Will med schools move to a model where you can skip the basic sciences?

[calimeds]

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Sorry if this has been discussed to death, but are any medical schools implementing programs where you can show up, test out of the basic sciences, and get on with the business of learning medicine?

In the world we live in, anybody with an internet connection and a bit of self discipline can teach themselves the sciences in a far more time-efficient and cheap way than paying a med school $100K for the privilege of spending 2 years trudging to a lecture hall to watch a bunch of powerpoints on somebody else's time schedule.

 

[VisionaryTics]

Sorry if this has been discussed to death, but are any medical schools implementing programs where you can show up, test out of the basic sciences, and get on with the business of learning medicine?

In the world we live in, anybody with an internet connection and a bit of self discipline can teach themselves the sciences in a far more time-efficient and cheap way than paying a med school $100K for the privilege of spending 2 years trudging to a lecture hall to watch a bunch of powerpoints on somebody else's time schedule.

No.

And thanks, pre-med, for your insight on the value of pre-clinical education.

 

[mvenus929]

I doubt it, and I don't think it'd necessarily be good even if they did. Surprising as it may be, you do actually learn some things during the first two years that can't be taught from a book--physical exam skills, interviewing skills, etc. Sure, there's a big learning curve switching to the clerkships, but generally students at least know how to take a history and do a physical exam, even if they're not very good at it yet.

 

[thethethe]

If they did that, what separates us from pa or np?

 

[Donald Juan]

I'd be really interested in seeing how many students fresh out of undergrad could just test out the basic sciences. I think the OP should study real hard for the next 6 months and go take NBME 15. When you ace it first try your plan will have some merit.

 

[dienekes88]

To some extent, I think this is the Yale system. A lot of self-directed study. No grades. Maybe someone more familiar with the program can weigh in on it. For many people - me included, it's good to have structure.

One of the issues I'm finding is that students and interns have a very poor grasp of the basic sciences in the context of the ward or ICU. Sure they can answer a multiple choice question or respond correctly if asked directly, but translating that basic science to the ward seems to be very difficult for most people.

Medical education isn't perfect at this time. We need a better means of drilling the fundamentals of physiology, pathophysiology, and pharmacology.

 

[calimeds]

I doubt it, and I don't think it'd necessarily be good even if they did. Surprising as it may be, you do actually learn some things during the first two years that can't be taught from a book--physical exam skills, interviewing skills, etc. Sure, there's a big learning curve switching to the clerkships, but generally students at least know how to take a history and do a physical exam, even if they're not very good at it yet.

Right - I should've clarified - all the stuff you mentioned is part of medicine. That would seem logical for stuff to leave "in" in med school.

 

[calimeds]

I'd be really interested in seeing how many students fresh out of undergrad could just test out the basic sciences. I think the OP should study real hard for the next 6 months and go take NBME 15. When you ace it first try your plan will have some merit.

Donald Juan - that isn't what I meant. I'm sure you're right - most people could not test out. I imagine I coudn't either.

What I should've explicitly stated was, in a world in which courses, tutorials, exam prep materials are free or low cost online it would save many med students a ton of money if they didn't have to pay for the pure sciences, and could study on their own time for a couple years, then demonstrate they knew the material, thus skipping a ton of additional student debt.

This capability didn't exist 15 years ago - and back then, the argument that in-person science lecture courses provide at least a modicum of value worth paying for had merit.

I built and funded a non-profit accredited online undergrad chemistry course with one of my professors - which we did because of the same reasoning - that faculty standing around lecturing have no justification for existing today's world. He changed to a model of making students watch lectures prior to class, class became optional, and those who wanted to show up got to use his class time to do problems together.

That experience got me thinking about the economics of med school. The first two years must be a cash cow that pays for institutional research, faculty salaries etc.

My guess is that models like straighterline.com, and the MOOC platforms from the likes of Coursera and that other program that M.I.T. is involved in, will eventually revolutionize med schools. But the monopoly power of accreditation bodies is a tough thing to overcome.

 

[calimeds]

If they did that, what separates us from pa or np?

presumably the body of knowledge and the skillset an M.D. is expected to possess is what separates them from pa's and np's.

