Learning vs. Studying

Are learning and studying the same?

Most people that are in medical school have probably had a conversation that goes something like this.

Non-Medical Student: "You're in medical school! You must love school, I could never put up with four more years of it"

You (or Me): "Well I don't know, I don't really think that I love schooling all that much..."

If you are anything like me, you probably find it really hard to give someone a satisfying answer to that question. I've thought about my own motivations a lot, and this is what I've been able to come up with.

I love learning. I love finding out something new that I think is applicable to my life (or to my future life). I love when I finally understand something, when I spend time trying to wrap my mind around something and then I finally "get it."

I hate studying. I hate being told to read 200 pages of notes and commit it to memory. I hate sitting down in a lecture hall for 5 hours of lectures followed by 3 hours of lab. For me at least, there is nothing fun about that.

I'd love to learn another language, or how to play a musical instrument--or even another sport--but the medical school curiculum is so constrained that there is no time for that. So what you end up with is a bunch of people who are (on some levels) miserable for the better part of two years with one test after another hanging over their heads.

I agree that much of the information learned in medical school is very valuable, but I think that there are much more efficient (and less costly) ways of training our future doctors.

So how would I change medical school to make it better.

The biggest change I would make is to switch to a 3 year preceptorship, broken down like this:

First year: anatomy, histology, physiology (6 months) pathology, pharmacology, microbiology (6 months)

Second-Third Year: 6 months of family practice at 2 different sites, 4 months of internal medicine, 4 months of general surgery. 1 month of Emergency Medicine, OB/GYN, Psychiatry, etc.

Fourth year: 8 months of required electives, 4 months for interviewing etc.

In this system you would have to expand the "shelf" tests to account for longer periods in each rotation, but I feel like this would be a better situation for everyone.

Current doctors can feel like they are having a greater influence on future doctors. Medical students will absorb much more information when facts are associated with real life situations. Patients will have better trained doctors, and hospitals can hire a few less MAs and save some money. In my mind, it seems like medical education is stuck in the dark ages--where medical students are still being taught to memorize side effects for 100s of drugs, even though that information is now only a PDA click away.

Wouldn't that time be better served learning how to be a better doctor instead of a fact-spitter-outer. How many times have you heard from doctors that many of their colleagues in medical school who were great students have made terrible doctors--isn't that a sign that something needs fixing?

Time to Start Throwing the Baby Out with the Bathwater, Studies Show

It’s common knowledge that young children are nothing more than freeloading ner-do-wells, but could they also be making you sick? That’s the question researchers from the University of Alberta wanted to find out.

“We were all sitting around the lunchroom one day when out of nowhere John starts coughing,” said Todd Maste, a doctor of homeopathic medicine. “And I said to him: ‘Hey didn’t you say your kid was coughing last week?’ And he was like, ‘Yeah he was.’ All the sudden it hit him. His kid was making him sick.”

But mere anecdotal evidence was not enough for this modern day Sherlocke and Homes. They sought a degree of certainty only attainable via a double-blind, randomized study.

“We took, uh, 20 kids who were sick, uh, and within two weeks 12 of [their] parents got sick too. Clear cut kid to parent transmission of disease.”

Armed with this knowledge, Maste and his colleagues sought out the manufacturing giant Pharmista, makers of Hydroxyfatburnercooker™ and Schlonger™ to see if there were any marketing possibilities for a new over-the-counter drug. Matt Barnes a marketing executive explains:

“The information that Dr. Maste had come up with was so groundbreakingly earthshattering, that I thought ‘We’ve got to take this and run with it.’” Barnes later added, “All the way to the bank.”

Sir, Do Helicopters Eat Their Young?

Be careful how you respond to this question if you find yourself looking up from a hospital bed--the wrong answer will get you admitted for Stage 3 alcohol withdrawl. Either that or the alcoholics just know something we don't.

Words That Draw People to This Blog

In looking at the demographic information about who actually reads my blog I found that there's been a gradual change from "people who accidentally find it because they typed in a google image search" to "people who accidentally find it because they were searching for something else."

Just for the fun of it here are the most common searches that lead people to my blog (in the past year):

How hard is medical school 20ppl 6.08%
medical hierarchy 16ppl 4.86%
Medical school is hard 13ppl 3.95%
medical school quotes 10ppl 3.04%
how hard is medical school? 6ppl 1.82%
med school quotes 4ppl 1.22%
is medical school hard 4ppl 1.22%
hierarchy of medicine 4ppl 1.22%
school of hard knocks baseball 3ppl 0.91%
hierarchy in medicine 3ppl 0.91%

I guess there are a lot of people out there concerned with how hard medical school is--maybe if those people got together with the "medical school is hard" people then they wouldn't have to search anymore.

Mostly for my own curiosity (and to record it for posterity) here is the geographic breakdown.

United States 713 67.90%
Netherlands 129 12.29%
Canada 40 3.81%
United Kingdom 38 3.62%
Australia 15 1.43%
Mexico 14 1.33%
France 8 0.76%
Italy 8 0.76%
New Zealand 7 0.67%
Spain 6 0.57%

In order to maximize the number of people to read my blog, I think I'll title my next entry: "Is Medical School Hard in the United States? Yes, Medical School is Hard in the United States." And then I'll throw the word "hierarchy" in there for good measure.

Addendum: I am now the number two hit on google if you were (for some unknown reason) to type "medical school of hard knocks." And I've got a message for someone out there, you'd better watch your back 'guy-who-once-wrote-an-article-for-TheOnion-using-the-words-medical-school-of-hard-knocks' or your going to lose your number one status.

My First Surgery

A week ago today I saw my first surgery. It was a sigmoidectomy. The patient has cancer that was occluding most of his/her sigmoid colon and as a result (s)he was unable to eat normally.

I was there was due to my working on some research involving tumor detection.

Specifically, the project that I am working on is trying to differentiate between tumor and non-tumor using a laproscopic probe and a special kind of laser (and a database of scanned regular tissue and different tumors). Put simply, the goal of the research is to be able to tell whether something is cancerous or not in a much shorter time than it takes to get results back from pathology, and the doctor doing today's surgery thought that we might be able to glean something valuable if we saw a tumor resection.

Back to the surgery, the patient also had secondary metastatic tumors in the liver, but these did not spread any further, thus making her a candidate for surgical removal of the primary tumor. (S)he previously had been undergoing chemotherapy, but from what I understood this has not been successful.

Before I entered the operating room I had the slightest bit of nervousness that I wouldn't be able to stand the sights and sounds of an operation without getting squeamish. I was afraid that (even though it was laproscopic) I wouldn't be able to handle seeing the blood or the inside of someone's abdomen, but luckily there was very little smell, and I tolerated the blood just fine. I think the key was not really taking the time to think about it, it's a bit sad but it seems like the best way to get through the first few times is to not think of the person as a human being--whether you're in the anatomy lab or watching a surgery.

The surgery went on for a few hours without anything especially exciting happing, but I was extremely excited to be there. To see someone performing a surgery made me feel like I could someday be doing it--which isn't to say that it wasn't an incredibly complex process, I just felt that it was something that I could learn.

The other thing that I was struck with was how advanced the tools are that the surgeon used, especially the staplers. I had seen/heard about cauteries before, but to see how a miniature stapler seals off both ends of the colon, and how they pull it out through a gel "hand port" to resect it--it really is a feat of engineering and antiseptic technique.

Altogether it was a very exciting 2 hours, but I definitely need more comfortable shoes if I'm going to be standing up for that long ever again.

An Argument for Detroit

If someone tries to start an argument with you while on a Detroit bus, think twice before saying something incindiary. Oh, and watch out for snakes.