There's no purpose to the first 2 years of medical school. Change my mind.

[afib123]

People in this thread can pay 100,000 for lectures or PBL or whatever that joke is called. Please don't cite some literature showing PBL is better than independent studying. I am sure I can do some studies to show how an intense carefully scheduled study plan from home can make you a superior clinical student and get higher score on Step 1 (I did it, I don't see why I can't replicate it with other students).

I will happily study on my own first the two years and take whatever exams they want to give me. NBMEs, Step 1 whatever. I am a top student in clinicals right now and got 6/7 Honors and I benefitted from studying on my own the first 2 years.

I will hire my own standardized patients for the fraction of cost I pay to the medical school. I can throw in 10k a year for getting clinical experience one afternoon a week for the first 2 years at the university hospital.

No way the first 2 years is worth 100,000. We are paying for professors that are teaching what can already be learned using outside resources. You are just a fool to spend first 2 years anyway studying from home and pay 100,000 for it.

---

Members don't see this ad.

 

[afib123]

My medical school did not have mandatory lecture attendance. As a class we took turns writing up lecture notes. I probably attended 10% of the lectures during the preclinical years and fell asleep in half of them. A parasitology lecture is the only one I still remember.

Why did you have to pay any money for that?

 

[joeception]

Are you at an MD school? Mandatory lectures are so 19th Century....med schools should NOT treat adult learners like children. You have my sympathies.

Alas, the problem with your idea is that then we'll have a generation of excellent test takers who have memorized everything and learned nothing.

The preclinical years aren't just about learning insertions and origins, or what oncogenes do, but about learning how to apply.

Medical knowledge is but one of six required competencies for both medical students and doctors. The other five are humanistic domains.

Strongly suggest that you show your curriculum deans the latest data about the efficacy of active learning and how it is superior to passive learning. This is why multiple schools have shifted to TBL or PBL curricula, even my DO school.

If you have any specific articles that really drive home the point of switching from a traditional curriculum I would love to have a look at them. Most of my schools curriculum is non-mandatory but a few are holding on to it.

 

[Goro]

People in this thread can pay 100,000 for lectures or PBL or whatever that joke is called. Please don't cite some literature showing PBL is better than independent studying. I am sure I can do some studies to show how an intense carefully scheduled study plan from home can make you a superior clinical student and get higher score on Step 1 (I did it, I don't see why I can't replicate it with other students).

I will happily study on my own first the two years and take whatever exams they want to give me. NBMEs, Step 1 whatever. I am a top student in clinicals right now and got 6/7 Honors and I benefitted from studying on my own the first 2 years.

I will hire my own standardized patients for the fraction of cost I pay to the medical school. I can throw in 10k a year for getting clinical experience one afternoon a week for the first 2 years at the university hospital.

No way the first 2 years is worth 100,000. We are paying for professors that are teaching what can already be learned using outside resources. You are just a fool to spend first 2 years anyway studying from home and pay 100,000 for it.

You're paying for your clinical training. It all goes into that pool because your clinical training is for more expensive. Would you rather be charged double the amount for your last two years of medical school?

Medical schools actually lose money on medical students. Any decent pathology or physiology Department can make more money on indirects from extramural Grants than an entire Class of students will pay in tuition.

And really, don't excite medical literature? That'll go over well with clinical studies. If you can find some studies that show independent studying is better, please cite them we will all be interested in seeing those.

 

[AnatomyGrey12]

Lol you can't be a pilot without first learning the names of all the buttons, what they do, how they work together, the physics of flight, etc. Only after learning that can you actually practice flying the plane. Being put in the cockpit day 1 and being taught how to fly based on a superficial knowledge of what buttons to push to take off, land, and steer is analogous to the midlevels. They might know how to push buttons, but when they find themselves in a massive crosswind that isn't textbook they don't know to get out of it safely. Do you want to be like that? Because I sure don't.

Mandatory attendance is garbage, but there is purpose to these first 2 years.