We aren't discussing the knowledge or the skillset - just the delivery method and economics of learning the core sciences.

 

[Kal EI]

Donald Juan - that isn't what I meant. I'm sure you're right - most people could not test out. I imagine I coudn't either.

What I should've explicitly stated was, in a world in which courses, tutorials, exam prep materials are free or low cost online it would save many med students a ton of money if they didn't have to pay for the pure sciences, and could study on their own time for a couple years, then demonstrate they knew the material, thus skipping a ton of additional student debt.

This capability didn't exist 15 years ago - and back then, the argument that in-person science lecture courses provide at least a modicum of value worth paying for had merit.

I built and funded a non-profit accredited online undergrad chemistry course with one of my professors - which we did because of the same reasoning - that faculty standing around lecturing have no justification for existing today's world. He changed to a model of making students watch lectures prior to class, class became optional, and those who wanted to show up got to use his class time to do problems together.

That experience got me thinking about the economics of med school. The first two years must be a cash cow that pays for institutional research, faculty salaries etc.

My guess is that models like straighterline.com, and the MOOC platforms from the likes of Coursera and that other program that M.I.T. is involved in, will eventually revolutionize med schools. But the monopoly power of accreditation bodies is a tough thing to overcome.

Medical schools aren't designed to save student's money or time.

 

[yehhhboiii]

you're not paying them for the education
you're paying for legitimacy

 

[manticus]

There are of course some subjects that couldn't be taught online, anatomy with cadavers, physical exams, etc. But for many of my classes I just stream the lecture from home and study a syllabus on my own time anyways, which is essentially what he is suggesting. I don't think medical schools are ever going to relinquish their control over basic science education though. Plus it is nice to have faculty you can approach with questions and I think it would be really depressing to just have self-study school for 2 years. It is nice to interact with other students, work in small groups, have older student and physician mentors, participate in interest groups, shadow, volunteer etc.

 

[johnmendes]

you're not paying them for the education
you're paying for legitimacy

This x1000000000000000

You make your own education and hope that your medical school doesn't stop you from doing it.

 

[mvenus929]

Right - I should've clarified - all the stuff you mentioned is part of medicine. That would seem logical for stuff to leave "in" in med school.

But if you skip basic sciences and just jump into clerkships, where are you going to put that information? It does take time to learn, so it's not like you can have a boot camp prior to clerkships starting and learn it all in 2 weeks.

 

[lesterfreamon]

There is more to preclinical years than passing tests. I hope they never have this it's a terrible idea.

Maybe compress preclinical years but definitely not make it optional wtf lol

 

[Law2Doc]

Sorry if this has been discussed to death, but are any medical schools implementing programs where you can show up, test out of the basic sciences, and get on with the business of learning medicine?

In the world we live in, anybody with an internet connection and a bit of self discipline can teach themselves the sciences in a far more time-efficient and cheap way than paying a med school $100K for the privilege of spending 2 years trudging to a lecture hall to watch a bunch of powerpoints on somebody else's time schedule.

No schools are considering this for the near term and its likely not going to happen. Some schools have cut down the in class hours to allow for a bit more self study or research during the first two years, and many places stream lectures over the Internet so you can watch them remotely, but generally not with the goal of getting you on the wards earlier. Why? Because it still takes about two years for the average person to learn what he needs as foundation. There's a lot to learn, and not many people master it completely on their own based on their undergrad study skills. What you are suggesting is akin to throwing a small child into the deep end of a swimming pool in lieu of swimming lessons. I suppose sometimes it works out but nobody is going to tell you that's a good idea either.

Also most schools have now incorporated some clinical skills classes into the first two years to appease those who simply can't wait to "play doctor", but honestly there is good value in the progression of basic sciences to clinical years, both as foundation and in terms of learning things you will actually need. You learn a lot from working with classmates, instructors, cadavers, simulators. As you progress through med school and beyond, you will realize that what they can pack in four years is just the tip of the iceberg of what you really would have loved to learn. Be thankful they are squeezing things into just four years as a compromise.

