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

[deleted407021]

Have you looked around lately?

Oh, we live in hell world, for sure

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[plasticsday1]

@Goro, we love you here on SDN, but please listen to all these motivated, intelligent young professionals when we raise concerns about tuition and how medical education is organized.

But we don't...

 

[Obnoxious Dad]

Really frustrated with all the mandatory classes my school requires so I needed to vent, ****post, and fantasize about my ideal medical school preclinical situation.

Why can't all medical schools:
-Assign UFAPS for years 1 and 2 and make learning entirely independent
-Never have a mandatory lecture
-Save us thousands of $$$ for all the resources this would remove the need for
-Probably have all the students destroy step
-Increase the productivity of PhD professors wasting their time with the same lecture year after year allowing them to pursue something more positive

This is the original post. From the outset the OP complained about the cost of the first two years of medical school.

 

[Goro]

Dig this:
Thought experiment: Step 1 becomes new MCAT

 

[Cassowary]

View attachment 260370
The OP was asking about doing the first two years independently, and now it's become a tuition bitchfest. Focus, SDNers.

Wrong again. If you read the OP you would see I clearly talk about the cost of tuition.

@Goro, we love you here on SDN

Speak for yourself. Maybe the premeds do...

1. Fragile ego
2. Forms opinions on areas he has no expertise
3. Is too stubborn to admit when he’s wrong
4. Gives snide side-eye when his fragile ego is tested

Whats to love

 

[VA Hopeful Dr]

Why proposing a solution that you know will never happen when there is another one that seems more feasible? We all know medical school tuition will NEVER take a downward trajectory unless the government stop giving out loan

so you think it's more likely that they will do away with the first two years of medical school than it is the tuition will eventually come down?

 

[Splenda88]

so you think it's more likely that they will do away with the first two years of medical school than it is the tuition will eventually come down?

Read post #133

 

[VincentAdultman]

@afib123 was wondering if you could tell me what field you were going into and how you’re doing relative to your peers. I hadn’t seen you mention it anywhere.

 

[docbsb2015]

Oh, I hear you, but that is a separate thread. This one started out on pedagogy.
One of the harsh and depressing truths about where your tuition money goes (other than clinical education) is into other parts of the university system. Just like a Surgery Dep't may fund Family Medicine, med schools often fund Schools of Art, Education, etc. Imagine how we Faculty feel when some 9/10ths of our students' tuition go off to fund money losing programs that really should have been shut down a long time ago!

If there are any stand-alone med schools out there, they're the only ones who don't have this problem.

This is sadly the most true thing I've read on this thread. I won't go into details but its unbelievable how a campus explodes with new things when a new med school hits. Smh.

 

[Little Green Mensch]

Essentially unlimited student loan money is the only way most people can afford medical school. Unfortunately, this also means the tuition can rise substantially faster than inflation, because being able to buy something on credit substantially bids up the price of that good.

Eventually, something's got to give. Schools that can offer less tuition by abbreviating (or go tuition-free, e.g. NYU) may start to attract higher-caliber applicants, but I think this will only have marginal impact unless something forces more schools to go this route.

Shortening time-in-training somewhere is the easiest solution to both the physician shortage and the cost of medical education. Shortening residency is probably bad for most fields (you could make a case that, for primary care, GPs who've completed a year of internship are better than midlevels, but that'd be a pretty big paradigm shift in the U.S.). Not requiring a bachelor's is, contra other posters' concerns about younger matriculants, probably the best way to go.

You could also get rid of 4th year spring semester easily - unlike the preclinical years, it truly serves no educational purpose.

 

[afib123]

@afib123 was wondering if you could tell me what field you were going into and how you’re doing relative to your peers. I hadn’t seen you mention it anywhere.

Well I know it comes across as bragging but I have to make to my point that you do not need to pay extreme amount of money the first 2 years to succeed in clinical years and on step 1 like medical school faculty try to make you believe.