 

[965978]

Nah. Not sure what year you are but Step 1 and 2 are the most important thing you will do unfortunately.

But regardless, they are both extremely important. So it’s risky to spend time studying for step 1 alongside doing the M3 clerkships.

 

[docbsb2015]

But regardless, they are both extremely important. So it’s risky to spend time studying for step 1 alongside doing the M3 clerkships.

I mean you can take a vacation month at the end of 3rd year and use those 4 weeks to study for Step 1. Plenty of ways to go about studying for it. And again, while 3rd year clerkships grades have value, they are not as important as doing well on your Step 1 and 2. I have a feeling we are just going to have to agree to disagree that the risk pales in comparison to the reward.

 

[Obnoxious Dad]

You're paying for your clinical training. It all goes into that pool because your clinical training is for more expensive. Would you rather be charged double the amount for your last two years of medical school?

Medical schools actually lose money on medical students. Any decent pathology or physiology Department can make more money on indirects from extramural Grants than an entire Class of students will pay in tuition.

And really, don't excite medical literature? That'll go over well with clinical studies. If you can find some studies that show independent studying is better, please cite them we will all be interested in seeing those.

Goro, cite us the reviewed cost accounting studies performed by independent third parties proving that medical students when efficiently taught are subsidized. Whatever the schools themselves say about expenses and revenues can be taken with a ton of salt. If you ask an internal controller, "What is 2 + 2" The answer will be "What would you like it to be?" Even if medical schools can make trillions from one service or another, that does not mean that they aren't making money off the students. One service does not necessarily crowd out the other.

At LECOM in the 2016 academic year the school took in $50 in tuition for every $38 it spent in total. That doesn't seem to prove your point.

https://www.aacom.org/docs/default-source/data-and-trends/fy2016-revenues-and-expenditures-by-osteopathic-medical-college.pdf?sfvrsn=fa392597_10

One of the gripes about offshore medical schools is that they will pay hospitals in New York City for rotations while the established MD schools in New York City will not.

Caribbean Med Schools Buying Clinical Rotations in NY

http://www.wsj.com/articles/new-yorks-medical-students-say-they-feel-squeeze-in-looking-for-clinical-clerkships-1461705483 And they are starting to squeeze out U.S. Med Students.

forums.studentdoctor.net

If medical students could employ commercially mass produced study aids instead of going to lectures and if the medical schools aren't paying for rotations, just what are the medical schools delivering aside from a punched ticket to residency?

 

[965978]

I mean you can take a vacation month at the end of 3rd year and use those 4 weeks to study for Step 1. Plenty of ways to go about studying for it. And again, while 3rd year clerkships grades have value, they are not as important as doing well on your Step 1 and 2. I have a feeling we are just going to have to agree to disagree that the risk pales in comparison to the reward.

Sure. Although I would l like to say that M3 performance also affects the quality of your rec letters.

 

[afib123]

You're paying for your clinical training. It all goes into that pool because your clinical training is for more expensive. Would you rather be charged double the amount for your last two years of medical school?

Medical schools actually lose money on medical students. Any decent pathology or physiology Department can make more money on indirects from extramural Grants than an entire Class of students will pay in tuition.

And really, don't excite medical literature? That'll go over well with clinical studies. If you can find some studies that show independent studying is better, please cite them we will all be interested in seeing those.

If it's 200,000 for the last 2 years that is fine with me. I want what I am paying to be accurate and transparent. I am not going to pay a penny for first 2 years when I can learn everything on my own and still be a top clinical student and do extremely well the first 2 years.

Just because you have some studies that shows PBL is better (in what ways I am not sure because you never posted them here), that is not empiric truth. There could be a thousand flaws in those studies. Like I am saying, I can also come up with a study provided I have the time and resources to show that people that study from home during the first 2 years can be superior clinical students and do well on step 1. I am one live example and lots of my classmates did the exact same thing.

