Why is med school...

[deleted862527]

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Hey guys,

I am not a medical student. I am only asking this question from threads I have read and what I have heard from past medical students. Many medical students claim medical school is similar to drinking water from a fire hose. Additionally, because there is so much material a med student is responsible for, it is impossible to know everything.

My question: why? Why is school made so you can't learn everything? From what I hear, it's important you memorize as fast as possible so you can pass an exam. That's not learning, that's memorizing. I know this can be said with other careers paths (pharmacy, etc.) but why is this system made so difficult you can't know it all? Why assign it if your students are more than likely not going to get to it and will skip it over instead, or memorize it for an exam and forget it later on?

Just don't want to be a doctor who may have to result in rote memorization to pass an exam and not learn it since there isn't enough time.

 

[nymd22]

If medical school were structured in a way to give you time to memorize everything, it would have to be much longer.

 

[HomeSkool]

It's impossible to know everything because the body of medical knowledge is vast and expanding at an ever-increasing rate. Furthermore, the practice of medicine isn't a purely academic exercise, but rather a practical one requiring critical analysis and reasoning. In order to lay the groundwork necessary for such expert-level function, medical school divides its time between classroom and clinical learning. The first two years are very memorization-intensive for knowledge acquisition, while the last two years put students in direct contact with patients so they can begin to apply the knowledge they've acquired.

Because of the sheer amount of knowledge they must master, doctors also complete residency training after med school. Residency is an apprenticeship period designed to further develop the doctor's fund of knowledge, critical thinking abilities, procedural expertise, and other important skills. Residents build upon the foundation laid during med school to gain the experience and judgment necessary to practice independently. And even after residency, doctors continue to study and learn. A core value of doctors everywhere is commitment to being a lifelong learner.

TL;DR: It's impossible for anyone to master all of the available information in any field. Everyone starts with lots of memorization before they can learn expert-level application.

 

[stayathomemom]

why is this system made so difficult you can't know it all?

Med school didn't make the system, the system made them. The human body is so complicated that it demands a fire hose of information. At the end of the first two years, med students should know enough relevant information to work in a clinical setting. If they don't have the ability to perfectly recall it, they should at least be familiar enough with it to be able to read up on it should it become necessary.

Just don't want to be a doctor who may have to result in rote memorization to pass an exam and not learn it since there isn't enough time.

The human body is not really so much a concept to be understood (like physics concepts) than it is a system to be memorized. Rote memorization is learning it.

 

[Durty-Trixxx]

Why is school made so you can't learn everything? From what I hear, it's important you memorize as fast as possible so you can pass an exam. That's not learning, that's memorizing. I know this can be said with other careers paths (pharmacy, etc.) but why is this system made so difficult you can't know it all?

Medicine is not like theoretical physics where you ponder an idea for decades until you fully grasp it. Med school is simply jamming a HUGE amount of information into your brain in a short period of time in order to get you prepared for residency and functioning like a "real doctor".

I suppose med students would be better prepared for clinical training if they spent 6 or 8 years in school instead of 4, but this is very impractical in today's world because of the enormous cost involved. Plus, most people already think spending 7+ years after college to get board certified is burdensome enough.

 

[Goro]

Hey guys,

I am not a medical student. I am only asking this question from threads I have read and what I have heard from past medical students. Many medical students claim medical school is similar to drinking water from a fire hose. Additionally, because there is so much material a med student is responsible for, it is impossible to know everything.

My question: why? Why is school made so you can't learn everything? From what I hear, it's important you memorize as fast as possible so you can pass an exam. That's not learning, that's memorizing. I know this can be said with other careers paths (pharmacy, etc.) but why is this system made so difficult you can't know it all? Why assign it if your students are more than likely not going to get to it and will skip it over instead, or memorize it for an exam and forget it later on?

Just don't want to be a doctor who may have to result in rote memorization to pass an exam and not learn it since there isn't enough time.

Well, for starters, there are about 5000 human body parts alone that you need to learn about.

Now add to that the pathologies of said parts.

Now add to that the pathologies of entire organ systems.

Now add to that trying to figure out how to recognize what's wrong.

Then add to that how to fix what's wrong.

NOW do you understand why in four years, it's not merely drinking from a fire hose, but doing so while running after the fire truck???

 

[longhaul3]

The human body is not really so much a concept to be understood (like physics concepts) than it is a system to be memorized. Rote memorization is learning it.

Medicine is not like theoretical physics where you ponder an idea for decades until you fully grasp it. Med school is simply jamming a HUGE amount of information into your brain in a short period of time in order to get you prepared for residency and functioning like a "real doctor".

I would argue that as one advances in one's training it really does become more of a concept to be understood than a list of facts to be memorized. This is certainly the case in clinical medicine, where you begin to recognize patterns, understand cause and effect relationships, and predict downstream consequences of clinical decisions.

This is in contrast to the notion that learning every disease by rote and being able to distinguish granulomatosis with polyangiitis from eosinophilic granulomatosis with polyangiitis or primary sclerosing cholangitis from primary biliary cholangitis is tantamount to being a physician. It's more about clinical acumen and overall understanding than it is about facts and details (although they are obviously important). In fact, the board of IM is moving to allow the use of UpToDate in recertification exams.

 

[Goro]

I would argue that as one advances in one's training it really does become more of a concept to be understood than a list of facts to be memorized. This is certainly the case in clinical medicine, where you begin to recognize patterns, understand cause and effect relationships, and predict downstream consequences of clinical decisions.

This is in contrast to the notion that learning every disease by rote and being able to distinguish granulomatosis with polyangiitis from eosinophilic granulomatosis with polyangiitis or primary sclerosing cholangitis from primary biliary cholangitis is tantamount to being a physician. It's more about clinical acumen and overall understanding than it is about facts and details (although they are obviously important). In fact, the board of IM is moving to allow the use of UpToDate in recertification exams.