Clear example in this thread where few people kept putting down the pre-meds or the M1/M2's ( not sure where they are in their education) as not knowing anything even though their thoughts that the pre-clinical curriculum right now is a big money waste is spot on. Actually, more surprising to me that pre-meds can figure that out but not medical school faculty. Or maybe they are aware but want the money

 

[VA Hopeful Dr]

Read post #133

Yeah my point still stands

 

[afib123]

Wrong again. If you read the OP you would see I clearly talk about the cost of tuition.



Speak for yourself. Maybe the premeds do...

1. Fragile ego
2. Forms opinions on areas he has no expertise
3. Is too stubborn to admit when he’s wrong
4. Gives snide side-eye when his fragile ego is tested

Whats to love

Well I am not sure what poster's reputation in these forums is but he did say that he doubted if you are an adult based on your post history which comes across as a pretty rude comment

 

[afib123]

Essentially unlimited student loan money is the only way most people can afford medical school. Unfortunately, this also means the tuition can rise substantially faster than inflation, because being able to buy something on credit substantially bids up the price of that good.

Eventually, something's got to give. Schools that can offer less tuition by abbreviating (or go tuition-free, e.g. NYU) may start to attract higher-caliber applicants, but I think this will only have marginal impact unless something forces more schools to go this route.

Shortening time-in-training somewhere is the easiest solution to both the physician shortage and the cost of medical education. Shortening residency is probably bad for most fields (you could make a case that, for primary care, GPs who've completed a year of internship are better than midlevels, but that'd be a pretty big paradigm shift in the U.S.). Not requiring a bachelor's is, contra other posters' concerns about younger matriculants, probably the best way to go.

You could also get rid of 4th year spring semester easily - unlike the preclinical years, it truly serves no educational purpose.

Yes. You could finish off all the 4th year curricular requirements by December, graduate and then start the interviewing season and match. Students can save a semester of money and spend that money on interviewing or whatever else they want to. But, nah, take the med students' money. It is loan money. They will earn it back.

See problem is like someone pointed out, we can say all these things in forums like this but are too scared to say anything in real life because of retaliation from medical school faculty. Pity but reality

 

[deleted938090]

UFAPS content is very limited in scope, and people learn at different rates, so a significant period of time, like 12 months, is wholly unnecessary. These resources are for review purposes and often greatly oversimplify the content. It is possible to memorize this content and have no idea of the underlying workings or context of the material. Furthermore, students actually learn and retain a significant amount of non-testable material that people deem "irrelevant" for exams, but that material has guided their research and professional interests. A student would lose out a lot on just focusing on test preparation - knowledge of the current and evolving standard of care, areas of research, which specialties interest them.

An argument could be made for money and time, but the issue of money is a different matter altogether, and time also correlates with maturity. I think having the preclinical as additional time for students to explore makes them make better decisions in choosing specialty. Yes, to a certain degree, STEP scores can affect the decision making process, but it is also valuable to realize that one may not be just solely interested in the competitive specialties. An extra one or two years learning about one's interests is extremely valuable.

 

[nimbus]

This is as good as any presentation I’ve seen on the topic and it’s free. It’s not necessary to pay tens of thousands to get canned lectures. The entire preclinical curriculum could be treated this way. Many of my medical school lectures were not half as clear or organized.

 

[Cassowary]

UFAPS content is very limited in scope

This is ridiculous. Where do you get this idea because its entirely false. People have been scoring 250+ using nothing but UFAPS. I (along with many other people) utilize solely ufaps and score well in my in house tests and nbme exams.

Are you making this up, or is there a reason you say this?

 

[afib123]

This is ridiculous. Where do you get this idea because its entirely false. People have been scoring 250+ using nothing but UFAPS. I (along with many other people) utilize solely ufaps and score well in my in house tests and nbme exams.

Are you making this up, or is there a reason you say this?

They would know if they read the thread.

 

[deleted938090]

I am speaking in relative terms of how much detail it goes into. Compared to lectures in classes (not "canned" lectures online), the material is not very much in depth. UFAPS is limited in scope in the sense that it tests material that is only relevant to Step 1 but not beyond that. Yes, it is more efficient to use them if that's your only goal, but there's definitely more to the subject than Step 1, which can be valuable for guiding a student to his or her interests.

