Guest mesoderm Posted October 19, 2003 Report Share Posted October 19, 2003 Hi Just a question. I'm not sure if its been asked before on this forum, but if it was can someone direct it to me? Thanks. For those of you who are in medical school, what do you LEAST LIKE about your education at this point? Thanks. Link to comment Share on other sites More sharing options...
Guest monksters Posted October 20, 2003 Report Share Posted October 20, 2003 Hi there, I haven't been in med school for long so I don't know if I am making a fair perspective. I must say that so far I have enjoyed every aspect of med school. I like the PBL format of UBC because it makes you want to learn. The cases we get usually present a mystery that you want to solve by doing some researching and discussing with your classmates. Family Practice is good because I can actually see patients! UBC also has a student run health center in the Downtown Eastside where students can volunteer and see patients as well. Anatomy is by far my favorite so far. The dissections are really fun to do and it is fascinating learning about how elegant our body design is. I am also excited about it because we learn so many things there that are clinically relevant. Histo is still interesting but by far the least interesting because most of the time is spent looking through a microscope. And most things look the same. Guess I need to spend more time studying it. Lectures are mostly interesting but definately depend on the prof Also there are so many social activities and other things to get involved in. Hockey, Jazz Band, Ski trips, Fundraising, PARTIES PARTIES PARTIES...! Link to comment Share on other sites More sharing options...
Guest drews97 Posted October 20, 2003 Report Share Posted October 20, 2003 I would say that so far I'm enjoying everything a lot (especially anatomy and the class social activities) but if I had to pick a least favorite part I would say (and most in my class would agree) that histology is fairly boring and, like monsters says, everything looks the same! Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted October 20, 2003 Report Share Posted October 20, 2003 I'd have to say hands down the overall disorganization of medical education. Not all my class would agree with me, but I find med school curriculae, or at the least UWO's curriculum, is highly disorganized. The problem is that the majority of the lectures are given by individual profs who lecture on a specific topic and then never see the class ever again. They often have no idea what the class has covered and what the class hasn't. . . as a result, some stuff is way over your head while other stuff you find you've had 5 lectures on it. And some key stuff falls through the cracks - at UWO, our coverage of antibiotics, surgery, pediatrics and anaesthesia was woefully thin before clerkship. Compounded to this in the fact that the profs are of course physicians and surgeons themselves and therefore very busy, not to mention some of them have little experience teaching and/or got roped into teaching being in an academic centre and hate it and/or just plain aren't very good teachers. Sufficed to say, while it might be a cliche, "Self Directed Learning" is key in medical school. If you don't do at least a little independent reading and just study strictly to pass the exams, you're not going to know enough to truly excel in clerkship. And while I can only truly comment on the UWO experience, I highly doubt this is isolated to UWO. I think it's inherent in medical education - few full time profs as you want clinicians to teach, but the $$ in teaching is peanuts compared to the $$ in clinical practice, so few docs want to teach full-time. This is pretty much true of ALL medical schools. When you have physicians presenting lectures only one at a time such that the presentation is disjointed and inconsistent, there's bound to be holes in the curriculum. But on the whole, I've had a mostly positive experience. I've learned a whole heck of a lot in my two and a half years of medical training. I just wished sometimes it were more organized, and that I didn't always have the nagging feeling something had been missed. Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted October 21, 2003 Report Share Posted October 21, 2003 Yags. :\ Those are some pretty disturbing comments. Definitely something that should be altered in the future. Do you know of any countries that take a more positive approach to medical education? Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted October 21, 2003 Report Share Posted October 21, 2003 Doubtful. As I iterated in my previous post, I think it's just inherent in the nature of medical school education. To add to what I said, and also something inherantly problematic in medical education from a clinical training perspective, medical education is somewhat dependent by patient's illness states and what they present with on rotations. You can't learn from a case of pancreatitis if none presents to your rotations. On my 6 week core Internal Medicine block, I saw a great variety of things but there was obviously a whole heck of a lot of things I never saw and therefore never learned to manage. Short of giving patients diseases to present with (such a ridiculous idea I won't even touch it) I don't see there is any way to control for this, at any school. Link to comment Share on other sites More sharing options...