In fact, I would have loved to participate in a randomized study where a cohort like me studied from home vs a cohort that went to class during the first 2 years and compare our performance during third and fourth years in terms of our evaluations, number of clinical honors and shelf scores. Considering my third year performance, I am probably amongst the top 10 students in my class and taking into account my shelf exam scores, I am doing better than most of the medical students across the country. I can say pretty confidently, there will be minimal difference because that is what 70% of students do now. Out of 180 students in my class, probably 20 went to class and probably 50 watched lectures every day. With the advent of boards and beyond and existing textbooks, primary literature, UptoDate, and so many other resources, there is not a single reason you can't learn this information on your own.

I am talking about my hard-earned money here even if it's in loans, I have to pay them back and take the burden of debt and interest rate. If you guys want to charge me 200,000 for the last 2 years that is completely fine with me, I have no issues with that. But no one with a logical mind will argue against the fact that the tuition will decrease from making first 2 years studying from home and only coming in for clinical experience.

Medical school is charging extreme amounts of money for no value in the first 2 years ( I do not need or want any professors teaching me the first 2 years, I can learn better on my own and be an excellent clinical student and pass whatever tests the licensing boards wants me to pass). It's high time medical students fight back against this.

I can pay 10k and hire excellent standardized actors for clinical practice and find a hospital somewhere in the country to get clinical experience in the first 2 years if the university is not willing to do provide that till 3rd year.

 

[afib123]

Lol you can't be a pilot without first learning the names of all the buttons, what they do, how they work together, the physics of flight, etc. Only after learning that can you actually practice flying the plane. Being put in the cockpit day 1 and being taught how to fly based on a superficial knowledge of what buttons to push to take off, land, and steer is analogous to the midlevels. They might know how to push buttons, but when they find themselves in a massive crosswind that isn't textbook they don't know to get out of it safely. Do you want to be like that? Because I sure don't.

Mandatory attendance is garbage, but there is purpose to these first 2 years.

First 2 years are extremely important. But the material can be studied from home. There is no reason to be paying 100,000 for it.

 

[puahate]

Don't people others things besides study for step in preclinical?

 

[theKingLT]

For all those who believe preclinicals should be reduced to self-study for STEP1, do you belive the same about undergrad? Should there be no pre-reqs and just use the MCAT? Should people even be required to get an undergrad degree or is an 18 yo who self studies for a year, kills the MCAT, and does some clinical volunteering, ready for medical school? Honest question about your opinion, not trying to be sarcastic.

 

[afib123]

Don't people others things besides study for step in preclinical?

Yes but the majority of the work is studying for step and learning clinical information. Whatever clinical activities that are done can be organized on your own pretty easily. One major activity is practice with standardized actors who act as patients. I think they get paid around 10-15 dollars an hour. I can hire my own. Heck, I can pay 4th year students 20 dollars an hour and they would love to teach me all the clinical skills.

Only thing missing would be clinical experience, but that is not that hard to get. You can pay your university a fraction of 100,000 that you are paying now for the first 2 years and ask them to allow you to come in a afternoon a week or you can tie up with community hospitals in your area for clinical experience and pay them.

In my university, we went to the hospital in the first 2 years about 8 afternoons so not very much clinical experience.

 

[puahate]

Yes but the majority of the work is studying for step and learning clinical information. Whatever clinical activities that are done can be organized on your own pretty easily. One major activity is practice with standardized actors who act as patients. I think they get paid around 10-15 dollars an hour. I can hire my own. Heck, I can pay 4th year students 20 dollars an hour and they would love to teach me all the clinical skills.

Only thing missing would be clinical experience, but that is not that hard to get. You can pay your university a fraction of 100,000 that you are paying now for the first 2 years and ask them to allow you to come in a afternoon a week or you can tie up with community hospitals in your area for clinical experience and pay them.

In my university, we went to the hospital in the first 2 years about 8 afternoons so not very much clinical experience.

Wait would people take STEP 1 as an entrance exam and automatically go into clinical rotation? Would there be a grace period to ease people in?