Perhaps the only resources you use are UFAPS and exams and have done well. Maybe you feel very irritated about the situation at your medical school where lectures are mandatory. However this doesn't imply the blanket statement that lectures are useless for students.

 

[VincentAdultman]

Not everyone can score 250 plus with just UFAP.

Or at all, for that matter.

 

[7331poas]

View attachment 260370
The OP was asking about doing the first two years independently, and now it's become a tuition bitchfest. Focus, SDNers.

Tuition is a large reason why the first two years are being questioned.

 

[afib123]

I am speaking in relative terms of how much detail it goes into. Compared to lectures in classes (not "canned" lectures online), the material is not very much in depth. UFAPS is limited in scope in the sense that it tests material that is only relevant to Step 1 but not beyond that. Yes, it is more efficient to use them if that's your only goal, but there's definitely more to the subject than Step 1, which can be valuable for guiding a student to his or her interests.

Perhaps the only resources you use are UFAPS and exams and have done well. Maybe you feel very irritated about the situation at your medical school where lectures are mandatory. However this doesn't imply the blanket statement that lectures are useless for students.

You bring up good points which I think brings up the need for 2 sets of pre-clinical curriculum. People like you can pay the full tuition, go to classes and take advantage of the lectures.

While, people like me and others in this thread will study on our own and only come to class for clinically related activities and we get the benefit of decreased tuition because we don't see the need to attend 90% of the lectures which can be studied on your own. I think meeting 2x a month is enough whether that's to learn soap notes, history taking, refine physical exam skills, learn IRB writing, manuscript writing, interview with standardized patients etc. That should decrease the tuition even if it's only 5-10k.

 

[AnatomyGrey12]

I am speaking in relative terms of how much detail it goes into.

I'm going to go out on a limb and say you have clearly never done UWorld. Boards and Beyond as well is a resource that has covered everything, and in many cases more, than what is covered in a class lecture.

knowledge of the current and evolving standard of care, areas of research, which specialties interest them.

There is literally no reason that schools cannot go to a standardized pre-clinical curriculum and do away with PhD lectures and slash tuition prices. Spare me about the these things you list here because literally none of them need a lecture from a PhD for you to find out.

 

[Cassowary]

Not everyone can score 250 plus with just UFAP.

Or at all, for that matter.

Not everyone can score 250 with anything...so I don't even get what you're trying to say.

 

[VincentAdultman]

Not everyone can score 250 with anything...so I don't even get what you're trying to say.

I (along with many other people) utilize solely ufaps and score well in my in house tests and nbme exams.

Cool, but your anecdotal experience adds what?

 

[Cassowary]

I am speaking in relative terms of how much detail it goes into. Compared to lectures in classes (not "canned" lectures online), the material is not very much in depth. UFAPS is limited in scope in the sense that it tests material that is only relevant to Step 1 but not beyond that.

Again, this is simply not true. And now you're making up that students need to know MORE than what step covers for preclinical (as if step wasn't already enough).

Cool, but your anecdotal experience adds what?

Oh you're one of those people "please provide me a peer reviewed journal article on any little phenomenon, otherwise it's false"

Also, I'm making the case for UFAPS because I believe in it but my original post has little to do with UFAPS. It has to do with the fact that our lectures are replaceable. Already, our lectures at my school are uploaded online. I choose not to use them and use UFAPS instead, and do better. Many other people at my school do so as well. There is an entire community (medschoolanki on reddit) that does this and consistently comes out with score reports with students scoring above 250+.

But if the only reason you disagree with me is because UFAPS: my school offers the lectures online and these saved lectures can be offered to incoming students every year. There, you UFAPS haters can be satisfied.

 

[deleted938090]

There is literally no reason that schools cannot go to a standardized pre-clinical curriculum and do away with PhD lectures and slash tuition prices. Spare me about the these things you list here because literally none of them need a lecture from a PhD for you to find out.

Do away with PhD lectures when some students are interested in academic medicine and the content could be their only exposure to the subject before hitting rotations? The lecture isn't really so much about the material that's covered in that time: it's to show what is happening in the field of medicine and then anyone can go home and read more about it if they're interested.

Not everyone can score 250 with anything...so I don't even get what you're trying to say.

