Does M1 and M2 serve a real purpose?

[Smurf Account]

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[Slack3r]

In this thread: M1s explaining what is relevant to clinical medicine.

 

[Shaq]

M1 and M2 basically comes down to what you put into it. Simply sitting in lecture and going through the motions isn't enough. There is a lot of information to learn and you not only have to get the facts down, you have to learn them at a deep level and think in an integrated fashion about what you are learning. The people who just memorize and do well in M1 and M2 are underprepared despite all their hard work because they train themselves to DO, not THINK.

 

[DermViser]

In this thread: M1s explaining what is relevant to clinical medicine.

That's always fun to hear. Hubris starts early in the M1 student.

 

[Bryan O’Blivion]

I learned a crazy amount in M1-M2. I think it was completely worth it. Sure, it was expensive, but it was the only time in my life where I was free to do nothing but learn, that is, except for high school, which WAS a waste of time. These "why do I have to learn this" threads make me wonder what people are doing in medical school. Did you not anticipate having to learn about how the human body works? If you just wanted to learn algorithms and get paid, you picked the wrong profession. Everything (almost everything) is useful. You will learn how to apply it in your clinical years, particularly if you use your head.

I have taught myself several subjects through self study, but it is pretty hard to do this and master the amount of material that you learn in medical school. Having guided study is pretty helpful. It is a pretty efficient way to learn things. When you are teaching yourself, you often spend a lot of time trying to figure out how to organize your learning, and trying to figure out what is important. You do learn well when you figure things out for yourself, but it is definitely more efficient to have someone who already knows simply tell you, or correct erroneous thinking before you waste a ton of time coming to dead ends.

Sorry you are bogged down. If you try to find it interesting, it will be better for you.

 

[Elisabeth Kate]

I learned a crazy amount in M1-M2. I think it was completely worth it. Sure, it was expensive, but it was the only time in my life where I was free to do nothing but learn, that is, except for high school, which WAS a waste of time. These "why do I have to learn this" threads make me wonder what people are doing in medical school. Did you not anticipate having to learn about how the human body works? If you just wanted to learn algorithms and get paid, you picked the wrong profession. Everything (almost everything) is useful. You will learn how to apply it in your clinical years, particularly if you use your head

Agreed, except when it comes to embryo. I'd love to go my whole life without hearing about endocardial cushions again.

 

[mulberry]

Agreed, except when it comes to embryo. I'd love to go my whole life without hearing about endocardial cushions again.

Sucks to suck! Our embryo prof would give us a review ppt a few days before the test and would stress what we should review. Most anatomy tests only had ~4 embryo questions (minus the shelf). I can't say I remember anything from embryo because I would be lying.

 

[Bryan O’Blivion]

@Elizabeth Kate, re embryo: Lots of people say that, but I disagree. I find embryo pretty useful, particularly in cardiology, as you point out, as well as in pediatric neurosurgery. I find it useful to remember the developmental process when understanding the 3 dimensional relationship of organs to one another, as well as variations on this, when learning radiology. I also liked the subject for its own sake.

If there was one class in M1-M2 I could have done without it was a behavioral science/psychology class. It was sort of interesting, and I liked the lectures and lecturers, but I think I would have done fine having it being a week's assigned reading. Maybe I missed the point. Some of the pre-clinical electives I took were a little weak as well, but maybe that was a result of my own poor choices in selecting them.

 

[Priapism4tooLong]

I thought endocardial cushions was the easiest thing in embryo lol, cuz I can still kind of remember that. Anyway if you know embryo, then you know anatomy. Easy peasy chicken squeezy.

 

[DermViser]

Agreed, except when it comes to embryo. I'd love to go my whole life without hearing about endocardial cushions again.

Endocardial cushion defect --> Down syndrome.

 

[DrBodacious]

It's total bull, but then again most of life is bull.

I'll eat my words if Charcot Marie Tooth disease ever comes up in clinic. But I doubt it.