Also what about research?

I'm just kinda confused about how this would work.

 

[docbsb2015]

Wait would people take STEP 1 as an entrance exam and automatically go into clinical rotation? Would there be a grace period to ease people in?

Also what about research?

I'm just kinda confused about how this would work.

Don't try to comprehend it. It's a bad idea.

 

[7331poas]

For all those who believe preclinicals should be reduced to self-study for STEP1, do you belive the same about undergrad? Should there be no pre-reqs and just use the MCAT? Should people even be required to get an undergrad degree or is an 18 yo who self studies for a year, kills the MCAT, and does some clinical volunteering, ready for medical school? Honest question about your opinion, not trying to be sarcastic.

....yes

Most countries in the world operate this way. Also it wouldn't be 18, it would be more like 20 because they need time to take the classes

 

[afib123]

Wait to would people take STEP 1 as an entrance exam and automatically go into clinical rotation? Would there be a grace period to ease people in?

Also what about research?

That is what first 2 years is now. If you fail Step 1, most medical schools won't let you start clinicals. Why would there be any grace period? All I am saying is doing what people are already doing. Go to medical school and see how many people show up to class.

You don't need to be in medical school to get research. You can do research at any state university close to where you are living. And I would say 70% of medical students don't do real research in medical school. Most research that medical students do is chart reviews which is basically doing the scut work for residents to write the paper, which is not real research by any means.

And I am not proposing that medical school ceases to exist the first 2 years. They just don't have the traditional classrooms and pay for professors. You study on your own and the medical school can organize clinical activities and coordinate things like research if so desired.

My only point is the 100,000 that you pay during the first 2 years is being wasted with unnecessary classes and professors when you can learn on your own.

 

[puahate]

Agree with the premise i guess i think the 1 to 1.5 year preclinical model is probably a decent solution and lower tuition for that first year

I personally live in a state with only one major hospital so getting clincal research there would be a pain. Having some sort of affiliation with a hospital through med school with immediate access to resources is definitely useful. I know if i tried to contact people at my hometown hospital system for research I'd go nowhere unless i had connections through a school or a local physician.

 

[MedicineZ0Z]

I think you need the knowledge gained in preclinical to practice as an effective; 3rd and 4th year are just about learning how to evaluate patients the first 2 years are about understanding disease processes and if you think that’s not useful than that can’t be helped. I do however think that US medical education should catch up to the rest of the world and skip the undergrad requirement and consolidate pre-residency education into 5 or 6 years. I’d also get rid of biochemistry.

Those countries also have a few different things:

- direct entry from high school (sounds good, but age 17? hmm)
- high attrition rates after getting in, even once you're well into it
- getting into a residency aka specializing is very important otherwise you're very poorly paid as a "GP"
- minimal to no tuition (good)
- low income once finished (worst part of it)

The last part would be a deal breaker for many if they understood it properly. Yes, no debt and 6-7 years (truly 10+ years to become a specialist) sound dandy but you'll almost certainly be upper middle class at the most.
In North America, almost all doctors (yes PCPs included) can become rich. The income potential is there, you just have to be efficient and work a tiny bit harder. Wheras good luck making 400k in those countries.

Also, this may be anecdotal but they don't tend to accumulate the same level of medical knowledge. I've looked into their curriculums.

North America lives under the capitalist model. Medicine is a highly paid profession which attracts many of the best and most well rounded minds. It's a different mindset to live in those countries.

 

[puahate]

And i guess it was already touched on but the American schooling system would need to change if we wanted to do what others countries do.

High school in USA serves a different function compared to other countries.

 

[afib123]

Agree with the premise i guess i think the 1 to 1.5 year preclinical model is probably a decent solution and lower tuition for that first year

I personally live in a state with only one major hospital so getting clincal research there would be a pain. Having some sort of affiliation with a hospital through med school with immediate access to resources is definitely useful. I know if i tried to contact people at my hometown hospital system for research I'd go nowhere unless i had connections through a school or a local physician.