The point of lectures isn't always to improve one's step 1 score. Step 1 may be a significant test but it isn't all of medicine; even if a lecture covers material that Step 1 doesn't, so what? You're conflating Step 1 = Medical school. Not everyone wants to do ortho or derm and require a razor focus on step 1 prep. People can elect to not go to lecture in many medical schools. And reducing tuition by cutting away training isn't what I had in mind.

 

[thegreatandmythical227]

I am speaking in relative terms of how much detail it goes into. Compared to lectures in classes (not "canned" lectures online), the material is not very much in depth. UFAPS is limited in scope in the sense that it tests material that is only relevant to Step 1 but not beyond that. Yes, it is more efficient to use them if that's your only goal, but there's definitely more to the subject than Step 1, which can be valuable for guiding a student to his or her interests.

Perhaps the only resources you use are UFAPS and exams and have done well. Maybe you feel very irritated about the situation at your medical school where lectures are mandatory. However this doesn't imply the blanket statement that lectures are useless for students.

Don't forget there's things like Boards and Beyond out there too.

 

[Chibucks15]

Again, this is simply not true. And now you're making up that students need to know MORE than what step covers for preclinical (as if step wasn't already enough).



Oh you're one of those people "please provide me a peer reviewed journal article on any little phenomenon, otherwise it's false"

Also, I'm making the case for UFAPS because I believe in it but my original post has little to do with UFAPS. It has to do with the fact that our lectures are replaceable. Already, our lectures at my school are uploaded online. I choose not to use them and use UFAPS instead, and do better. Many other people at my school do so as well. There is an entire community (medschoolanki on reddit) that does this and consistently comes out with score reports with students scoring above 250+.

But if the only reason you disagree with me is because UFAPS: my school offers the lectures online and these saved lectures can be offered to incoming students every year. There, you UFAPS haters can be satisfied.

and you're obviously one of those "what I believe has to be true and you're wrong" types of people. Is there a reason why both of you aren't right? Things work differently for different people. I mean chill out sparky you're coming in hot on this thread. Also I think most people will listen to an actual attending physician on these kinds of things.

 

[Cassowary]

Step 1 = Medical school

No I'm conflating step 1 to the first 2 years of medical school. which is what its supposed to be.

 

[VincentAdultman]

Oh you're one of those people "please provide me a peer reviewed journal article on any little phenomenon, otherwise it's false"

Actually I practice entirely based on what the last thing I read on a message board was. Consider yourself owned.

 

[Cassowary]

Actually I practice entirely based on what the last thing I read on a message board was. Consider yourself owned.

Maybe form your opinion on things you have used yourself and have experience with instead of speaking on things you haven't even seen before

 

[deleted938090]

I understand that debt and the feeling of wasted time can make you very upset, but it would be a bit of a stretch to say the first two years have "no purpose". First two years is time to make friends with people you're going to the wards with, to talk with doctors to explore specialties, to conduct research in the spare time, and to build your knowledge base of the basic sciences, which isn't equivalent to scoring high on step 1. I speak of the latter from a friend who has 265+ step who admits that step 1's scope pales to that of the entire field. A significant reason he's doing the research he's currently doing is from interest in a lecture topic back in preclinical years.
Rather we should focus on lowering the cost of medical education, perhaps through education reform, policy, etc.

 

[AnatomyGrey12]

when some students are interested in academic medicine and the content could be their only exposure to the subject before hitting rotations?

Wut? So class lectures should exist to cover current research and what is happening in the field of medicine? Yeah no. I have multiple publications and exactly zero of my research interest was piqued in a class lecture.

The lecture isn't really so much about the material that's covered in that time: it's to show what is happening in the field of medicine and then anyone can go home and read more about it if they're interested.

No, it's quite literally not. If you want this then do an MD/PhD program, or go to a residency with built in research years.