Psych was cool though.

C-M-T has a prevalence of 1 in 2500. Funny name, but not that rare.

 

[D elegans]

They are definitely essential. Imagine starting third year without them. You will revisit concepts from those years throughout your training. You can also tell the knowledge base difference between a doc in training and midlevels, bc once you start digging into the details of pathophysiology, immunology, whatever you will find you know more than you think you do and that it makes you a better provider

 

[coffeesnob]

If you just jump in and try to pick up words over time without that foundation, you'll get there...but you'll have the grammar and language skills of a Vietnamese nail salonist*.

*No racism intended.

What? You did this again on this thread? The disclaimer doesn't help at all. Such stereotyping is as bad as saying "you'll have the grammar and language skills of a Black worker at McDonalds." A racist never "intends" to be one. Just saying.

 

[Elisabeth Kate]

@Elizabeth Kate, re embryo: Lots of people say that, but I disagree. I find embryo pretty useful, particularly in cardiology, as you point out, as well as in pediatric neurosurgery. I find it useful to remember the developmental process when understanding the 3 dimensional relationship of organs to one another, as well as variations on this, when learning radiology. I also liked the subject for its own sake

Embryo is useful in a roundabout way, but I think you can learn cardiology, anatomy, and radiology just fine with a superficial understanding of embryo. I don't think it's vital to understanding medicine. Just my opinion.

If there was one class in M1-M2 I could have done without it was a behavioral science/psychology class. It was sort of interesting, and I liked the lectures and lecturers, but I think I would have done fine having it being a week's assigned reading. Maybe I missed the point. Some of the pre-clinical electives I took were a little weak as well, but maybe that was a result of my own poor choices in selecting them.

Now THAT'S what's useful to medicine. No matter what you field you go into (except maybe radiology and pathology), having a decent understanding of behavioral science is important. You're going to see psych patients everywhere.

 

[Elisabeth Kate]

I thought endocardial cushions was the easiest thing in embryo lol, cuz I can still kind of remember that. Anyway if you know embryo, then you know anatomy. Easy peasy chicken squeezy.

Correction: if you know embryo, you know the primitive major structures in anatomy. Embryo doesn't cover most of gross anatomy.

 

[Elisabeth Kate]

Endocardial cushion defect --> Down syndrome.

And that's about all I remember.

 

[username456789]

One of the problems is that most of you don't know what you will and won't need to know in the future when it comes to the "minutiae." Some of it is specialty-dependent, and not as easy to predict as you think. Many fields will utilize a lot of information you learned in embryology, biochemistry, genetics, molecular biology, etc. And even if you don't feel like it all pertains to your daily practice, it will sure as hell be tested (and often disproportionately more heavily than more common things) on your board exams in residency.

It's common to be frustrated with the level of detail and the volume of information that comes your way in M1/M2. Savor it, you've basically got one job for two years and that's to absorb and understand as much as possible. Not a day goes by now that I don't appreciate how hard I worked in medical school, and how accordingly simple it is for me to recall important "useless minutiae" that has become very relevant in my chosen field.

 

[KGflyboy]

It's total bull, but then again most of life is bull.

I'll eat my words if Charcot Marie Tooth disease ever comes up in clinic. But I doubt it.

Psych was cool though.

I know preclinical years spend a lot of time on the zebras most won't see often, if ever. But it seems quite necessary to learn about this stuff. If it wasn't taught, who would diagnose these patients?

 

[Arkangeloid]

Perhaps I should have picked some useless zebra like Fabry's Disease rather than something that actually shows up like CMT.

Then again, if my instructors actually mentioned the prevalence of these diseases I wouldn't have made such a mistake.

 

[Anastomoses]

Perhaps I should have picked some useless zebra like Fabry's Disease rather than something that actually shows up like CMT.

Then again, if my instructors actually mentioned the prevalence of these diseases I wouldn't have made such a mistake.

Epidemiology, Biostats. They're coming.

