What makes your med school curriculum unique?

[Qwerty122]

Hey guys, so I'm applying to be an OSA rep in my med school and we have the opportunity to create a long 4 year project to improve medical training at our school. Some past projects include meditation courses, more mentorship, and earlier and more diverse specialty exploration options.

Beyond cookie cutter courses like anatomy, biochem, renal, GI, clinical med, etc, I'm sure each medical school is slightly different and offers slightly different resources for its medical students. That's what intrigues me right now.

One idea I've been thinking about is In response to step 1 being p/f. The goal would be to shift the focus of medical school from being too academic-focused to building your narrative, further development of your identity, and experiencing new challenging things in medical school. I think although step 1 being p/f can introduce a lot of confusion, it seems silly to not maximize the opportunity that this change gives us, more time to do other non-academic things. The exact methods to achieve this goal is still TBD though.

I have some other ideas of my own but I was wondering what part of your medical school curriculum did you particularly find to be quite foundational to your training/unique/surprisingly useful (beyond the cookie cutter courses and resources)? Thanks!

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[Goro]

TBL is the fad in medical education now, so suggest looking into that.

 

[OnePunchBiopsy]

Not done at my old school, but just and idea:

Shorten basic science to 1.5 years

Add a 6 month period with clinical experience and/or research. Assign each student both a research and clinical mentor (students can pick if they want). If they want to do surgery, get them in the OR. If they want to do research, get them plugged into projects.

Students could either take Step 1 before, during, or after this 6month period. Once Step is done and/or the 6 months are over, transition to clerkships.

 

[jurassicpark]

I have some other ideas of my own but I was wondering what part of your medical school curriculum did you particularly find to be quite foundational to your training/unique/surprisingly useful (beyond the cookie cutter courses and resources)? Thanks!

Some of us got to do our intro to clinical work with strippers from a local club. Good times had by all.


yeah, true story actually. 😎

 

[JSReed]

Like most schools, we have a longitudinal (M1/2) course where we basically shadow a primary care physician. This is generally...pretty low yield and probably not that useful in the long run.

There’s a school near me where they basically pace you with a local family with a “high need for complex medical services”. You basically serve as a liaison to the family to help them set up appointments, and support physicians in understanding the needs of the patient/family. Seems wayyyyyy more eventful and impactful within the community (but needs really strong local community links).

 

[blockrudder1]

Not done at my old school, but just and idea:

Shorten basic science to 1.5 years

Add a 6 month period with clinical experience and/or research. Assign each student both a research and clinical mentor (students can pick if they want). If they want to do surgery, get them in the OR. If they want to do research, get them plugged into projects.

Students could either take Step 1 before, during, or after this 6month period. Once Step is done and/or the 6 months are over, transition to clerkships.

This is cornell

 

[OnePunchBiopsy]

There’s a school near me where they basically pace you with a local family with a “high need for complex medical services”. You basically serve as a liaison to the family to help them set up appointments, and support physicians in understanding the needs of the patient/family. Seems wayyyyyy more eventful and impactful within the community (but needs really strong local community links).

Sounds low-yield

 

[Oedipa Maas]

Check out Cleveland Clinic Lerner College of Medicine’s curriculum. Probably not possible to implement everywhere, but neat ideas there.

 

[Tangerine123]

My school added a Bioinformatics/Omic Sciences/Biotechnology mandatory course the year I graduated. I would have loved to take that course now that I'm in research.

Legal Medicine. Not sure if that's usually taught. It was nice to know what your legal obligations and rights are.

 

[JSReed]

Sounds low-yield

Relative to shadowing where you have no context and only half a clue whats going on? Idk.

Health/disease is based on what happens outside of clinic walls, so I feel like this model gives you a much deeper insight into that (rather than just throwing scripts at everyone based on what you figure out in a 9 min window).

 

[OnePunchBiopsy]

Health/disease is based on what happens outside of clinic walls, so I feel like this model gives you a much deeper insight into that (rather than just throwing scripts at everyone based on what you figure out in a 9 min window).

To each their own. I support furthering the humanitarian aspect of medicine at all levels, including what goes on outside the clinic walls.

I just feel that learning how to manage things inside the walls, such as how to manage the patient’s disease, should take precedent.

Managing appointments, etc is important, but IMO does little to prepare students for the actual work done in residency and independent practice.

 

[Qwerty122]

To each their own. I support furthering the humanitarian aspect of medicine at all levels, including what goes on outside the clinic walls.

I just feel that learning how to manage things inside the walls, such as how to manage the patient’s disease, should take precedent.

Managing appointments, etc is important, but IMO does little to prepare students for the actual work done in residency and independent practice.

I suppose @JSReed 's can be good, to broaden the understanding of healthcare for future physicians, and get them involved early. It definitely provides students a unique tool and experience in medical school, especially for those considering to go into primary care (or even to persuade students to go into primary care). But I do agree that some things such as clinical skills and diagnostic accuracy might take precedent before we get the luxury of being trained in the way @JSReed mentioned.