 

[Microshaft]

why don't they just make the MD a bachelors degree already jesus

 

[michaelrack]

. What you are suggesting is akin to throwing a small child into the deep end of a swimming pool in lieu of swimming lessons. I suppose sometimes it works out but nobody is going to tell you that's a good idea either.

.

Are you saying that I am a bad parent?

 

[mirimonster]

What you are proposing would only cut about 5-6 hours out of my time on campus, and about half of my class is already doing that via streaming 4 weeks in. you seem to think that all you learn in the first 2 years is biochemistry and physiology, but in reality there is a lot more going on. In my first month of school I've already interviewed a standardized patient (sounds a little premature, but right now we're working on communication skills - how to ask the right questions to get the information you need, etc). Every day that I have my basic science classes, they present clinical correlates including real patients who visit and talk to us (those classes are rightly required). My anatomy class is entirely lab based. There are recorded lectures if you want them, but it's really learn however works for you. Believe it or not you need to do anatomy in person because you're going to have to know anatomy on real live people, not just a netter model.

Basically I think schools have reached the same conclusion as you already. Most are moving toward optional and recorded lectures for stuff you can learn at home, limiting class hours to things that need to be done and practiced in person. They test you regularly and give you checkpoints for those who need structure (like me), but mostly you're free to study however you need to study. So although you could condense pre-clinical, I doubt they'll ever do away with it, because you do a lot more the first two years than trudge to class just to listen to some guy talk about his basic science research (although that does happen too).

 

[michaelrack]

why don't they just make the MD a bachelors degree already

that would be nice. A reform I think would also make sense would be to separate the 2 preclinical from the 2 clinical years. A master's degree could be offered after the preclinical years, or it could be part of a bachelor's degree.

 

[calimeds]

Because it still takes about two years for the average person to learn what he needs as foundation. There's a lot to learn, and not many people master it completely on their own based on their undergrad study skills.]

Agreed, I wasn't suggesting it could be done any quicker than that.

 

[Barcu]

The biggest flaw with this plan is how are you going to make the time to study all this stuff independently? Yeah, med school is expensive, but it also provides you two years of dedicated study time. How long would it take if you actually had to hold down a job and make extra money? Is a bank going to give you a loan to cover living expenses so you can self-study for a year or two? And what if you don't get in after that? I think it would be disastrous for some people and I think most people overestimate their ability to do this without the structure of med school. Even if you don't go to class at all, the access to materials and structure and resources is still very valuable. I don't think a prep course could provide all this (and again, whose going to give you money to just study?).

Med school provides you the time to study, gives you some early exposure to patients and physical exam skills (and is moving more and more in that direction), and it pretty much guarantees you will graduate with an MD after all that work. It's expensive and could be improved, but I think the system works pretty well.

 

[Laryngophed]

Are you saying that I am a bad parent?

He's not saying you're a good parent.

 

[Law2Doc]

...

 

[Law2Doc]

Well, your initial post notion of "testing out" of things and saving $100,000 kind of implied that.

Just my own nonscientific limited personal observation -- the people ive known personally who were most vocal about shortening the preclinical years, skipping things, wasted time, finding shortcuts or being scutted tended to end up being the people with the weakest foundations who really needed all this hand holding the most. The people who were self starters, who would buckle down and learn their stuff regardless of the format rarely fretted about this kind of thing. Also most people end up surprised as to how unprepared they are for med school from college -- it's a different set of skills. And about 50% of the A students who got into med school were shocked to learn that, as opposed to college where they coasted to the upper echelon of the class, in med school they were suddenly below average.

 

[Food]

Well, your initial post notion of "testing out" of things and saving $100,000 kind of implied that.

Just my own nonscientific limited personal observation -- the people ive known personally who were most vocal about shortening the preclinical years, skipping things, wasted time, finding shortcuts or being scutted tended to end up being the people with the weakest foundations who really needed all this hand holding the most. The people who were self starters, who would buckle down and learn their stuff regardless of the format rarely fretted about this kind of thing.

Agreed - always be wary of one who speaks of circumventing education in fundamentals and basics. They define the syndrome of illusory superiority.