 

[Cassowary]

I understand that debt and the feeling of wasted time can make you very upset

This isn't upset; this is not some emotionally charged reaction. I bought into the system knowing what it was going to be. But like a lot of systems, this one is archaic, and I'm producing a logical argument as to how it can be improved.

two years is time to make friends with people you're going to the wards with

The purpose of school isn't to make friends. I could have done that at the bar.

to talk with doctors to explore specialties

This is something independently done, that the school doesn't help much with. I shadowed in undergrad, if I cared to I could do it again in years 1 and 2. But I don't bc rotations and subIs will take care of that later

to conduct research in the spare time

Again, independent pursuit that would be greatly aided by not having mandatory classes. Schools can set up connections but they would ultimately help very minimally

to build your knowledge base of the basic sciences

UFAPS

 

[afib123]

I understand that debt and the feeling of wasted time can make you very upset, but it would be a bit of a stretch to say the first two years have "no purpose". First two years is time to make friends with people you're going to the wards with, to talk with doctors to explore specialties, to conduct research in the spare time, and to build your knowledge base of the basic sciences, which isn't equivalent to scoring high on step 1. I speak of the latter from a friend who has 265+ step who admits that step 1's scope pales to that of the entire field. A significant reason he's doing the research he's currently doing is from interest in a lecture topic back in preclinical years.
Rather we should focus on lowering the cost of medical education, perhaps through education reform, policy, etc.

This is precisely why 2 curriculums are needed with people like you paying full tuition and getting lectures from professors while the others study on their own for decreased tuition.

No one is saying first 2 years have no purpose. Quite the contrary. They are extremely important but I don't need professors to learn 90% of the material.

 

[AnatomyGrey12]

I understand that debt and the feeling of wasted time can make you very upset, but it would be a bit of a stretch to say the first two years have "no purpose". First two years is time to make friends with people you're going to the wards with, to talk with doctors to explore specialties, to conduct research in the spare time, and to build your knowledge base of the basic sciences, which isn't equivalent to scoring high on step 1. I speak of the latter from a friend who has 265+ step who admits that step 1's scope pales to that of the entire field. A significant reason he's doing the research he's currently doing is from interest in a lecture topic back in preclinical years.
Rather we should focus on lowering the cost of medical education, perhaps through education reform, policy, etc.

There are good arguments for the pre-clinical years, i've made some of them myself in this very thread, however literally none of the stuff you mention are good arguments.

Also, scoring high on Step is quite literally the definition of having a knowledge base of the basic medical sciences.

 

[Cassowary]

They are extremely important but I don't need professors to learn 90% of the material.

I'd argue 99%

 

[VincentAdultman]

Maybe form your opinion on things you have used yourself and have experience with instead of speaking on things you haven't even seen before

In going to duck out now but I look forward to what I’m sure will be a long posting career from you.

 

[fldoctorgirl]

Our school sent us a very kind email a couple of months ago, where they started off with "we are very conscious about limiting your debt load" and ended with "but the board decided to approve a 4% tuition increase". Meanwhile, attendance isn't mandatory and I'm learning everything from the comfort of my couch. For those arguing for PhD lectures: fine. Record them and renew the recording if some fundamental knowledge changes, or every 5 years. Let the professors focus on research and mentoring students who are interested in research in the meantime. Let everyone else sit at home and learn however they learn best.

 

[Dwan]

Do away with PhD lectures when some students are interested in academic medicine and the content could be their only exposure to the subject before hitting rotations? The lecture isn't really so much about the material that's covered in that time: it's to show what is happening in the field of medicine and then anyone can go home and read more about it if they're interested.



The point of lectures isn't always to improve one's step 1 score. Step 1 may be a significant test but it isn't all of medicine; even if a lecture covers material that Step 1 doesn't, so what? You're conflating Step 1 = Medical school. Not everyone wants to do ortho or derm and require a razor focus on step 1 prep. People can elect to not go to lecture in many medical schools. And reducing tuition by cutting away training isn't what I had in mind.

I'm interested in academic medicine, but all my knowledge of current topics have come from following journals and twitter accounts of prominent professors in my field. Even when these lectures go into research, it's usually on topics that are of little relevance and shouldn't be a priority to clinicians who need to learn the basics of medicine first, so they don't end up killing patients in residency. If you have extra time and want to stay current, learning is best from the primary sources - there are excellent reviews available in the literature as well if individual studies are too complex/time-consuming.

