tag:blogger.com,1999:blog-4968787219619380438.post7902952018685517227..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: An MD's thoughts on medical educationSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger113125tag:blogger.com,1999:blog-4968787219619380438.post-3132217960423277892018-12-09T12:40:03.965-05:002018-12-09T12:40:03.965-05:00Your school sounds like it has a few problems. You...Your school sounds like it has a few problems. Your comments mirror what the author wrote. I wonder if you are attending the same school he teaches at.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-36874118111421136712018-12-09T01:12:14.237-05:002018-12-09T01:12:14.237-05:00I found this post out of frustration with PhDs tea...I found this post out of frustration with PhDs teaching my M1 curriculum. I am an older, non-traditional student with a healthcare background in the hospital setting. We are learning cardiopulmonary right now from a textbook that uses antiquated terminology and obsolete diagnostics. They teach from this book as if it's the bible. Forget that this EKG reading is a STEMI, can you calculate the mean vector of the injury current? Isn't it more important that we can recognize a STEMI and how to treat it? I don't think we will hear "injury vector" again unless we become a cardiology resident. Another good one is treating CO poisoning with 95% O2 and 5% CO2, because the PhD teaching us doesn't know that CO2 tanks aren't exactly hanging around the ER and that the RT needs to dig one out of a closet somewhere and hook it up to a gas blender first. It's ridiculous! They are going to put you on a non-rebreather on max O2. It is mind boggling and infuriating for anyone in our class that has clinical experience, because we know we are being spoonfed B.S. All the while the 22 year olds straight out of undergrad, still on mom and dad's insurance, who know nothing about healthcare just smile and nod - accepting it all as gospel.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-86601789735859989692018-03-19T09:18:05.397-04:002018-03-19T09:18:05.397-04:00Al, I'm not sure where the great doctors are c...Al, I'm not sure where the great doctors are coming from. I have often said that some people could learn medicine by studying a few good textbooks and having a few good teachers. Maybe the great doctors would be great no matter how they are taught.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-84487782131801029582018-03-17T22:17:46.701-04:002018-03-17T22:17:46.701-04:00If medical education sucks as badly as these moane...If medical education sucks as badly as these moaners claim where the hell are all the great drs we have coming from?Anonymoushttps://www.blogger.com/profile/01560377580152318228noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-49623766494240895602018-03-17T21:36:48.764-04:002018-03-17T21:36:48.764-04:00AMENAMENAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-28145802814169988812017-12-12T07:14:49.048-05:002017-12-12T07:14:49.048-05:00This was a post written by one of my readers, not ...This was a post written by one of my readers, not me. I agree with most of what he said. Your comments are also appreciated.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-90727438035377385672017-12-09T13:06:48.924-05:002017-12-09T13:06:48.924-05:00Skeptical scalpel: Immensely thankful for voicing ...Skeptical scalpel: Immensely thankful for voicing your observations. I thought I was the odd one who was thinking the same way! Some of the PhD's I got to work with, as a med-school anatomy TA (during my Neurophysiology PhD program in the US), were expert researchers on topics like certain extinct species, dinosaur eggs, medical education etc. What I saw was these 'educators' were teaching most of the anatomy on the whiteboard and not in the cadaver! Obviously, they missed out on vital clinical implications of that information ! Especially, when these educators were themselves not aware of the likely real-life presentation of the situation. As I said, I can absolutely hear what you convey !!! I worked as a clinician (MBBS MD), and taught anatomy as an adjunct for several years in med schools India, prior to coming to the US. Over the years during my doctoral program, I have heard med-students express similar concerns as expressed in many of the comments above! I hope faculty-selection ventures for anatomy teaching positions should be more transparent as to specific criteria for selection and perhaps performance evaluation of the candidate as per a trial performances as to how they perform teaching selected topics to a group of students. I hope the future doctors get the best they deserve !!! <br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-42207944580393587642017-03-12T11:52:27.721-04:002017-03-12T11:52:27.721-04:00I really can't offer any advice on that subjec...I really can't offer any advice on that subject. I don't have the depth of knowledge required to do so.