Have a pathology final (shelf) exam tomorrow on a whole year of pathology – fun!!! Pink and purple microscopic slides you’ll never look at as a practitioner and pass along to the pathologist is my idea of awesomeness.
So this is finals week. This coming Wednesday we have two back to back exams in our “how to be a doctor class” also known as “Practice of Medicine. ” One is a final exam for the semester and one is a “National Board of Medical Examiners (NBME) style” shelf (final) exam designed to test us on two years of “behavioral sciences” (minus psychopathology). In sum here’s what the multipart multimoving schizophrenic class consists of:
“Patient Centered Case Based Learning” (PCL) : Reading on pieces of paper about fake patients, devising fake differential diagnoses and presenting on anatomical, ethical and psychosocial elements related to the fake case. This class is once a week for the whole year.
“Doctor, Patient and Society” (DPS): Here we learn how to “interview”. We practice we various standardized patients and doctors serve as the group leaders. We often talk about ethics, how to deal with difficult patients, etc. You meet about 5 times each semester in this group.
“Physical Diagnosis” (PDx): Here is where you learn the bread and butter of physical skills. Again, in most instances practice with standardized patients take place. However, this is never integrated with the above interviewing class, so never do you learn how to interview and examine a patient in the same visit. There are about 5 of these per semester. I have written here about one such session.
“Clinical Apprenticeship” (CAP): Here you meet with a clinical preceptor about 7-8 times per semester to try to achieve various tasks together. You can read this post about one of my first experiences in CAP here.
“Ethics”: Self explanatory. See here for a good description .
“Random other lectures on statistics and biostats”: Coming from the field of public health I had to take a semester of biostats and epidemiology both, so in my estimation, these courses attempt to equip a med student with basic skills in both these disciplines to feel comfortable enough reading articles from JAMA.
If you think it is impossible to know where you need to be when you are correct. In any case, this Wednesday we have the following:
-approximately a 75 multiple choice exam on all of the above subjects immediately followed by:
-unknown length of time multiple choice test on computer covering all of the above from the past two years.
Yes, two exams in the same class back to back. I was curious both as to a) why this was necessary and b) what objectives this was going to achieve. Why could all of this material not be on one longer exam? Our professor maintains a “ask the professor blog” where we are able to ask questions about the upcoming exam on the how to be a doctor class. My question was worded “Why are there two exams? I understand the shelf exam is new but why could material from this semester not be integrated into the computerized shelf exam?”
Upon asking a colleague if that question was appropriate (I have gotten in trouble before for asking inappropriate questions anonymously on an electronic bulletin board) I was told it was not, and rude to ask such a question at this juncture in time. Perhaps I could have asked it earlier, or perhaps I should have emailed the professor directly. So I proceeded to delete the question.
The thing that bothers me about med school that I have discussed with others before is that it is a culture of “shut your mouth and do what people tell you.” It doesn’t matter why you are having two tests, you just are. It doesn’t matter if you approve or not, just do it. You are forbidden to ask questions, or challenge anyone’s authority. This is just another thing (that I don’t deal well with) that equates med school to the military. In the military you don’t question anything. Perhaps I could e-mail him the question privately, but at this point it’s moot, and I have recently just accepted that I have to sit through 4 hours of questioning on the biopsychosocial elements of medicine without knowing why.
Bottom line: Be mindless sheep medical students who keep your mouth shut, only offer feedback when asked, and don’t ask any questions. ❤
PS. I would also like to know why we have two back to back tests the last day of finals – the second designed to be a three hour diagnostic mock national board exam. I would love to ask the authorities that be if there was any other time that this could have been scheduled. Baaaaaahhhh.
Tales from med school 