 

[username456789]

Perhaps I should have picked some useless zebra like Fabry's Disease

Sure it's a zebra, but it still comes up again in the future.

In Derm, we have to memorize every little detail about the disease/pathology simply because it's associated with a ****-ton of angiokeratomas.

Again, it does no good to get upset about all the uncommon things you have to learn about in M1/M2. That doesn't end with medical school.

 

[DermViser]

I thought endocardial cushions was the easiest thing in embryo lol, cuz I can still kind of remember that. Anyway if you know embryo, then you know anatomy. Easy peasy chicken squeezy.

Uh, no. Just, no.

 

[DermViser]

Sure it's a zebra, but it still comes up again in the future.

In Derm, we have to memorize every little detail about the disease/pathology simply because it's associated with a ****-ton of angiokeratomas.

Again, it does no good to get upset about all the uncommon things you have to learn about in M1/M2. That doesn't end with medical school.

I LOL'ed when I saw Fabry's disease again, as I truly thought after biochemistry I would never hear about it again. Of course, the dang disease had to have a dermatologic manifestation (something never taught in our Biochem course or if it was it as glossed over), so I had to learn about the disease. But if I had never learned about Fabry's disease to begin with, in Biochem, it would have been harder.

 

[Priapism4tooLong]

Uh, no. Just, no.

i should have rephrased, it helped a lot with gross anatomy, structures/arteries/innervations

 

[Elisabeth Kate]

Perhaps I should have picked some useless zebra like Fabry's Disease rather than something that actually shows up like CMT.

Then again, if my instructors actually mentioned the prevalence of these diseases I wouldn't have made such a mistake.

If doctors don't know zebras, who will when they come up? It's not Fabry's is never diagnosed. If you don't want to know about uncommon things, med school really wasn't a smart choice.

 

[Elisabeth Kate]

i should have rephrased, it helped a lot with gross anatomy, structures/arteries/innervations

How so?

 

[DermViser]

i should have rephrased, it helped a lot with gross anatomy, structures/arteries/innervations

Once again, no. Just, no.

 

[DermViser]

If doctors don't know zebras, who will when they come up? It's not Fabry's is never diagnosed. If you don't want to know about uncommon things, med school really wasn't a smart choice.

Yes, for those people, PA would have been a better choice.

 

[Priapism4tooLong]

How so?

Most people tend not to study embryology more than what is expected on Step 1. I'm talking about complete embryology not just the first few days or one month lol. It definitely helped a lot. Maybe my teachers were good i don't know.

 

[Elisabeth Kate]

Most people tend not to study embryology more than what is expected on Step 1. I'm talking about complete embryology not just the first few days or one month lol. It definitely helped a lot. Maybe my teachers were good i don't know.

How did it help you? Can you give some examples? I just really don't see the connection beyond the obvious major structures, which is maybe 5% of gross anatomy.

 

[Bryan O’Blivion]

Now THAT'S what's useful to medicine. No matter what you field you go into (except maybe radiology and pathology), having a decent understanding of behavioral science is important. You're going to see psych patients everywhere.[/QUOTE]

RE: Behavioral science.

You know, you are right about that. I should not have been so dismissive of it, it is hugely important. I do think that it is a subject that is difficult to teach effectively. I remember thinking that most of it seemed pretty intuitive if one had some social awareness and personal empathy, and that the attempts to teach this seemed like they were belaboring the obvious. It is necessary though.

I think that there is great truth and effective patient management embodied in the notion so succinctly stated by Osler: "It is much more important to know what sort of patient has a disease, than to know what sort of disease a patient has." It is just difficult to teach that kind of clinical sense in 4 weeks.

Re Embryo:

Vital? As in could not understand or perform medicine without it? Of course not. It is helpful though, in understanding anatomical relationships if you imagine the movements of the different tissues and structures with respect to each other, and recognizing where they should be and also recognizing why they might not be there. I'll stop carrying the torch for embryo here, but I think it is so derided among medical students, someone needs to stick up for it.