Guest RAK2005 Posted October 21, 2003 Report Share Posted October 21, 2003 I totally agree with UWOMED2005. In fact, lectures have been a total waste of time for me, and about a third to a half (on some days!) skip class regularly. I learn the stuff at home from course notes, review packages and textbooks. Usually lecture note are of variable quality, and lecturers can be just as variable. Except for practical learning (clinical skills, etc), you could learn most of the didactic stuff yourself. That's another reason why 15k in tutition is so hard to swallow ! Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted October 21, 2003 Report Share Posted October 21, 2003 Damn skippy. $15k X 4 is a lot to pay for a piece of paper alone. I say they bring back old fashioned apprenticeship, like they had in the middle ages. I'm actually quite serious - apprenticeship is essentially what clerkship is, and it's been the most effective learning. 4 years of clerkship, with associated well organized lectures interspersed within and time to study on own (and some guidance as to what resources to use) seems to me like a much better system - particularly if you had a more organized premed system, ie mandatory dbl major or combined honours, with one half being a "premed degree" and the other anything the student chose - music, arts or whatever.. Link to comment Share on other sites More sharing options...
Guest jmh2005 Posted October 21, 2003 Report Share Posted October 21, 2003 Well, I unfortunately must also agree with UWO2005....SO TRUE, it is exactly the same at McMaster. Overall, I'm happy because this was SO where I wanted to be, and ultimately will pave the way for me to become a physician, but there are problems. There is little consistency among tutors (our main method of learning, PBL, requires good tutors) and not only does the quality of tutors leave a bit to be desired, the quantity is a huge problem! We barely had enough tutors for Unit 3 (heme, endo and GI blocks, 14 weeks)... they were telling us that we were going to have to learn in groups of 8...what a joke!! Thankfully some amazing faculty came forward to offer their time to tutor so we were able to keep the groups to a maximum of 6 (so much better for learning!). However, I don't really blame these docs for not wanting to tutor, it really is a thankless job, little to no pay or recognition for their time and if they have to deal with students who have issues, it can be mentally and physically draining. The same goes for clinical skills...there is so much inconsistency between preceptors. Most are really good, but some are down-right bad...and if you get a 'bad one' it really can impact on your learning. I have been fortunate that I have had good instructors and tutors, but I have friends who have had a negative experience or two. Also, you rarely ever see tutors who are Family Physicians...and we wonder why the Family Medicine interest is dying...we have little to no role models in this area and are always given our small and large groups by specialists! This is understandably a difficult situation... why would they wish to give up 2 afternoons per week in their office (and pay overhead among other things), for peanuts, when they can help their patients and get paid?? Again, with all this being said, I do love Mac and the programme as a whole, but when you are on the other side and paying 15+ grand, I guess I just expected it to be SO perfect...but when is anything perfect? Link to comment Share on other sites More sharing options...
Guest fox Posted October 22, 2003 Report Share Posted October 22, 2003 I can say there are two things I dislike about med school. The first thing that isn't so great is having class every day at 8am. Secondly, sitting through 8 or 9 hours of lecture in the same room is also killer. Luckily, it only happens to us once a week, but it is still brutal! Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted October 22, 2003 Report Share Posted October 22, 2003 Yeah, that is also another problem at UWO. Consistency in lectures AS WELL AS consistency in clinical methods and PCL group tutors is lacking (BTW our clin methods groups were 4 and our PCL groups something like 12.) Some are fantastic, and some I would describe as. . . well, let's just call them 'not so fantastic.' And yeah, we have had to juggle a lot our small groups the last few years as well. This problem of course is being exacerbated by the increases in med school enrolment. How many extra spots have been added in the last few years at Mac? It's not surprising jmh2005 that Mac and UWO are having problems finding enough tutors to keep the group size down considering how rapidly the classes have grown - we at UWO have grown 37 spots, or about 38% between the classes of 2003 and 2006. That's a big jump. Seemed great when we were applying, but now that we're on the other side and we're noticing the med education resources are being stretched. . . And I've noticed we at UWO don't use all that many family physicians for PCL and clinical methods (Though there are some who teach these classes here, and of course teach clerkship family med rotations). I'm not sure why - but if I had to guess it would be a combination of 4 factors: 1) Family Physicians as independent business owners operate outside the realm of the university so there might not be the communication lines in place to recruit them to teach. 2) Family Physicians as independent business owners have no obligations to teach medical students, and as I argued in a previous post, that might very well be the primary motivation for many of the academic specialists who teach us! After all, teaching is often poorer renumerated and less respected than clinical or research medicine. 3) Seeing as the renumeration in family medicine isn't what it is in internal medicine, and there's virtually no renumeration for teaching, it might be difficult to lure family physicians away from prime billing hours to teach classes. 4) (Complete and utter speculation on my part) - While our Dean of Medicine at UWO is a family physician herself by training, many of the faculty admin who set curriculum are academic specialists by training. And some specialists do have a bias against the skill-set of family physicians. . . it wouldn't surprise me all that much if that was one of the reasons the majority of our clin methods profs are internists. But really, the above is all just speculation. I'm not really certain why family physicians aren't more involved in our curriculum. And I'd like to reiterate I'm certain these issues are inherent to the nature of med schools themselves. Please don't think any less of UWO, Mac or Queen's just because we've come forward in acknowledging these issues! Link to comment Share on other sites More sharing options...
