "on-the-record" answer (i.e., it's all important and the amount you forget is proportional to the number of patients you'll kill... which in my case means I should stop now). I'd like to hear from 3rd and 4th years or residents.

I've heard a lot ranging from the typical "it's all important" to "nothing you learned in years 1 and 2 really matters and once you hit the wards your education might as well start over." I'm sure the truth lies somewhere in the middle, I just want to hear some other people's thoughts.

Thanks.

 

[Telemachus]

I'm sure the truth lies somewhere in the middle.....

You are correct.

 

[el_chavo]

The basic sciences are sort of like learning the grammar as you learn a language. We all do just fine with English now and probably don't remember any rules but we have to learn something to be able to communicate.
So basic sciences are like that. We have to be able to know something of the language and the reason before we can use the knowledge to save lives. That's why we'll be doctors. Further, there's something very powerful about learning scientific reasoning and problem solving.
Now if only med school curriculum would give us the time to reason some more. But that's a topic for another thread.

 

[WatchingWaiting]

As I sit here studying for my respiratory system final, I can't help but think about all the things I learned, and then forgot, last year... not to mention the stuff from the previous systems I've learned and forgotten this year.

And all that got me wondering... what, really, is the usefulness of the stuff we learn in years 1 and 2 beyond step 1? I know the "on-the-record" answer (i.e., it's all important and the amount you forget is proportional to the number of patients you'll kill... which in my case means I should stop now). I'd like to hear from 3rd and 4th years or residents.

I've heard a lot ranging from the typical "it's all important" to "nothing you learned in years 1 and 2 really matters and once you hit the wards your education might as well start over." I'm sure the truth lies somewhere in the middle, I just want to hear some other people's thoughts.

Thanks.

Well, intuitively speaking, some of the stuff is not very relevant to clinical practice. Go ask some attending mechanistic details about lipid degradation diseases, for example. On the other hand, most of the first two years will come back somewhere in the third year. Path, physiology, pharmacology, microbiology to pretty much every rotation. Anatomy will get some representation in surgery; neurobiology in neurology; Behavioral science in psych.

Point being, aside from some random biochem points, mol bio details about what chromosome is associated with what disease and the like, most of the first two years (and the second year in particular) will be utilized during the clinical years.

 

[YouDontKnowJack]

Point being, aside from some random biochem points, mol bio details about what chromosome is associated with what disease and the like, most of the first two years (and the second year in particular) will be utilized during the clinical years.

and that is exactly why i'm doomed.

stupid stupid memory. WD40 is doing nothing to restore my rusty brain cells.

we've already done a couple bedside observation PBL & pimping sessions, and I've found that I don't remember stuff learned a couple weeks ago. I wonder when i'll be able to not depend on Harrison's or cecil's.

 

[fun8stuff]

and that is exactly why i'm doomed.

stupid stupid memory. WD40 is doing nothing to restore my rusty brain cells.

we've already done a couple bedside observation PBL & pimping sessions, and I've found that I don't remember stuff learned a couple weeks ago. I wonder when i'll be able to not depend on Harrison's or cecil's.

i have heard that everyone forgets a lot and not to worry because the most important stuff you will see again and again and again. First time you see it is in years 1 & 2. Then you see the important stuff of these years again while studying for step 1. Then you see the most important parts of this again during years 3&4. Then you continue to see this important stuff again during residency... etc. So through this process of repetition... hopefully the important stuff will stick by the end.

 

[Arsenic]

Now if only med school curriculum would give us the time to reason some more. But that's a topic for another thread.

thats funny, i actually had this convo with some of my classmates today. fewer lectures and more case based problem sessions or independant study time would be awesome.