 

[notbobtrustme]

At the same time, there is a ton of fluff that could be cut out and no one would be the wiser. There are 2-4 lectures each block/system that are basically seminars of the research of the teaching professor.

 

[mvenus929]

At the same time, there is a ton of fluff that could be cut out and no one would be the wiser. There are 2-4 lectures each block/system that are basically seminars of the research of the teaching professor.

Varies by school. My school has a 1.5 year preclerkship curriculum, and there's relatively few lectures on the research of the professor... sometimes, it'll be mentioned a couple times during a presentation, but the presentation is always about a bigger concept.

 

[deleted6669]

if they did that, what separates us from pa or np?

the residency....

 

[KnuxNole]

Basic sciences IS medicine....

And didn't you guys learn in college you do NOT pay for lectures, you pay for a degree? In undergrad, there are so many people that don't even show up. In med school, you learn on your own anyway...since noone is ever gonna spoonfeed you information. Teaching to a test only is very weak-minded.

 

[tiedyeddog]

Basic sciences IS medicine....

And didn't you guys learn in college you do NOT pay for lectures, you pay for a degree? In undergrad, there are so many people that don't even show up. In med school, you learn on your own anyway...since noone is ever gonna spoonfeed you information. Teaching to a test only is very weak-minded.

yup.

also, OP, you are in for a rude awakening during 3rd year when you realize you're paying 40K a year to work.... Not all of (maybe a small fraction?) of third + fourth year has educational value......

 

[Law2Doc]

yup.

also, OP, you are in for a rude awakening during 3rd year when you realize you're paying 40K a year to work.... Not all of (maybe a small fraction?) of third + fourth year has educational value......

It's mostly what you make of it. And you'll see in residency you didn't really do that much "work" on the wards while in med school.

 

[Kal EI]

At the same time, there is a ton of fluff that could be cut out and no one would be the wiser. There are 2-4 lectures each block/system that are basically seminars of the research of the teaching professor.

This still is assuming that the curriculum is designed to be maximally effective, efficient, and economical. It's not.

 

[Kahreek]

basic sciences sucks, then you go clinical, you'll like it, but then you will want to know more and explain some things, and back to the basic sciences you go, only then you are amazed how valuable was that education. You graduate not to know it all, but to be able to study and do your own research and self learning later in your career, so you can have a clinical reasoning to choose and apply new treatments, etc ,etc, yadda yadda
It is the foundation, after that you decide how you built it or even if it is worth to build it at all

 

[tiedyeddog]

It's mostly what you make of it. And you'll see in residency you didn't really do that much "work" on the wards while in med school.

two points here

1. you get paid in residency. I expect to do whatever I am told in residency, no matter if I am learning or not. I expect the hours to suck, I expect there to be tons of busywork. Btw, nowhere in my post did I complain about the volume of "work" I have done in 3rd year. Not sure where you got that from.

2. I agree with you to an extent. I love rotations where attendings and residents have tons of time to teach, or any time no matter how little. Sometimes you just get shafted on what service you get put on. If you are stuck with an attending who won't let you interview patients or present them, your time is wasted. If you are stuck with residents who don't have time to teach/don't want to teach, your time is wasted. If you're writing tons of progress tons/H&P's that higher ups aren't really critiquing or don't care to read, your time is wasted. It's just that simple.

We have to go home and study at night regardless of what occurs while in the wards, that's a fact. Learning handed down from those who have experience is not something medical students can control.

 

[514901]

It's mostly what you make of it. And you'll see in residency you didn't really do that much "work" on the wards while in med school.

This is not true

 

[Law2Doc]

...
We have to go home and study at night regardless of what occurs while in the wards, that's a fact. Learning handed down from those who have experience is not something medical students can control.

you will go home and study in residency too, probably moreso.

 

[Law2Doc]

This is not true

This has been addressed in another thread, where several US residents, including myself, explained why it is. You apparently aren't a US med student, so FWIW I don't think you can realistically contribute to a discussion on US allo med student life.

 

[phonyreal98]

That experience got me thinking about the economics of med school. The first two years must be a cash cow that pays for institutional research, faculty salaries etc.

Nope. Grant money pays for research and faculty salaries.