 

[Arkangeloid]

I'm not sure what "Psychology" is (we don't have it at our school), but Psychiatry was the best class we've had thusfar at med school.

I didn't think a lot of it was obvious. Our class in Psych focused on diagnostic criteria of diseases, pharmacology, making effective drug treatments, minimizing side effects, etc. The Psych professor also pointed out various psychiatric sequelae of diseases and how to deal with them. It was the first class I had that reminded me I was actually training to become a doctor, rather than just being a dude who spent his day at a desk memorizing arcane neuropathology slides.

 

[Bryan O’Blivion]

I'm not sure what "Psychology" is (we don't have it at our school), but Psychiatry was the best class we've had thusfar at med school.

I didn't think a lot of it was obvious. Our class in Psych focused on diagnostic criteria of diseases, pharmacology, making effective drug treatments, minimizing side effects, etc. The Psych professor also pointed out various psychiatric sequelae of diseases and how to deal with them. It was the first class I had that reminded me I was actually training to become a doctor, rather than just being a dude who spent his day at a desk memorizing arcane neuropathology slides.

Sorry for the confusion. I did not mean Psych as the subject as taught from the biomedical perspective. That is fascinating, and intersects with almost every field. I was referring to a short course on behavioral science taught from a purely social science perspective. Maybe it is curriculum specific. As I said earlier, it actually is very important, just a difficult subject to teach effectively. When it is taught in the typical M1 fashion of lists and sets of criteria, it becomes reductionist to the point of being absurd. When expanded upon, it very often becomes dependent upon anecdote, allegory, etc. Some of it was clearly lost on me.

 

[DermViser]

I'm not sure what "Psychology" is (we don't have it at our school), but Psychiatry was the best class we've had thusfar at med school.

I didn't think a lot of it was obvious. Our class in Psych focused on diagnostic criteria of diseases, pharmacology, making effective drug treatments, minimizing side effects, etc. The Psych professor also pointed out various psychiatric sequelae of diseases and how to deal with them. It was the first class I had that reminded me I was actually training to become a doctor, rather than just being a dude who spent his day at a desk memorizing arcane neuropathology slides.

Behavioral Science is the basic science subject. The clinical science rotation is Psychiatry.

If you flip through a BRS Behavioral Science, you'll see that much of the diagnostic criteria of psychiatric diseases, pharmacology, side effects, etc. are covered in there.

 

[tco]

It's total bull, but then again most of life is bull.

I'll eat my words if Charcot Marie Tooth disease ever comes up in clinic. But I doubt it.

Psych was cool though.

I've seen quite a few patients with CMT. However, we had one of the best known neuromuscular neurologists in the country working in our clinic for the past 40 years, so maybe my sample population is skewed.

 

[FIREitUP]

So the suggestion among some on SDN is to get rid of 4th year. Great in that you don't have to learn tuition, but if lack of learning is your beef, getting rid of it won't solve that problem either. You still can't go straight from third year to residency. It's logistically impossible without speeding up the basic sciences to one year and I don't see that happening any time soon.

there's absolutely no reason preclinicals should not be 1 year. first year of med school was a **** show

 

[evilbooyaa]

If you don't want the pre-clinical years, please go be a NP. There is a pathophysiological foundation of disease processes that is built during M2. The easiest way for that to be built is by learning where and how everything goes wrong. Unfortunately, you have to learn how everything works when it's functioning properly before you can start breaking it down at a bunch of different stages. That is M1 at this time.

The only diseases I learned about during 1st year were gout and zebras (because they dealt with specific deficiencies in biochemical pathways, like the one-step-in-the-pathway difference between Niemann-Pick and Tay-Sachs)

 

[Brain Bucket]

I always thought the normal processes stuck better when the relevant pathologies were also presented. Context is important. If it were up to me, I'd just replace the MCAT with the Step 1 and have 3-4 years of clinicals in med school. So far, I'm entirely self taught. There's no reason I shouldn't be able to do this at home.