 

[fun8stuff]

thats funny, i actually had this convo with some of my classmates today. fewer lectures and more case based problem sessions or independant study time would be awesome.

there is such thing as independent study... it's called not going to class... ha ha. "classes will dull your mind." -John Nash, A Beautiful Mind

 

[undercover]

I know as you go through the first two years, nonstop studying is very draining and seems pointless. However, looking back on things, there's never a moment I don't wish I had studied something better, more in depth, etc. Perhaps I'm still an idealist, but it's hard to place a value on knowledge, especially prospectively. You never know what's important to you until you look back on things. There are many things in college even that I wish I had learned better because it helps me understand patients better. But I didn't know the value of learning things then, but in retrospect, I wish I had. I know it sounds very idealistic and difficult to accept, but you're best off trying to learn as best you can without worrying what the utilty of something is. It's possible that you'll never need to know it beyond a test, but it's more probable that you'll need it in the future some time when you least expect it. Also, it's hard to say what you would or wouldn't understand without proper background. For example, I used to think learning the Frank-Starling curve in physiology was useless. But if you understand it well, it makes understanding CV physiology and CV diseases such as CHF much easier, thus giving you better insight into patient care rather than blindly following algorithms.

Long reply, sorry. Just throwing in my $0.02.

 

[Bobblehead]

Some of the stuff also comes back to haunt you later on as you embark on becoming an "expert" in whatever niche of academic medicine you choose to partake of. It also seems that the "smartest" people you'll meet later on in your career are the ones that have an excellent foundation in the basics that everyone learned in year 1/2.

 

[Hoya11]

Point being, aside from some random biochem points, mol bio details about what chromosome is associated with what disease and the like, most of the first two years (and the second year in particular) will be utilized during the clinical years.

The thing is, that is mostly what you spend your time memorizing. Everyone understands the "basics" that you go on to use, you could sum that up in a fraction of the time it takes to learn all the irrelevant monotony that makes or breaks you on the curve in reality.

 

[G'ville Nole]

The thing is, that is mostly what you spend your time memorizing. Everyone understands the "basics" that you go on to use, you could sum that up in a fraction of the time it takes to learn all the irrelevant monotony that makes or breaks you on the curve in reality.

Don't be too quick to assume that everyone understands the "basics", or at least that they are universally retained and applied to clinical practice. I've seen numerous instances of residents and fellows crashing and burning in conferences when asked relatively straightforward anatomy or physiology questions. I guess the further you get into a specialty, the easier it is to "pigeon-hole" your knowledge, which can be bad if you start forgetting things you really should be retaining.

I suspect that the tenor of this thread is dictated by the fact that you guys are right in the middle of absorbing a TREMENDOUS volume of information. Just appreciate that EVERYONE is in the same boat, everyone is getting more information that you could possibly expect to retain on a long term basis, and before long, you will be able to happily triage a fair chunk of these details into the deepest rescesses of your memory. Just hold on to them for Step I, because those Ornithyl-tranferase cycles et al. are what tend to separate the 220s from the 240s.

FWIW

 

[skiz knot]

stupid stupid memory. WD40 is doing nothing to restore my rusty brain cells.

I think i know your problem...

stop huffing WD40!

 

[run4boston]

Some of the stuff also comes back to haunt you later on as you embark on becoming an "expert" in whatever niche of academic medicine you choose to partake of. It also seems that the "smartest" people you'll meet later on in your career are the ones that have an excellent foundation in the basics that everyone learned in year 1/2.

One of my friends is doing research related to bone formation. Lo and behold, he's having to go back and study all that embryological stuff that I am now learning. So, it sounds like what Bobblehead says is true.

 

[OmahaMX80]

Puh-leeze. The material in years 1 and 2 at Creighton is so easy that Jayne routinely aces all the exams without even studying. It can't be that important.

She also has the answer key.

Anyway it's not that I'm failing out or anything I was just curious... lordy.

 

[Hurricane]

Point being, aside from some random biochem points, mol bio details about what chromosome is associated with what disease and the like, most of the first two years (and the second year in particular) will be utilized during the clinical years.

Then you spend a day in Peds Neuro/Metabolic clinic, and people actually expect you to know all of those esoteric biochem pathways! 😱

Seriously, you have to know the basic stuff so that you can actually learn - and not just memorize - the clinical stuff. You may not apply every little detail in the clinics, but the basic concepts are in your brain somewhere, helping to put the clinical stuff in context.