Guest phantom8 Posted October 22, 2003 Report Share Posted October 22, 2003 While most of our lecturers are usually specialists, I will say that I've had a lot of family docs for the 'smaller group' stuff that goes on in Calgary (i.e. clinical skills). I think it's a pity that family docs don't lecture more. So far this year we've only had 1 family medicine-oriented lecture -- "Headaches in Family Medicine." But really, why just headaches? Hypertension, diabetes, depression, etc. etc. are things you'll see over and over again in family med... it would be nice to hear how family docs handle these problems as opposed to specialists who have a lot more time and resources at their disposal. Self-directed learning is what med school is all about. While you're always hearing about how schools like students who are "independent learners," I admit that I never thought that med school would require SO MUCH independent learning. Gone are the days where you used to be able to argue that an exam question "wasn't fair" just because it wasn't covered in lecture or wasn't "in the book." Takes a little while to get used to it. I don't really see this as a negative in medical education, but it certainly puts the responsibility on the student. It's interesting that some of you have brought up how many of the lectures and tutors can be pretty poor, resulting in bad student turnout. The problem is that this is a perpetuating cycle, since it makes it harder to recruit good clinician-lecturers as a lot of them aren't so eager to present to a class in which only 25% of the students turn up for lecture! Link to comment Share on other sites More sharing options...
Guest jmh2005 Posted October 22, 2003 Report Share Posted October 22, 2003 UWO 2005 is right, enrollments have sky-rocketed, which is good...we need more physicians...for us here at Mac, the MD Class of 2003 graduated 108 students and my class of 2005 had 138 (with 4-5 more joing us after taking time off, doing an enrichment year, etc..) so we are now at 143 I believe...that too is a big jump in just 2 years! I just don't think that the resources have been increased to accomodate the numbers. A program such as ours can't be successful if the resourses, especially human/teaching resources aren't there! Thankfully, we don't have 8 hours of straight lectures every day like some schools, (good think that is only 1x/week out there in Edmonton!!)... so I guess I really shouldn't be complaining. Nice to see that Family Physicians are a bit more active in the cirricula in other schools...I wonder if there are any incentives for their participation? Great discussion folks! Link to comment Share on other sites More sharing options...
Guest UTMed07 Posted October 27, 2003 Report Share Posted October 27, 2003 What blew me away was the fact that the lecture notes I had for an undergrad anatomy course I took (at U of T) are a whole lot better that what I'm working from now. It seems there is some sort of inverse relation between cost and the quality of the lecture notes. I can't help think it is a cry'in shame; U of T has a really excellent group of medical illustrators. As for family physicians and medical education, I have the impression most family physicians just aren't interested in doing large group teaching. The people I know that want to do family tend to be more hands (want to see patients), don't love research and aren't so fond of book-learning. The university for these reasons doesn't have much to offer vis-a-vis their practice. I don't think money and organization are the real problem, whereas I imagine they don't help. Link to comment Share on other sites More sharing options...
