Medical school was excellent preparation for this. Throughout the pre-clinical curriculum, many people stopped attending lectures and reading textbooks in favor of browsing BRS and High Yield a few days before exams. These people did quite well for themselves. During the clinical year, classmates took every opportunity to hide from residents and leave the wards early in order to essentially memorize Blueprints and Pre Test. Many of these people obtained honors and high praises on their evaluations and dean's letters without ever sticking around after rounds or cracking open a textbook. Usually, when attending physicians pimp medical students, they seem more interested in one word responses than they are in listening to a student explain the mechanism underlying disease or therapy. When there are multiple students present, praise is given to those who are able to spit out the correct answers the fastest. The USMLE examinations are largely a test of recall and those who are better at multiple choice exams tend to score higher than those who are not as adept at choosing the correct bubbles. It is no wonder that many students turn to USMLE World and Kaplan Q Bank to prepare for the boards. It's quite an efficient and intelligent strategy. Many of them score just fine by developing a rudimentary knowledge of "high yield" topics and by sharpening their abilities to recognize buzz words and question formats.
When it's time to apply and interview for residency, leverage is possessed by individuals who have demonstrated excellence in multiple choice testing. Given the competition between applicants over desirable specialties and the time demands of medical education, it is not a surprise that some students take as many shortcuts to match day as possible. Perhaps these come at the expense of knowledge. Is that knowledge necessary for every future physician? Does an undergraduate medical education consisting of BRS, High Yield, Blueprints, Pre Test, and USMLE World prepare students adequately to pursue graduate training? Is a sophisticated understanding of pathology and pathophysiology integral to the practice of evidenced based medicine? Exactly how much general medical knowledge is required for each individual specialty?
These were the very questions I struggled with while deciding on a medical specialty and also while having to divide my time between seeing patients, reading textbooks, reading abridged study materials by authors who seemed to know exactly what would appear on my exams, and enjoying my limited personal time.
It is understandably discouraging to those who got involved with medicine out of intellectual curiosity and enjoyment of the sciences that fact memorization and check lists have taken precedence over the sophisticated knowledge and passion for learning that physicians have historically demonstrated. On the other hand, there are still many medical students and physicians representing every specialty who are intellectually curious and push themselves to learn more than what is necessary to perform well on recall examinations. In every specialty, there will exist individuals of various levels of interest and commitment. Perhaps the shelves of medical school book stores are now filled with 200 page review guides, but the classic texts remain (in their tiny, crammed corner of the store... you have to sort of blow the dust off of the covers to see that they are there) and they will be revised... and even purchased and studied on occasion by some inspired students! The new Robbins professional version seems to be a full version and has approximately 1,500 pages 🙂