 

[run4boston]

and that is exactly why i'm doomed.

stupid stupid memory. WD40 is doing nothing to restore my rusty brain cells.

we've already done a couple bedside observation PBL & pimping sessions, and I've found that I don't remember stuff learned a couple weeks ago. I wonder when i'll be able to not depend on Harrison's or cecil's.

Yeah, I have the same problem.

 

[noncestvrai]

As a wise rapper once said..."Kowledge, be it power, wicked..." or some variation thereof...

I just finished my preclinical stuff, and I feel much more comfortable going in the clinic with a decent base, I estimate this now to be like little hooks that I can pull if confronted with a question, i.e. I have an idea of this problem, I know where to look for or what to look for if in a bind.

Now, I have a certain issues with the current format of medical school. Why not making it 2 years (i.e. that you pay for)? You can stay home learn all of Harrison's or USMLE-type of information, write the tests, then start clinical med.*

noncestvrai

*This is coming from someone with profound disdain of lectures after a year and a half of them...

 

[DrRobert]

Here is my opinion of the usefulness of the basic science classes commonly taught during the first two years:


Useful: Anatomy, Physiology, Pharmacology, Pathology, Microbiology/Immunology

Borderline useful: Histology

Useless: Biochemistry, Embryology

 

[orientedtoself]

Useful: Anatomy, Physiology, Pharmacology, Pathology, Microbiology/Immunology

Borderline useful: Histology

Useless: Biochemistry, Embryology

Folks in ENT get off on the embryology of the branchial arches.

 

[DrRobert]

Folks in ENT get off on the embryology of the branchial arches.

Unless they are operating on embryos, anatomy will suffice.

 

[run4boston]

Then you spend a day in Peds Neuro/Metabolic clinic, and people actually expect you to know all of those esoteric biochem pathways! 😱

Seriously, you have to know the basic stuff so that you can actually learn - and not just memorize - the clinical stuff. You may not apply every little detail in the clinics, but the basic concepts are in your brain somewhere, helping to put the clinical stuff in context.

makes sense 👍

 

[orientedtoself]

Unless they are operating on embryos, anatomy will suffice.

Nope. . . branchial cleft cysts, thyroglossal duct cysts, and cleft palate are directly related to embryologic development. My ENT rotation was the one rotation where I got asked about embryology. Nobody else remembers anything or cares about embryology.

 

[DrRobert]

Nope. . . branchial cleft cysts, thyroglossal duct cysts, and cleft palate are directly related to embryologic development. My ENT rotation was the one rotation where I got asked about embryology. Nobody else remembers anything or cares about embryology.

But how does understanding the embryology actually play an integral role in the diagnosis and treatment? I can see why it might be nice to know from an academic standpoint, but I fail to see the clinical significance of knowing every detail about how these malformations developed.

I'm glad that I didn't have an affinity for ENT.

 

[orientedtoself]

But how does understanding the embryology actually play an integral role in the diagnosis and treatment? I can see why it might be nice to know from an academic standpoint, but I fail to see the clinical significance of knowing every detail about how these malformations developed.

I'm glad that I didn't have an affinity for ENT.

Understanding the embryology is necessary for understanding the pathophysiology and location of the lesions. If you're going to resect my second branchial cleft cyst, I hope you know its relation to my carotid artery, because I don't want to bleed out on the table. These relationships are embryologically determined. (Second branchial cleft cyst passes deep to the second branchial arch structures, including the external carotid a., and superficial to the third branchial arch structures, such as the internal carotid a. Yes, I had to look that up.)

 

[Ypo.]

Understanding the embryology is necessary for understanding the pathophysiology and location of the lesions. If you're going to resect my second branchial cleft cyst, I hope you know its relation to my carotid artery, because I don't want to bleed out on the table. These relationships are embryologically determined. (Second branchial cleft cyst passes deep to the second branchial arch structures, including the external carotid a., and superficial to the third branchial arch structures, such as the internal carotid a. Yes, I had to look that up.)

You guys are depressing me. Stop taking this thread so seriously-its winter break...please... 🙁

 

[orientedtoself]

You guys are depressing me. Stop taking this thread so seriously-its winter break...please... 🙁

I'm just making a point, even the most seemingly pointless minutiae have some clinical relevance to some doctor somewhere