 

[link2swim06]

You COULD test out of the basic sciences self-studying on your own if it was broken up by subject.



I'd guess less than 10% of med students could learn all of step 1 stuff without being enrolled in some sort of med school and being set on a schedule.

However, most med students could self study a subject like micro for a few months and then pass the subject nbme for it. Over the course of 1.5 years of self study you probably could go through all the subjects on your own and then take and pass step 1. This would be without enrolled in any med school.


Granted you still need to be taught gross anatomy and physical exam in a more formal environment.

 

[link2swim06]

Nope. Grant money pays for research and faculty salaries.

Ya but the school often shares the cost with the researchers to build and then maintain the buildings they work in.

This is not a small cost when multi-million dollar buildings are built every decade. Plus maintaining big buildings with specialized needs isn't cheap either.

 

[calvnandhobbs68]

you will go home and study in residency too, probably moreso.

Come on, don't even try to pretend that residents spend most days off studying. Yes, you'll need to study for Step 3 or licensing exams at some point but you aren't going home every night to study because you aren't taking a test every 4-12 weeks that determines your grade for that time period.

Every resident I've been on service with told me being a medical student sucks and they would way rather be a resident than be back as a student.

 

[KnuxNole]

Come on, don't even try to pretend that residents spend most days off studying. Yes, you'll need to study for Step 3 or licensing exams at some point but you aren't going home every night to study because you aren't taking a test every 4-12 weeks that determines your grade for that time period.

Every resident I've been on service with told me being a medical student sucks and they would way rather be a resident than be back as a student.

While I agree with the bolded, there is reading involved as a resident too. The difference? The reading is for your education, to reinforce what you are doing on the wards/clinic so that you'll have a stronger grasp to manage and/or work up similar patients. Besides board exams, there isn't a test to study for, which is good. In a way, it makes reading better, because you aren't doing it to study for a multiple choice test. I read nightly, but it's not bad at all. After all, an hour a night doesn't kill anyone. To be honest, I think that's more than what most people do...30 mins to read a topic daily isn't unheard of at all.

Even as a med student, you only need to read an hour or so a night to do fine on shelf exams. So it's not like 3rd year med students are studying till they are blue in the face. A few days before, you can crank it up a notch. 3rd year is definitely not as bad as studying for hours on end in the first 2 years!

 

[todds]

Come on, don't even try to pretend that residents spend most days off studying. Yes, you'll need to study for Step 3 or licensing exams at some point but you aren't going home every night to study because you aren't taking a test every 4-12 weeks that determines your grade for that time period.

Every resident I've been on service with told me being a medical student sucks and they would way rather be a resident than be back as a student.

I honestly study probably just as much if not more in residency than i did as a medical student on wards.

Im just much more efficient at studying at the hospital and after work. To those who say you don't study as much in residency, i don't know how thats possible. You are constantly being evaluated just not by tests.

Sure you don't have exams monthly, but you have have WAYYYY higher expectations, at least if you're in a good residency program. You expected to know things by a certain time. You are expected to understand and know management, in depth understanding of pharmacology/diagnostic testing, being able to quote clinical studies. I'm surprisingly constantly learning more in-depth basic science stuff, reading more in depth on pharmacology especially

You get pimped all the time and are expected to contribute during grand rounds, morning report etc... If you are not showing any progress in your knowledge base/aptitude, you will get poor evaluations and perhaps have a talk with your PD.

Its true that being a resident is way better than being a medical student. You have a lot more autonomy, actually feel like you are making more of a difference for patients, probably doing more of what you're are interested in. On the flip side, a lot more stress/weight on your shoulders. You cannot just find somebody else on call when s**t hits the fan, you gotta try to deal with it yourself.

 

[KnuxNole]

I honestly study probably just as much if not more in residency than i did as a medical student on wards.

Im just much more efficient at studying at the hospital and after work. To those who say you don't study as much in residency, i don't know how thats possible. You are constantly being evaluated just not by tests.