Guest bad hombre Posted October 27, 2003 Report Share Posted October 27, 2003 Western: the lectures and partying are solid. most of the profs are solid. PCL (our PBL) is a load of @#%$. i can't believe some schools have their entire curriculums based on it. Link to comment Share on other sites More sharing options...
Guest dakar Posted October 28, 2003 Report Share Posted October 28, 2003 Agreed. It's a good thing most schools don't have curricula based on Western's PBL. party on, dude. Link to comment Share on other sites More sharing options...
Guest jmh2005 Posted November 8, 2003 Report Share Posted November 8, 2003 Well, in my opinion, McMaster has it when it comes to PBL...it's too bad Western hasn't figured it out...they should come for a visit it's only just over an hour to visit Link to comment Share on other sites More sharing options...
Guest McMastergirl Posted November 8, 2003 Report Share Posted November 8, 2003 I've got to agree with all of you who say that medical education is disorganized! Actually I'm a bit relieved to hear it isn't just Mac! How many times have I wished that someone would write a book called "Everything you need to know to be an MD." (but I guess that wouldn't be very self-directed!) Link to comment Share on other sites More sharing options...
Guest moo Posted November 8, 2003 Report Share Posted November 8, 2003 Even at my school (a "top 20" school) where I pay 35000/year, it's very disorganized. I mean, at times we get excellent teachers and the first two units this year were just awesome. We had great profs, good notes, pretty much we knew what our learning objectives are. Then all of a sudden, this block (heme, onc, endo) things are so disorganized. We had one arrogant prof who couldn't stop bragging about his Hopkins education and who didn't want to post his slides on the net cuz he said that he never got that luxury 20 years ago. That combined with his dinky syllabus led to major revolt by us and he finally posted it. Then we had this guy give us a couple lectures on AML and CML and all he could talk about was clinical trials and all the amazing drugs that are coming out... he hardly even defined the diseases, let alone the signs and symptoms, lab stuff, etc. Link to comment Share on other sites More sharing options...
Guest macMDstudent Posted November 9, 2003 Report Share Posted November 9, 2003 I agree that I was quite surprised how unorganized everything seemed to me when I came to McMaster. Perhaps I was expecting too much, but it seems to me that there is a fine line between letting us be self directed; and letting us spin our wheels and not providing us with some basic organization. It seems that something as basic as having our group lists and our tutorial problems ready on time at the start of the unit (or even before hand so that we can actually plan ahead) would not be something we as students should have to worry about and deal with time and time again. I agree with others that it is frustrating to have a lecture by a specialist who does it once per year, has no clue what our other lectures have been in or even where we are in the curriculum. They often assume (judging by their comments) that the whole class is a bunch of young, niave people who have not learned anything yet; completely forgetting that there are people in our class with a wealth of knowledge including foreign trained MD's, nurses, PT's OT's, Ph.D's etc. As an aside, the closest thing I've seen to an "everything you need to know" book is the MCCQE Review Notes (aka Toronto notes). Granted, you need lots of basic knowledge to understand them, but it seems to have a little bit about everything. If more detailed info is required for something, obviously other resources would be required. But as summary of topics, it is quite exhaustive and current (IMHO). Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted November 9, 2003 Report Share Posted November 9, 2003 I agree we need to be excellent self-directed learners, particularly in an age where all the therapies change on a yearly basis and pharm reps love to prey on unknowledgeable physicians. But I find "self directed learning" easily becomes an excuse for deficits in the curriculum. "Oh you don't know any anatomy?* Didn't you know that was what you were supposed to teach yourself in self-directed learning? Comeon, you're smart enough to get into med school? Couldn't you READ OUR MINDS and figure out what we weren't teaching you? I spent most of 1st and 2nd year with this nagging awful feeling that there were key concepts that we were missing being assigned to "Self-directed learning." I remember noting that we never covered Tourette's or Huntingdon's disease, and thinking to myself "Umm, if I can note that they're not covering these diseases and I have only a partial medical education, what is there that I DON'T EVEN KNOW ABOUT that we're not covering?" *I'm being completely facetious on the anatomy example. I'd say anatomy is one of the STRONGEST things in the UWO curriculum. Link to comment Share on other sites More sharing options...
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