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-81305677209963496232017-03-10T15:13:48.386-05:002017-03-10T15:13:48.386-05:00What are your suggestions for a premed student tha...What are your suggestions for a premed student that in with you on this problem! Any suggestions for schools that are more progressive and clinically more oriented?? Anela Birdhttps://www.blogger.com/profile/15102187336613939501noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-29949053251274346422016-05-09T11:42:56.697-04:002016-05-09T11:42:56.697-04:00Anon, you make some good points. I just don't ...Anon, you make some good points. I just don't know if there are enough autopsies being done these days to accommodate every med student in the country. And that's too bad.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-1458709488320490832016-05-07T18:54:41.168-04:002016-05-07T18:54:41.168-04:00As pathology resident, I've learned a lot from...As pathology resident, I've learned a lot from doing autopsies on patients who weren't living or breathing. In my first year of training I performed over 50 autopsies and assisted on countless others. I’ve seen everything from congenital heart defects leading to pulmonary edema and ARDS to advanced metastatic cancer. Each case, including writing the report, researching the clinical history, presenting the dissected organs showing the gross pathology to the attending, and taking microscopic sections to exam the disease under the microscope takes about 10-20 hours each case. What is gained is a vast understanding of relevant anatomy and spatial relations of organs within the body. In my surgery rotation, I was lucky if I was able to even seen the surgical site because often times there were techs , resident, or fellows who took obvious precedence over me. My recommendation would be that every medical student be asked to a certain number of autopsies showing they understand the anatomy, are able to identify specific gross pathology, and be able to describe the particular disease process that eventually lead to that individual demise. That’s my 2 cents. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-72194332025331624122016-04-26T09:48:22.678-04:002016-04-26T09:48:22.678-04:00Thank you for sharing. I became privy to pharmaceu...Thank you for sharing. I became privy to pharmaceutical fraud and mental health abuse at an early age. I also shadowed a Pharm tech and a deliverer. I had a kin who dated a POA and she enabled me to be able to shadow her as well. I have been a steady neuroscience and biochemistry student since age 12. I have majored in every main category in college. I have approximately 8 years of college. I dropped science at college because it is fragmented bits of knowledge and false credibility. I have worked in three different hospitals now and in two different states. I talk to many other nurses and third year med students. I have challenged a few of them. They can’t give me any details about the human anatomy or neuroscience. One gave me a lie. She said, "Neurotransmitters send messages to each other". Neurotransmitters are messengers that help regulate biochemical activity. They are not messaging each other. Many third year students, do not even know what their medicine focus is. You have to have a purpose for any medicine research, synthesis and retention. If you don’t - you’re just playing a play memory game. You cram those purposeless fragmented bits of knowledge in to short term memory, and hope you get the right answer for the exam. Nurses, excluding (Cardiac/ED) have told me that they do just what they do for their kids, except administering drugs. Many have mentioned that the cock-eyed equipment was the bulk of what they needed to learn and use. I have seen the equipment myself. Of course, there is much typing and being on a computer.Anonymoushttps://www.blogger.com/profile/03985037269314647829noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-60831460021481785652015-09-11T10:36:55.937-04:002015-09-11T10:36:55.937-04:00Thank you for your comments. I couldn't agree ...Thank you for your comments. I couldn't agree more. As physicians and surgeons we rely on the knowledge and skills of all our colleagues. This has never been questioned--or argued. Our current system of medical education does not allow future physicians to pay homage and respect to ALL who've contributed, no matter how small the contribution, to the advancement of science and medicine. Therefore, we must be selective in what we teach--and focus on relevance while admitting our failure to teach it "all". We should pay respect to every physician, surgeon, and basic scientist who has contributed to our knowledge bank; unfortunately, choices must be made on relevance. Thank you for your comments and paying homage to a favorite surgeon, Dr. Semmelweis.