Sure you don't have exams monthly, but you have have WAYYYY higher expectations, at least if you're in a good residency program. You expected to know things by a certain time. You are expected to understand and know management, in depth understanding of pharmacology/diagnostic testing, being able to quote clinical studies. I'm surprisingly constantly learning more in-depth basic science stuff, reading more in depth on pharmacology especially

You get pimped all the time and are expected to contribute during grand rounds, morning report etc... If you are not showing any progress in your knowledge base/aptitude, you will get poor evaluations and perhaps have a talk with your PD.

Its true that being a resident is way better than being a medical student. You have a lot more autonomy, actually feel like you are making more of a difference for patients, probably doing more of what you're are interested in. On the flip side, a lot more stress/weight on your shoulders. You cannot just find somebody else on call when s**t hits the fan, you gotta try to deal with it yourself.

At least with the first few months of intern year, you can always mass text your senior who's on call with you when your patient starts to crash in the evening to find out what to do 😳

 

[calvnandhobbs68]

I honestly study probably just as much if not more in residency than i did as a medical student on wards.

Im just much more efficient at studying at the hospital and after work. To those who say you don't study as much in residency, i don't know how thats possible. You are constantly being evaluated just not by tests.

Sure you don't have exams monthly, but you have have WAYYYY higher expectations, at least if you're in a good residency program. You expected to know things by a certain time. You are expected to understand and know management, in depth understanding of pharmacology/diagnostic testing, being able to quote clinical studies. I'm surprisingly constantly learning more in-depth basic science stuff, reading more in depth on pharmacology especially

You get pimped all the time and are expected to contribute during grand rounds, morning report etc... If you are not showing any progress in your knowledge base/aptitude, you will get poor evaluations and perhaps have a talk with your PD.

Its true that being a resident is way better than being a medical student. You have a lot more autonomy, actually feel like you are making more of a difference for patients, probably doing more of what you're are interested in. On the flip side, a lot more stress/weight on your shoulders. You cannot just find somebody else on call when s**t hits the fan, you gotta try to deal with it yourself.

Nobody is evaluating you at morning report or grand rounds, at least not anywhere I've been. You just show up and answer questions generally asked to the room. This is kinda what I mean, don't act like some things are more than they are.

As for the other things...come on man medical students get pimped on that exact same stuff. Yeah you have more patients you get asked about but I've yet to hear a question posed to a intern that was somehow deeper than something I'd be expected to know from reading uptodate. Not as much management wise but on the flip side, whenever a question pops up about the molecular mechanics or basic science behind something the medical student is on the spot becuase "you just took step 1 so you should know this right?".

I'm not saying being an intern/resident isn't HARDER than being a third year because there's absolutely no doubt about that. I just think that most third years have to do more studying on a daily basis than most interns/residents and the residents I've worked with seem to think the same thing. Of course, this would make sense as we're years behind you guys in experience. It'd be like saying I think residents study more than attendings...I don't think anyone would disagree with that.

 

[Anastomoses]

Wouldn't the amount of studying done during residency also depend on the type of residency? Which residents have a notorious bulk of studying to do?

 

[KnuxNole]

Maybe I'm at a disconnect, but the amount of reading time for 3rd years isn't that bad to begin with. Like you said, maybe it's an experience thing, or maybe I'm having early dementia 😳

It's much less as a 3rd year compared to 1st and 2nd, that I believe everyone can agree on. Which is one thing I liked about rotations, depending on downtime, you can go home and not worry about studying. After all, after a day of rotations, it's overkill to go home and read for 4-5 hours...unless it's like the week of the exam or something. 6 weeks for OB for example is more than enough time to get through Blueprints in one pass and be ok for the shelf.

However, calvin, I see where you are coming from in terms of needing to study to pass/honor a rotation which is based on a shelf. That feeling can suck. I'm not sure which rotations you've done, but a lot of services give you time during the day where you can get through some reading. IM for example has a lot of info to know, but there will be time to read all of it, trust me. I thought I would never finish Step Up to medicine but found that I was able to do so just fine. Same feeling with most of my peers.

Utilize your downtime wisely! Be active and involved in rotations, but when your resident says you can go read something for a bit, do it! It's not a trick or a test, when residents tell you to go read, they are basically saying "Yeah, we have nothing for you. You can stand and watch me do discharge paperwork, or do something productive".