Yes. The argument in here not about the utility of learning clinical information the first 2 years. That is extremely important. It is about the money you are paying when you can learn on your own and medical school can function to organize clinical activities at a fraction of the cost.

Nothing about medical school will change except you stop paying for professors to teach you in a classroom whether that's through PBL or lecturing or whatever other new gimmick they come up with. You just pay less and you need to learn on your own which is completely doable for any student with the resources in the market right now.

 

[AnatomyGrey12]

But regardless, they are both extremely important. So it’s risky to spend time studying for step 1 alongside doing the M3 clerkships.

Sure. Although I would l like to say that M3 performance also affects the quality of your rec letters.

Look man, you're a pre-med. Best to simply read and learn than comment on things you don't really understand. Schools that have moved Step 1 to after M3 clerkships have almost uniformly seen a boost in their Step averages. Step 1, despite the constant bemoaning of the exam, has become very highly clinical. Gone are the days of knowing the answer is granulomatosis with polyangiitis simply because the stem mentions a C-ANCA and URI. Another tidbit that people don't like to talk about, or try to deny, is that the students who perform better on Step 1 tend to be those who are better on the wards. It's not a hard rule, but it is the general trend whether people like it or not.

First 2 years are extremely important. But the material can be studied from home. There is no reason to be paying 100,000 for it.

My only point is the 100,000 that you pay during the first 2 years is being wasted with unnecessary classes and professors when you can learn on your own.

I agree on all accounts.

 

[Giovanotto]

You're paying for your clinical training. It all goes into that pool because your clinical training is for more expensive. Would you rather be charged double the amount for your last two years of medical school?

Medical schools actually lose money on medical students. Any decent pathology or physiology Department can make more money on indirects from extramural Grants than an entire Class of students will pay in tuition.

And really, don't excite medical literature? That'll go over well with clinical studies. If you can find some studies that show independent studying is better, please cite them we will all be interested in seeing those.

To the bolded: obviously, yes. I want to know where my money is going. Show me a breakdown. Until then, my entire medical education is a scam until proven otherwise. The burden of proof lies in the institutions providing the education at a set price.

 

[VA Hopeful Dr]

Rather than either completely scrap or massively overhaul medical education, why not focus on getting tuition lower?

 

[VA Hopeful Dr]

To the bolded: obviously, yes. I want to know where my money is going. Show me a breakdown. Until then, my entire medical education is a scam until proven otherwise. The burden of proof lies in the institutions providing the education at a set price.

Seriously?

 

[Giovanotto]

Seriously?

Definition of SCAM
yes

 

[VA Hopeful Dr]

Definition of SCAM
yes

Ah, so med school isn't a scam then. Glad we cleared that up.

I paid tuition and in exchange got an MD. Seems a fair deal. No deception was involved.

 

[afib123]

Rather than either completely scrap or massively overhaul medical education, why not focus on getting tuition lower?

My school has been increasing tuition every year and I imagine it's the same for many medical schools. Unless you make drastic changes, which I highlighted in my posts, that is unlikely to happen.

You don't need to share if you don't want to, but I would be interested in knowing when you graduated from medical school and how much you paid for medical school compared to the tuition it is now. I would also be interested in knowing how much you think the salary increased for new attendings compared to how much you made during the first year as an attending.

My guess would be tuition increased pretty dramatically (why? I am not sure. It keeps going up and up every year for a completely useless first 2 years) while salaries are not changing much. If this tuition increase in only accounting for inflation, I wonder if salaries also increased in the same ratio.

Regardless, even it means the tuition only decreases as little as 10,000 in the first 2 years if you take out all the professors and classroom teaching through PBL or lecturing, I am all for it. I imagine it will decrease a lot more if there are no professors you need to pay for. I will take whatever decrease in debt I get.