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-62628603480205248962015-09-10T18:14:17.082-04:002015-09-10T18:14:17.082-04:00I must say, this is absolutely disgusting. Science...I must say, this is absolutely disgusting. Science is the whole reason medicine has been so successful and medical doctors are respected by society. Your total disregard for the scientists and researchers that brought your profession out of the darkness of quackery and superstition is horrid. Without basic science you people would still be doing blood lettings and thinking disease is caused by humor imbalances. And that physicians totally couldn't be causing the deaths of thousands by not being sanitary (go look up Ignaz Semmelweis). When you are bleeding out and need a doctor to stitch you up, you should not just be thanking him, but also the countless scientists who's ideas and findings have made sure you won't die from you surgeon sticking his filthy unwashed hands in your wound and killing you with a bacteria infection. There's a reason the pre-SCIENTIFIC and EVIDENCE based medicine and lack of knowledge caused more deaths than direct combat did during wars. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-46534653133918442882015-04-08T10:09:52.334-04:002015-04-08T10:09:52.334-04:00To, "By the way, I'm an MD). . .thank you...To, "By the way, I'm an MD). . .thank you for your insight. I agree with you the brachial plexus is important and the cerebellum is important. Unfortunately, this blog does not allow me to test you, directly, on how much of that knowledge you've retained on instant recall over the years. I would argue advanced thermodynamics is important, too--but how much of THAT do you use, on instant recall, in your treatment of a patient? Organic chemistry? Important...sure. Do we need them to be in our memory banks on instant recall? I think not. While you are entitled to your opinions--so am I. Hence, the purpose of such blogs. Unfortunately, your name calling as dropped your impact factor to nearly zero. Thanks for the insightful comments.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-84068585940049033512015-04-08T05:35:56.533-04:002015-04-08T05:35:56.533-04:00You are a douche. The brachial plexus is important...You are a douche. The brachial plexus is important and everyone should know it. The structure of the cerebellum is also quite important, and you are a douche for claiming otherwise. (By the way, I'm an MD.)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-82557740994029880082014-10-09T16:08:57.926-04:002014-10-09T16:08:57.926-04:00Thanks for the interesting comments. Is this Wash ...Thanks for the interesting comments. Is this Wash U in Seattle or St. Louis?<br /><br />I'd like to read that OR communication study too.<br /><br />I am not aware of the composition of med school admissions committees. Although this post has had over 14,900 page views, it's a bit dead at this point. I hope someone else will enlighten us.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-82862951118841838302014-10-09T10:56:38.016-04:002014-10-09T10:56:38.016-04:00Just another anonymous biochemistry PhD here who j...Just another anonymous biochemistry PhD here who just stumbled on this fascinating blog. I have no dog in this fight since it has been decades since I've done anything in medical school education. (But do you remember doing problem sets on the acid-base chemistry of amino acids? I might have been your TA.) <br /><br />I was interested in the comments about medical school admissions committees because I have never heard any PhD talk about being on such a committee. (But I have heard many complaints over the years about being assigned to teach medical students. I have yet to meet a PhD who enjoys it. If MDs were willing to do it, I am sure the PhDs would happily give it up.) Anyway, I wondered how often PhDs serve on these committees.<br /><br />So this is my quick and dirty look at PhDs on admissions committees. Wash U's committee came up near the top of my Google search. It had a list with pop-up bios of the members so it was easy to find information. Here's a rough analysis of that one admissions committee:<br /><br />Total members: 74<br />Total MDs (including MD PhDs): 63<br />No advanced degree: 3 (university apparatchiks)<br />Total PhDs (excluding MD PhDs): 8 (all women, for what it's worth)<br /><br />Drilling down:<br />Of the 8 PhDs, 2 have substantial experience related to patient care <br />-One is a clinical psychologist who directs psychotherapy training for psych residents<br />-one is an assoc director of hospital labs--clinical chemistry, serology, immunology <br /><br />A third PhD is an associate dean for medical student research.