As a resident, what do you think are some concrete ways that can prepare students for the residency and independent practice life? Any glaring or even not-so-obvious holes in knowledge that you've seen from PGY1s?

 

[JSReed]

To each their own. I support furthering the humanitarian aspect of medicine at all levels, including what goes on outside the clinic walls.

I just feel that learning how to manage things inside the walls, such as how to manage the patient’s disease, should take precedent.

Managing appointments, etc is important, but IMO does little to prepare students for the actual work done in residency and independent practice.

That's fair. TBH I don't know all the ins and outs of it. My understanding is that you go to clinic appts with them (as well as non-clinical stuff). Its a very community-driven school with a big primary care focus, so there's that too.

Plus honestly, I can't say I really learn much from my glorified shadowing rotations. Its no different that shadowing as an undergraduate, except that I am now required to do it by my school.

Would also second the comment on CCLCM, I hear they're doing some good stuff (though very PBL-focused IIRC).

 

[OnePunchBiopsy]

As a resident, what do you think are some concrete ways that can prepare students for the residency and independent practice life? Any glaring or even not-so-obvious holes in knowledge that you've seen from PGY1s?

Accomplishing this is difficult. Short of residency itself, there is no concrete way that I know of that would completely prepare students for residency, let alone independent practice.

Some potential ways to at least maximize outcome could include:

1. Having students actively involved in patient care in multiple settings, including clinic, the ER, and the hospital. This means seeing patients alone, examining them, formulating a plan, and giving an oral presentation of said plan to a senior resident or attending.

2. Make medical students take call and see consultations, under the guidance of a senior resident or attending. This will show them the actual lifestyle of different specialties.

3. Have medical students actually do minor procedure under resident/attending supervision: things like abscess I&D’s, GYN exams, Foley catheters, shave biopsies, mole excisions, etc. This helps them learn the basics of performing procedures in awake patients.


Regarding knowledge shortfalls, I’m somewhat biased since I’m a surgery resident. Most PGY-1’s entering surgery may have a lower amount of knowledge since most medical schools don’t emphasize all the core tenets of care for surgical patients.

One potential shortfall may be patient care after hospital discharge. Not all patients can just go home. Homelessness, health literacy, Deconditioning after surgery, and advanced wound care requirements may necessitate the need for tranfer to acute rehab, a skilled nursing facility, a shelter, or home health. More knowledge about this during medical school could be helpful. I feel like my school did very little to prepare me for this, so more knowledge about this during 3rd/4th year could have been helpful.

 

[Qwerty122]

@OnePunchBiopsy Great answer, it's always helpful to see medical school curriculum from the perspective of a resident. I think with step 1 being p/f, my hope is that the system would encourage and reward students who seek out various opportunities, have a more holistic knowledge about healthcare, and develop their unique personalities, rather than rewarding the student who can hammer through 1000 anki cards a day.

So it seems like most of your answers revolve around adopting the responsibility of a resident doctor much sooner, so the transition to residency would be less stressful for them and for the other senior residents. Also you touched upon the social determinants of health beyond the clinic and I think that can be a potentially interesting topic to look into as well.

 

[whosthatcreepininmywindow]

Not done at my old school, but just and idea:

Shorten basic science to 1.5 years

Add a 6 month period with clinical experience and/or research. Assign each student both a research and clinical mentor (students can pick if they want). If they want to do surgery, get them in the OR. If they want to do research, get them plugged into projects.

Students could either take Step 1 before, during, or after this 6month period. Once Step is done and/or the 6 months are over, transition to clerkships.

WSUBSOM does this.

 

[Dave1980]

This is my curriculum. There are many like it, but this one is mine.
My curriculum is my best friend. It is my life. I must master it as I must master my life.

Without me, my curriculum is useless. Without my curriculum, I am useless. I must fire my curriculum true. I must shoot straighter than my enemy who is trying to kill me. I must shoot him before he shoots me. I will ...

My curriculum and I know that what counts in war is not the rounds we fire, the noise of our burst, nor the smoke we make. We know that it is the hits that count. We will hit ...

My curriculum is human, even as I, because it is my life. Thus, I will learn it as a brother. I will learn its weaknesses, its strength, its parts, its accessories, its sights and its barrel. I will keep my curriculum clean and ready, even as I am clean and ready. We will become part of each other. We will ...

Before God, I swear this creed. My curriculum and I are the defenders of my country. We are the masters of our enemy. We are the saviors of my life.

So be it, until victory is America's and there is no enemy, but peace!

 

[yogglo]

TBL is the fad in medical education now, so suggest looking into that.

I feel like flipped classrooms are more efficient. TBLs feel far too time consuming for their results.