 

[965978]

Look man, you're a pre-med. Best to simply read and learn than comment on things you don't really understand. Schools that have moved Step 1 to after M3 clerkships have almost uniformly seen a boost in their Step averages. Step 1, despite the constant bemoaning of the exam, has become very highly clinical. Gone are the days of knowing the answer is granulomatosis with polyangiitis simply because the stem mentions a C-ANCA and URI. Another tidbit that people don't like to talk about, or try to deny, is that the students who perform better on Step 1 tend to be those who are better on the wards. It's not a hard rule, but it is the general trend whether people like it or not.



I agree on all accounts.

So why are some schools still requiring it before third year?

 

[AnatomyGrey12]

So why are some schools still requiring it before third year?

Because change is hard. Look at how many places still think hours on end of listening to PhDs lecture is the best way to learn medicine.

 

[Giovanotto]

Ah, so med school isn't a scam then. Glad we cleared that up.

I paid tuition and in exchange got an MD. Seems a fair deal. No deception was involved.

 

[965978]

Because change is hard. Look at how many places still think hours on end of listening to PhDs lecture is the best way to learn medicine.

Do schools have to change their curriculum when switching from a pre-M3 to a post-M3 requirement?

 

[AnatomyGrey12]

Do schools have to change their curriculum when switching from a pre-M3 to a post-M3 requirement?

What? That's completely irrelevant. My point was that instituting any change that deviates from how things were done in the past is hard. Medicine in particular is historically bad at this. Look at how long it took physicians to finally accept that the bodily humours weren't a thing.

 

[VA Hopeful Dr]

My school has been increasing tuition every year and I imagine it's the same for many medical schools. Unless you make drastic changes, which I highlighted in my posts, that is unlikely to happen.

You don't need to share if you don't want to, but I would be interested in knowing when you graduated from medical school and how much you paid for medical school compared to the tuition it is now. I would also be interested in knowing how much you think the salary increased for new attendings compared to how much you made during the first year as an attending.

My guess would be tuition increased pretty dramatically (why? I am not sure. It keeps going up and up every year for a completely useless first 2 years) while salaries are not changing much. If this tuition increase in only accounting for inflation, I wonder if salaries also increased in the same ratio.

Regardless, even it means the tuition only decreases as little as 10,000 in the first 2 years if you take out all the professors and classroom teaching through PBL or lecturing, I am all for it. I imagine it will decrease a lot more if there are no professors you need to pay for. I will take whatever decrease in debt I get.

I graduated in 2010 from a state school, tuition that last year was I think 26k give or take a grand. For the upcoming year, my schools tuition is 40k. That is a massive problem as I'm fairly certain the education isn't twice as good - if you look, my post history in this part of the forum hits on this frequently.

The average debt for my class for people who used loans for all their expenses at graduation was about 160-180k. This year that's the debt from just tuition, doesn't even include living expenses.

When it comes to medical education, I'm fairly conservative. We have a system that works well and has worked well for decades. That said, if my debt was going to be twice what it is I'd be looking for ways to change the system as well.

But instead of changing a system that works, why not just reduce tuition? Rhetorical question obviously, but that's the approach I would take if I could snap my fingers and make things happen.

 

[VA Hopeful Dr]

View attachment 260205

Pretty much. You know what the tuition is going to be. You know the degree you'll end up with when you graduate. You have hundreds of options across the country to choose from. Not sure how you think this is in any way a scam.

 

[965978]

What? That's completely irrelevant. My point was that instituting any change that deviates from how things were done in the past is hard. Medicine in particular is historically bad at this. Look at how long it took physicians to finally accept that the bodily humours weren't a thing.

Ok.

 

[afib123]

I graduated in 2010 from a state school, tuition that last year was I think 26k give or take a grand. For the upcoming year, my schools tuition is 40k. That is a massive problem as I'm fairly certain the education isn't twice as good - if you look, my post history in this part of the forum hits on this frequently.

The average debt for my class for people who used loans for all their expenses at graduation was about 160-180k. This year that's the debt from just tuition, doesn't even include living expenses.