 

[Charles_Carmichael]

two points here

1. you get paid in residency. I expect to do whatever I am told in residency, no matter if I am learning or not. I expect the hours to suck, I expect there to be tons of busywork. Btw, nowhere in my post did I complain about the volume of "work" I have done in 3rd year. Not sure where you got that from.

2. I agree with you to an extent. I love rotations where attendings and residents have tons of time to teach, or any time no matter how little. Sometimes you just get shafted on what service you get put on. If you are stuck with an attending who won't let you interview patients or present them, your time is wasted. If you are stuck with residents who don't have time to teach/don't want to teach, your time is wasted. If you're writing tons of progress tons/H&P's that higher ups aren't really critiquing or don't care to read, your time is wasted. It's just that simple.

We have to go home and study at night regardless of what occurs while in the wards, that's a fact. Learning handed down from those who have experience is not something medical students can control.

I agree with most of your points. I've been lucky enough to have wonderful residents and attendings who spent a good amount of time teaching so far, so I've been really enjoying 3rd year. As cheesy as it sounds, it's incredible how much I've learned over the past 3 months.

Regarding the bolded, that's not limited to just us med students. The residents I worked with were absolutely reading in their free time at the hospital, at home, etc. They'd be reading the bigger, specialty-specific textbooks (plus UpToDate) and actual clinical studies, while I'd be reading mostly out of review books for the shelf exam (and UpToDate). I'm pretty sure I've had it easier than my interns and residents so far, even with the rough schedule of surgery.

Come on, don't even try to pretend that residents spend most days off studying. Yes, you'll need to study for Step 3 or licensing exams at some point but you aren't going home every night to study because you aren't taking a test every 4-12 weeks that determines your grade for that time period.

Every resident I've been on service with told me being a medical student sucks and they would way rather be a resident than be back as a student.

I think that has more to do with the fact that, as a resident, you're doing much more meaningful stuff than you are as a med student. Plus, you're actually in the field that you want to spend the rest of your career in -- that's absolutely a morale boost compared to doing clerkships in specialties you're not interested in. Their opinion also matters much more than ours -- that's got to feel a lot better too!

I honestly study probably just as much if not more in residency than i did as a medical student on wards.

Im just much more efficient at studying at the hospital and after work. To those who say you don't study as much in residency, i don't know how thats possible. You are constantly being evaluated just not by tests.

Sure you don't have exams monthly, but you have have WAYYYY higher expectations, at least if you're in a good residency program. You expected to know things by a certain time. You are expected to understand and know management, in depth understanding of pharmacology/diagnostic testing, being able to quote clinical studies. I'm surprisingly constantly learning more in-depth basic science stuff, reading more in depth on pharmacology especially

You get pimped all the time and are expected to contribute during grand rounds, morning report etc... If you are not showing any progress in your knowledge base/aptitude, you will get poor evaluations and perhaps have a talk with your PD.

Its true that being a resident is way better than being a medical student. You have a lot more autonomy, actually feel like you are making more of a difference for patients, probably doing more of what you're are interested in. On the flip side, a lot more stress/weight on your shoulders. You cannot just find somebody else on call when s**t hits the fan, you gotta try to deal with it yourself.

Sounds pretty similar to the residents I've worked with.

 

[tiedyeddog]

I just want to clarify that I absolutely wasn't trying to say residents and attendings don't study or read outside the hospital, I know they do and that is a reason why I am becoming a doctor. The whole life long learner thing is great.

I was just trying to say that it doesn't matter if I get a little or a lot of education from the attendings and residents while on the wards. Studying is something we have to do to pass shelves. I don't have to pay 40 grand to go home and read uptodate or do a literature search or memorize Lawrence's surgery essentials, I can do that without going into debt. I could get a 99 percentile on a shelf and still have been taught nothing on the wards outside of what I read myself, and that is NOT what I am going to debt for.

I am paying 40 grand a year to be taught in how to practice medicine and ,most of the time, learning it depends on how much the attendings and residents are willing to teach or have time to teach. Also, there is quite a bit of stuff we are to do of the wards that is non educational.