The thing about moving on with your education is that you tend to downplay the importance of the years that came before. For whatever reason its just difficult to have the perspective to see that you were able to succeed at the next level because of the base you built at the lower level. Yes, the information you actually need to learn to practice will be learned largely on the wards. But learning the basic science and pathophysiology in the classroom is essential for learning the clinical skills later. Also how are you supposed to keep up with your reading and assimilate new information if you don't have strong background knowledge?
I'm finishing up my 1st year right now, and in many of my classes (especially those taught by PhDs) I stop and question the value of learning all this basic science and seemingly esoteric detail. But it seems that every single time I shadow in the hospital I see a clinician using a piece of basic science knowledge that I had dismissed as trivial. Will you use all of it? Of course not, but you never know what bits will be useful and it will be different for everyone. A surgeon I shadowed questioned the value of knowing what happend to each individual glucose carbon in glycolysis...then found himself doing biochemistry research where the knowledge was valuable. The internist probably takes for granted that his knowledge of steroid hormone synthesis allows him to know that hyperpigmentation can be caused by a defect in that pathway causing a buildup of pro-opiomelanocortin, my 4th year friend was glad she paid attention in immunology when she got pimped about the complement cascade by an allergist, I thought it was pointless to lecture 1st years on an esoteric disease like neurofibromatosis...but then got to impress a neurosurgeon i was shadowing by droppin' a little knowledge when he had 3 NF patients in one day in clinic.
You never know what's important and you can't lose perspective about how your knowledge base allows you to excel at the next level.