When it comes to medical education, I'm fairly conservative. We have a system that works well and has worked well for decades. That said, if my debt was going to be twice what it is I'd be looking for ways to change the system as well.

But instead of changing a system that works, why not just reduce tuition? Rhetorical question obviously, but that's the approach I would take if I could snap my fingers and make things happen.

Thanks for sharing. Goes to show how ridiculous of a problem tuition is. I would do the same, but that's extremely unlikely to happen without drastic but very doable changes. Forget about decreasing tuition, medical schools keep increasing it every year. Baffles me.

 

[Oh_Gee]

I'll second this. I remember hating all of the minutiae and "low-yield" lectures, and focusing 80% of my energy toward Step 1. I got bent out of shape about every mandatory lecture or lab that would make me drag my butt to campus, and wished I could just be hitting the high-yield material.

Now that I'm two months from being a PGY-5, I still run into situations daily where I'm thankful for the knowledge and esoteria I acquired in medical school (preclinical years, specifically), or wish I had placed into long term memory back at that time (instead of cramming for exams). The review resources are great (apparently uworld, first aid, and pathoma now have an acronym?), but they're really not the point. They are a means-to-an-end to do reasonably well on Step 1, which is not the end -- or even the START -- of a career in medicine.

P.S. Just memorize those MEN1/MEN2s now and be done with it. It'll come up enough in the next 10+ years to be worth it.

have you seen a lot of MEN cases?

 

[VA Hopeful Dr]

have you seen a lot of MEN cases?

More than I have pheos...

 

[nimbus]

Why did you have to pay any money for that?

Good question. For me it was because there was no alternative pathway for an MD. I was a biochem/cell bio major at a well known premed grind school so much of the material was repetitive for me as it was for many of my classmates.


Edit: the med school I attended is now tuition free so I guess someone got the memo.

 

[CherryRedDracul]

There are 3-year programs in reputable schools... that alone should be enough to make everyone else ask why they are forking over many thousands of extra tuition dollars if the outcome is the same.

And if the argument is that they are lesser physicians... I’m gonna’ need to see data to prove it.

I think the real answer is simpler

At least from my standpoint, preclinical years could have been shortened. I was an efficient at studying and had a lot of free time in my first 2 years.

 

[Mass Effect]

Yes, US MD student. Appreciate it but if I'm not mistaken, you're not a student but an administrator. And with all due respect, administrators are some of the most out of touch people with regards to what works best for us students. "learning" and "applying" is a false dichotomy. If you learn, you can apply. Also, those "humanistic domains" which schools work so hard to instill cannot be taught. You can't teach a robot social skills. Most people have them, and if you don't, then good f*ing luck.

Preclinicals is not about being a good physician.

I'm sorry, what? I, for one, am not an administrator and I can tell you that everything I quoted above is completely out of touch, especially the bolded. You'll recognize it when you hit the wards. The first two years isn't just about textbook learning, it's also about learning how to doctor, learning clinical skills and how to care for patients, learning a hospital functions.

I personally disagree and would never advocate for shortening the curriculum and making the majority of the doctors in the country 21 years old. As someone who has seen residents at age 23 and residents at age 30, there is a huge difference.

 

[Cassowary]

As someone who has seen residents at age 23 and residents at age 30, there is a huge difference.

This has literally nothing to do with the point you are trying to make

 

[700825]

The first two years isn't just about textbook learning, it's also about learning how to doctor, learning clinical skills and how to care for patients, learning a hospital functions.

The first two years teaches you basically none of this...you learn how to take a patient history (which just consists of memorizes a bunch of questions you have no idea the application of yet) and physical on standardized patients. I could learn this with a friend and a week of time. Then you're in the clinical maybe 8-10 times doing glorified shadowing. There's definitely arguments for the value of the first two years (learning the stuff to recognize it), but let's be real there is basically nothing learned that couldn't be easily learned on one's own.

 

[Cassowary]

learning how to doctor

I think these are the new “empty words” medicine. Words that literally mean nothing.

