Medical School 2020, Year 1, Week 2

by philg

From our anonymous insider…

This week I learned about the National Board of Medical Examiners (NBME) Step I board exam. Typically taken after the second year of medical school, just before clinical rotations commence, the score on this exam is the most important criterion for the residency application (the first year of a residency is technically the future specialist’s “internship”). There is some bad news for nervous parents who worried about getting a child into the right preschool to ensure entrance to the right elementary school to ensure entrance to a prestigious high school to ensure entrance to a selective college to ensure admission to medical school: the real career-determining educational institution is the residency.

Our dean gave us some additional bad news this week: there is a worsening shortage of residency positions. (See “Squeeze Looms for Doctors; More Medical Students Are In the Pipeline, but Too Few Residencies Await Them” (WSJ).) Medical students have responded to this situation by applying to 15-20 hospital residencies rather than the traditional 4-5. Residency admission committees have responded to this flood of applications by increasingly their reliance on Step I board scores. All of our tests for the first two years are in fact covering the same material as the Step I test.

In our morning cellular/molecular biology lecture series, doctors and researchers may preface a detailed explanation with “don’t worry; you don’t need to know all of this detail for the test.” Nearly 20 percent of my classmates have at various points raised their hands to ask “is this going to be on The Test?” When the answer is “no,” I wonder how many tune out the nitty gritty details of a cancer signaling pathway or the extracellular matrix remodeling in vasculogenesis.

Three days this week, including the weekend, I joined a group of 6 or 7 classmates at a local bar’s happy hour for $2 beers and rail drinks. Roughly half of our class is female and one difference in conversation is that the men are less likely to talk about their romantic situation. Within the first 2-3 conversations with a woman, I’ve learned if she is single, dating, engaged, or married. About half of the women seem to be single, a fifth are engaged or married, and the rest are dating.

Though we have only recently met, it is already time for the class election. The positions up for grabs include president, vice-president, and a handful of Association of American Medical College student interest group representatives. Some eager beavers have been campaigning since the first week. There are three candidates for president and three for vice-president. All are male.

I did about six hours of homework total this week and went to bed every night before 11:00 pm.

The Whole Book: http://tinyurl.com/MedicalSchool2020

12 thoughts on “Medical School 2020, Year 1, Week 2”

  2. Everyone knows the anonymous insider is none other than Phil himself. It wasn’t enough for him to be an tech-entrepreneur, photographer, airline pilot, professor, engineer etc. Now due to truly satisfy his ego he wants to put M.D. after his name. What’s next a law degree?

  3. PN: Oh that is a beautiful article. Thank you! “Don’t ask an Asian student you don’t know for help on your math homework” is my favorite tip. The argument at the end around people who can’t decide if they are white, black, or Cuban is also pretty good. Perhaps I can get paid for offering the following tip: “Don’t ask a student who identifies as Cuban to make you a Mojito.”

    Toucan Sam: I wouldn’t last 5 minutes in an anatomy lab! One good thing about computer nerdism is the lack of blood, lymph, and other bodily fluids!

  4. PN: But on the other hand, I’m not sure how to weave a good blog posting out of that nytimes article. It is already kind of a parody of itself. On the other hand maybe the story is the generation gap (if we can defrost that page from the 1960s). A presentation that seems laughable to people of my generation is valued by today’s 18-year-olds (or at least some of them).

  5. Doctors and Lawyers might as well be unionized the way they manufacture their scarcity. Doctors by controlling admission and lawyers by keeping the system unnecessarily complex. Firefighters and longshoremen do the same. I like one suggestion from the H1B visa thread: start bringing in doctors.

  6. Phil: my personal favorite was the part where a student came to learn in the re-education camp that the phrase “you guys” was a microaggression. Although the part where a student was upset that the pictures of famous chemists were all white men was great too.

  7. Phil,
    I head the technology team at Firecracker, a learning tool/platform that might benefit your anonymous insider. we help med students memorize and apply the large amounts of info they need to do well on the boards and get those coveted residences. it would be awesome to get your thoughts on it. you can tell me if i put those 6.916 lessons to good use 🙂 .
    Ilya

  9. The problem with the USMLE Step 1 and 2 is that medical students focus more on ‘learning the test’ instead of building a solid foundation of knowledge to learn medicine. 15 years ago students would spend a month studying for Step 1 at the most (I studied for about 10 hours), but now they spend 2 years learning the test, which is encouraged by the medical schools to make their numbers look better. There is also the trend of pass/fail exams, or at least withholding class rank information from the students, which raises the importance of the USMLE in applying for residency higher still.

    It’s analogous to spending 2 years studying ACT/SAT tests in high school, or 2 years studying the MCAT in undergrad…that time should be spent learning to think instead of learning tests.

  10. Senorpablo – I have worked with many medical doctors who were educated overseas. Many of them equal or outperform their American counterparts but I would say the majority of them do not. We call them foreign medical grads (FMG), and it is more difficult for them to get training in the US because we know they are weaker students in general.

    Letting in more doctors from overseas may not be the best solution.

  11. I’m at the age where I engage several doctors, from GP’s to a big-city-big-reputation melanoma specialist. Fortunately they have collectively kept me not just healthy but robust.

    I have seen little difference in ability vs. country- or school-of-origin. I did quit one practice that operated several offices and could not seem to schedule me and the doctor to the same time and place.

Comments are closed.