 

[Philosopher Jagger]

it grinds my gears that not all schools use NBME exams in MS1 & MS2. All schools should switch to NBME subject exams in pre-clinicals MS1 and MS2. No professor written exams since the NBME compose great standardized pre-clinical exams.

THANK YOU! I know in particular at my school there are questions lingering around the test bank from PhD's who have been dead and gone for more than a decade. Specific, stupid, useless knowledge makes its way onto the exams of many schools who don't use NBME across the board

 

[Philosopher Jagger]

So what? I love being a doctor and whether you like it or not I will be a surgeon in a year graduating amongst the top students in my class and my test scores and clinical grades (shelf scores + evaluations) put me amongst the top students across the country.

Just because I love being a doctor, that doesn't mean students should be asked to pay hundreds of thousands dollars when they can learn it on their own.

I will pay 200,000 for last 2 years if that's what is needed for me to be in the hospital. That is necessary but what medical students pay the first 2 years is absolutely unnecessary.

After going through medical school and realizing how much of a waste of money first 2 years is, I am not allowed to talk about it?

Absolutely ridiculous argument. Like I said in my previous post, I am going to be a surgeon graduating in the top of my class in an year. There is no reason for me to care about this issue because I already wasted my money and I am done with step 1, but I do because medical students should not be paying 100,000 to professors when they can learn that material on their own.

Even if I knew coming into medical school that I can self-study first 2 years (I did not know coming in), I still would because love to be a doctor. That does not mean I am not going to give my voice to make medical education less of a burden on students. Even if the tuition decreases 5000 a year, I will take it because any money on an unnecessary resource is waste of money.

Medical schools can come up with whatever gimmicks they want to, but the fact is that any money spent on professors to teach whether in PBL or traditional lecturing is a waste of money. Medical students can learn that material on their own and decrease their debt load.

I can assure you no one is as impressed as you think

EDIT: I'm not trying to be a d!ck...I understand you are passionate about this topic. But flexing like this (before you've matched, nonetheless) is a bad image. Humble people make better arguments.

 

[afib123]

I can assure you no one is as impressed as you think

EDIT: I'm not trying to be a d!ck...I understand you are passionate about this topic. But flexing like this (before you've matched, nonetheless) is a bad image. Humble people make better arguments.

Well I know it comes across as bragging, but they are not isolated statements and are made in context like I already replied before.

1) I have to make to my point that you do not need to pay extreme amount of money the first 2 years to succeed in clinical years and on step 1 like medical school faculty try to make you believe

2) There was one guy specifically asking who asked me to come to medical school if I don't want to pay this money for useless resources. This was my way to tell him that I deserve to be here.

Maybe they came across more strongly than I intended, but they are only to make my points stronger and as a retort to someone who asked me who forced me to come to medical school. Either way, I can't do much now because I already made those statements

 

[getdown]

 

[Goro]

I can assure you no one is as impressed as you think

EDIT: I'm not trying to be a d!ck...I understand you are passionate about this topic. But flexing like this (before you've matched, nonetheless) is a bad image. Humble people make better arguments.

I see you also noted that the loose cannon was strong in that one. Residencies pick up on this as well during interviews. Just sayin'

 

[DeucesHigh3]

have you seen a lot of MEN cases?

Yeah, actually - just saw one today in fact (MEN1 with nonfunctional pancreatic lesions). I'm in radiology though, so weird tumors are our jam.

 

[Matthew9Thirtyfive]

Keep the thread on topic. Whether that’s the utility of the first two years of med school or how ridiculous tuition is, I don’t care. If the personal attacks continue, I will close the thread and moderator action will be taken.

 

[DeucesHigh3]

As a PG-5, are you familiar with Sketchy and Zanki? Lots have been released since you graduated

Sketchy, yes I was aware of it but never used it; I think it covers a lot more material than it used to. Zanki I had never heard of until I popped into the Allo forum this weekend for the first time in a few years, but I assume it's just a pre-built deck. We had to make them ourselves... not fun.

 

[mmmcdowe]

If you're going into surgery then be aware the two most important classes you'll take are physics one and anatomy IMO.