 

[Psai]

I always thought the normal processes stuck better when the relevant pathologies were also presented. Context is important. If it were up to me, I'd just replace the MCAT with the Step 1 and have 3-4 years of clinicals in med school. So far, I'm entirely self taught. There's no reason I shouldn't be able to do this at home.

I get where you're coming from but we definitely get guidance from our teachers on what to learn. It's easy to look back and think we did it ourselves but the punishing pace is something that comes from outside. I doubt that I would have learned as much if I were studying by myself, especially for anatomy.

 

[Elisabeth Kate]

there's absolutely no reason preclinicals should not be 1 year. first year of med school was a **** show

That's easy to say when you're done with it, but most first years have trouble enough adjusting with two years (all those "drink from a firehose" cliches anyone?). I realize some schools do that, but I think it's ridiculous. Frankly, I think every year of med school is necessary.

 

[Elisabeth Kate]

I always thought the normal processes stuck better when the relevant pathologies were also presented. Context is important. If it were up to me, I'd just replace the MCAT with the Step 1 and have 3-4 years of clinicals in med school. So far, I'm entirely self taught. There's no reason I shouldn't be able to do this at home.

You can believe you're entirely self-taught if you want, but I'd bet my car that you're not.

 

[Anastomoses]

You can believe you're entirely self-taught if you want, but I'd bet my car that you're not.

BB, get that car! And get me the cappucino machine.

 

[Brain Bucket]

I get where you're coming from but we definitely get guidance from our teachers on what to learn.

Congrats for having professors that are sane. I am studying for the boards despite the bs the professors force us to learn.

It's easy to look back and think we did it ourselves but the punishing pace is something that comes from outside. I doubt that I would have learned as much if I were studying by myself, especially for anatomy.

I can see how you might think that. I suppose drive does vary.

I suspect people had similar arguments before the pure sciences were removed from med school curricula.

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[DermViser]

I get where you're coming from but we definitely get guidance from our teachers on what to learn. It's easy to look back and think we did it ourselves but the punishing pace is something that comes from outside. I doubt that I would have learned as much if I were studying by myself, especially for anatomy.

Yeah, it seems like Goljan and Sattar are universal teachers who give guidance for medical students, but yes, let me give the actual credit to my university-hired professor (which my tuition money goes to pay his salary), who doesn't give a **** whether I fail boards or not.

 

[Brain Bucket]

You can believe you're entirely self-taught if you want, but I'd bet my car that you're not.

http://i.imgur.com/lqKpe2E.jpg

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[Arkangeloid]

You can believe you're entirely self-taught if you want, but I'd bet my car that you're not.

I don't even know who my professors are. Most of my learning comes from BRS and Firecracker and ish lol.

 

[Psai]

I don't even know who my professors are. Most of my learning comes from BRS and Firecracker and ish lol.

Dude these things are not primary sources. They're review aids for after you learn the material.

 

[Elisabeth Kate]

Yeah, it seems like Goljan and Sattar are universal teachers who give guidance for medical students, but yes, let me give the actual credit to my university-hired professor (which my tuition money goes to pay his salary), who doesn't give a **** whether I fail boards or not.

Since when is being a doctor strictly about board material? I'm not saying there isn't a lot of BS in the pre-clinical years, but to suggest that anyone teaches themselves everything they need to be a physician is plain bull.

 

[Elisabeth Kate]

I don't even know who my professors are. Most of my learning comes from BRS and Firecracker and ish lol.

Which could be why you didn't know that a torn hymen bleeds. Perhaps you should close the review books and learn the basics first. Just a thought.

 

[Elisabeth Kate]

Dude these things are not primary sources. They're review aids for after you learn the material.

Exactly. If you can get by solely on review books, your med school isn't doing its job and you'll realize that third year (or when you engage in a conversation about something like the aforementioned hymen incident).