Standardize Me

I didn’t post at all last weekend, even though I really wanted to do so. There are a few good reasons why. Besides unsuccessfully fighting off a cold and studying for three exams this week, I am also incredibly lazy and didn’t have the time or motivation to sit down and write the post that has been on my mind for several weeks. It’s only fitting that I find this motivation shortly before my pathology final, most likely using a blog post as another reason to avoid studying  for this test. As one classmate posted on Facebook so accurately: “I find that I Netflix better with study going on in the background”.

I don’t even have to study all that hard for this exam. Because of our grading system (pass/fail) and the assignments and tests I have already completed give me all but six points I need to pass the class. To put in another way, I need to get just 6/100 questions correct to pass this class. I could do that in my sleep. Don’t worry, I will study hard and do fine. (Edit: I actually did pretty well on it).

Our Pathology overlords are doing us a bit of a favor, they tell us. All of their exam questions are “board style”, similar to the format we can expect when we take Step 1 next year. This means that we take the exams on our computers through secure browsers, and that some of the multiple choice questions have options a-h instead of a-e.

Our questions are slightly harder than this, by the way.

Another way we are being prepared for Step 1 is that we are doing everything way faster than previous classes have ever done anything. As I write this in the first week of March, we have already completed all of the Year 1 curriculum. Next week we will begin Year 2 curriculum. The benefits to us include more time to study for Step 1, and more time in rotations before having to make important residency decisions. This all seems like a good idea to me, but we are the guinea pigs in this little experiment, so only time (and our board scores) will tell how it worked out.

This got me thinking about all of the standardization we are receiving. The main goal of the first two years of medical education is to perform well on Step 1. My understanding is that this test makes sure new medical students have an appropriate amount of basic medical knowledge before entering the wards and practicing on real patients. This actually works out very well for me, as I have a long history of crushing standardized tests (including NBME pathology most recently).

Recently my brother-in-law graduated from the police academy. Police officers have a very important and challenging job not unlike a doctor. They have a huge body of knowledge to learn, including the geography of their city, procedures of their department, legality issues, physical ability to drive, arrest, restrain, and I know many cops that have a highly developed “sixth sense” that gets them out of dangerous situations. Even my limited EMS experience has shown me the value of this sixth sense, but I doubt it could be taught.

Now if the police academy worked like medical school, they would spend 2 years in a classroom watching powerpoint presentations on street layouts, with the dangerous areas highlighted. They would take multiple choice exams on how to handle interactions with dangerous suspects, maybe watch videos on driving skills. Thankfully, my brother’s academy didn’t work like this at all. He rode with cops, listened to their advice, and saw firsthand dangerous areas of town. He went to an abandoned runway and spent an afternoon learning defensive driving techniques.

Medical school isn’t taught like that, and I’m not even sure it should be. All I know is that medical school has been taught the same way for a very long time, which is why it is so standardized. There is a well defined process to becoming a doctor, steeped in tradition and learning. If improving the quality of medical education came at the cost of leaving behind those traditions, would anyone attempt it? Will there be a series of huge sweeping changes in the coming years, or will innovation come in small steps, creeping along over the years?

I’ll have to think more about this, but it’s something that will be on my mind as I work my way through medical school.

This post is now very late, but thank you for reading!

 

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