To follow up these wise words, it's not merely about knowing...you need to be able to apply.

 

[AnatomyGrey12]

Why is school made so you can't learn everything?

Because it’s impossible to learn everything, and also knowing everything doesn’t necessarily translate to clinical application.

The human body is not really so much a concept to be understood (like physics concepts)

Completely disagree. The human body is most definitely a concept to understand, if you don’t understand the concept then you won’t understand the details.

 

[Durty-Trixxx]

I would argue that as one advances in one's training it really does become more of a concept to be understood than a list of facts to be memorized. This is certainly the case in clinical medicine, where you begin to recognize patterns, understand cause and effect relationships, and predict downstream consequences of clinical decisions.

Yeah I'd have to agree with that. For better or worse, 4 years of med school is simply rote memorization in order to pass national boards. Once you become a seasoned attending with a lot of experience under your belt, you can really maximize that knowledge set in a myriad of ways. The best physicians are those with very detailed history-taking and physical exam skills. That is something you don't get from cramming Harrison's at 2am every night.

 

[dr_kateb]

Yeah like everyone else said, basically so you can start making some money around age 26 (depending on specialty) and not 40.

 

[libertyyne]

 

[WingedOx]

Actually, I hear that analogy a lot, and I'm not a fan of it. Drinking from a fire hose is an impossible task, which as many will attest, med school isn't.

My favorite is "med school is like having to eat five pancakes per day." It's not exactly the most pleasurable task, you'll feel kind of gross afterwards, but you can do it. The problem is, maybe you decide to take a day off. Tomorrow, if you want to make it up, you have to eat ten pancakes. Or then maybe you space your pancake debt out, so you're eating six for the next week, but if you don't keep up, you'll be stuck trying to eat 20 pancakes the day before the exam without throwing up.

^^^^

 

[freedoctor17]

It's impossible to know everything because the body of medical knowledge is vast and expanding at an ever-increasing rate. Furthermore, the practice of medicine isn't a purely academic exercise, but rather a practical one requiring critical analysis and reasoning. In order to lay the groundwork necessary for such expert-level function, medical school divides its time between classroom and clinical learning. The first two years are very memorization-intensive for knowledge acquisition, while the last two years put students in direct contact with patients so they can begin to apply the knowledge they've acquired.

Because of the sheer amount of knowledge they must master, doctors also complete residency training after med school. Residency is an apprenticeship period designed to further develop the doctor's fund of knowledge, critical thinking abilities, procedural expertise, and other important skills. Residents build upon the foundation laid during med school to gain the experience and judgment necessary to practice independently. And even after residency, doctors continue to study and learn. A core value of doctors everywhere is commitment to being a lifelong learner.

TL;DR: It's impossible for anyone to master all of the available information in any field. Everyone starts with lots of memorization before they can learn expert-level application.

I vote we rename residences to apprenticeships. I think calling myself an apprentice (hopefully some day) would be cooler than a resident.

 

[Mad Jack]

I vote we rename residences to apprenticeships. I think calling myself an apprentice (hopefully some day) would be cooler than a resident.

I call myself a second-rate bone wizard most days

 

[freedoctor17]

I call myself a second-rate bone wizard most days

You'll always be a first-rate bone wizard in my eyes <3

 

[FutureOncologist]

I'd say it's more than rote-memorization, in my opinion. You HAVE to apply knowledge, real-time, to not only succeed in medical school, but also save your patient's life.

For example, in undergraduate biochemistry II, I had to learn the basic physiology of the pancreas. In terms of the class, I learned M = B, C, and D + E. When Type I Diabetes affects the patient, B is lost. So how does the loss of B affect the body? It hits body parts P, Q, R, S, and T. That was child's play memorization. Maybe throw in a concept of "what happens if B is restored too quickly to the system?" But for the most part, elementary.

Medical School: You need to memorized A --> Z, all nerve innervations, and the upstream/downstream innervations that innervate those nerves that release B. But wait! What happens if Nerve F can't be parasympathetically innervated by Nerve E? How does that affect organ J if B can't be released? Also, tell me where in the spine Nerve E derives and what neurotransmitter is released during a parasympathetic response.

Now, the patient has T2D, is clinically obese, hypertensive, and has a hx of CAD and heart failure. In a state of metabolic acidosis, how would you treat this patient?

Edit: this is what you face during pre-clinical and clinical years of medical school. Yeah, you memorize more normal and pathological pathways than one person could every really want to know, but it goes so far beyond just memorizing 15,000 terms and body parts.

 

[stayathomemom]

Completely disagree. The human body is most definitely a concept to understand, if you don’t understand the concept then you won’t understand the details.

I would argue that as one advances in one's training it really does become more of a concept to be understood than a list of facts to be memorized. This is certainly the case in clinical medicine, where you begin to recognize patterns, understand cause and effect relationships, and predict downstream consequences of clinical decisions.

Ah, you are right. I really shouldn't have put it like that. I was looking at it through my own lens of learning.
Everything other than the very basic of physics is hard and slow for me to "get", but anatomy and physiology has always been super fascinating and easy for me to understand. If I'm taught it once, I don't really have problems with the application, but more of retaining it all.
See also: why I've always sucked at tutoring others. ("I don't understand why you don't understand")

 

[SouthernGent]

I vote we rename residences to apprenticeships. I think calling myself an apprentice (hopefully some day) would be cooler than a resident.

That's how I describe it to non med people. Med school = Trade school. Residency = Apprenticeship. Fellow = Journeyman. Attending = Master.