Reminds me a lot of those “we treat the patient not the disease” empty words that DOs love to throw around.


Edit: Ok I re-read your post and it’s basically all empty words, straw-men, or factually incorrect so I’m not even going to respond

 

[theKingLT]

....yes

Most countries in the world operate this way. Also it wouldn't be 18, it would be more like 20 because they need time to take the classes

What classes? I asked about people's opinions on replacing prereqs with the mcat.

I can't speak for all countries, but in Mexico they start med school at 18 but it's 6-7 years long. The first 4 years are mostly lecture based. They start with the equivalent of our undergrad sciences crammed into the first or 2 followed by the start of what we would call med school courses. So they don't really skip the basic science courses, they just don't have all the liberal arts gen eds added in. And the entrance exams to get in are by no means like taking the mcat, more like taking the SAT. I dont know if other countries are like that, but that's very different from what I'm asking about which is you spend X amount of time after high school to self-study for the mcat and volunteer, then just enter med school. No undergrad classes needed.

 

[Cassowary]

Given your attitudes here, you have yet to learn anything.

“Yet to learn anything.” drop the DO napoleonic complex you got and learn how to graciously take criticism you receive from people more experienced than you.

All the premeds kowtowing to you and fueling your ego has given you a superiority complex. Medicine is no place for ego.

 

[Goro]

If it's 200,000 for the last 2 years that is fine with me. I want what I am paying to be accurate and transparent. I am not going to pay a penny for first 2 years when I can learn everything on my own and still be a top clinical student and do extremely well the first 2 years.

Just because you have some studies that shows PBL is better (in what ways I am not sure because you never posted them here), that is not empiric truth. There could be a thousand flaws in those studies. Like I am saying, I can also come up with a study provided I have the time and resources to show that people that study from home during the first 2 years can be superior clinical students and do well on step 1. I am one live example and lots of my classmates did the exact same thing.

In fact, I would have loved to participate in a randomized study where a cohort like me studied from home vs a cohort that went to class during the first 2 years and compare our performance during third and fourth years in terms of our evaluations, number of clinical honors and shelf scores. Considering my third year performance, I am probably amongst the top 10 students in my class and taking into account my shelf exam scores, I am doing better than most of the medical students across the country. I can say pretty confidently, there will be minimal difference because that is what 70% of students do now. Out of 180 students in my class, probably 20 went to class and probably 50 watched lectures every day. With the advent of boards and beyond and existing textbooks, primary literature, UptoDate, and so many other resources, there is not a single reason you can't learn this information on your own.

I am talking about my hard-earned money here even if it's in loans, I have to pay them back and take the burden of debt and interest rate. If you guys want to charge me 200,000 for the last 2 years that is completely fine with me, I have no issues with that. But no one with a logical mind will argue against the fact that the tuition will decrease from making first 2 years studying from home and only coming in for clinical experience.

Medical school is charging extreme amounts of money for no value in the first 2 years ( I do not need or want any professors teaching me the first 2 years, I can learn better on my own and be an excellent clinical student and pass whatever tests the licensing boards wants me to pass). It's high time medical students fight back against this.

I can pay 10k and hire excellent standardized actors for clinical practice and find a hospital somewhere in the country to get clinical experience in the first 2 years if the university is not willing to do provide that till 3rd year.

The smell of cognitive dissonance is strong in this one.

That's the best you can do? "I'll bet they're bad studies"?

I'm not providing citations because it's the weekend and this is SDN, not a submission to the British Medical journal

Again, can you show us the gun that was put to your head that made you apply to medical school, and matriculate?

You chose this path.

 

[Goro]

“Yet to learn anything.” drop the DO napoleonic complex you got and learn how to graciously take criticism you receive from people more experienced than you.

All the premeds kowtowing to you and fueling your ego has given you a superiority complex. Medicine is no place for ego.

Thank you for proving my point. Just a word of advice, it's not a good idea to go full-blown Loose Cannon here