<br /><br />Another PhD seems to bridge the gap between research and patient care. Just going by her little bio, she does research in hearing loss and speech recognition, she has worked with the deaf and hearing impaired, she has set up rehabilitation programs, and she is also involved in a study of communication breakdown in ORs (Now there's a study I'd like to read!).<br /><br />The remaining 4 PhDs are basic researchers who don't seem to have experience with patients:<br />-a microbiologist who works on H. pylori<br />-a geneticist who studies abnormal lipid metabolism<br />-a biostatistician interested in community-based research and health disparities<br />-and, finally, yes, the dreaded anatomy professor who does research on baboons.<br /><br />So this is just one committee, but it looks to me that there are only 4 PhDs devoted to basic research. That's 5% of the committee.<br /><br />At least on this one committee, it doesn't look like basic scientists have much influence in medical admissions at all.<br /><br />Does anyone know if this breakdown is typical?<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-28738106944974114502014-08-06T02:17:26.366-04:002014-08-06T02:17:26.366-04:00Good and Interesting Article.Good and Interesting Article.MBBS in Philippineshttp://www.imes.org.in/why-study-mbbs-in-philippines.htmlnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-28901019433125243312014-08-05T21:23:10.594-04:002014-08-05T21:23:10.594-04:00Ayeekaz, you are right. In my fourth year of med s...Ayeekaz, you are right. In my fourth year of med school elective time, which was 12 weeks, I taught anatomy. It was a great way to refresh my memory about the subject. <br /><br />It is interesting to know that other countries share our problems. <br /><br />Unfortunately, I don't see a viable solution. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-17306922150926565472014-08-05T14:47:45.746-04:002014-08-05T14:47:45.746-04:00I'm currently in my final year of med school, ...I'm currently in my final year of med school, doing an orthopaedics rotation, and what I want more than anything is a cadaver. I learnt anatomy 4 years ago, and had no appreciation for it: mainly because of all the minutiae that obscured the real knowledge. I had excellent anatomy teachers, but what they told me was important for me know has proved to be in contrast with what the clinicians want me to know. <br /><br />I believe that a thorough knowledge of anatomy and physiology allows one to make clinical inferences and understand disease. In fact, that's my "get out of jail card" in exams: I think about the basics and approach the questions asked from there. But there really is no substitute for a clinician that understands the link between the theory and the practice, and while PhD's have a phenomenal grasp of the theory, they really don't have a clue about the subtleties of practice.<br /><br />I think it's a rather poor indicator of trends in medical education that as a student in a different country, coming from an undergraduate programme, this article resonates so strongly with me. Globally it seems we have a problem. <br /><br />And, by the way, although I went from grade school straight to med school, I will still earn a comfortable living from my career. That doctors are paid high salaries goes with the fact that in most cases, they work crazy hours, are highly skilled (not knowledgeable - skilled) and subject to the whims and fancies of the government, insurance companies and patients. At least, that's my opinion. ayeekazhttps://www.blogger.com/profile/03963454910789250507noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-915537265021812022014-07-02T12:17:32.472-04:002014-07-02T12:17:32.472-04:00Thanks for the comments. Interesting analogy with ...Thanks for the comments. Interesting analogy with gasoline.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-5394903316586296742014-07-02T11:58:10.330-04:002014-07-02T11:58:10.330-04:00Al:
I had to walk a mile through two feet of snow...Al:<br /><br />I had to walk a mile through two feet of snow in sub-freezing temperatures just to get to the school bus, too. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-50973419640641143972014-07-02T11:55:57.517-04:002014-07-02T11:55:57.517-04:00"Who care what some PhD taught you. . ."..."Who care what some PhD taught you. . ."<br /><br />I do. I was paying for the product. I was paying for my own education. While there is truth in what you say, it is akin to saying, "Let me teach you the structure of gasoline. . .to drive your car." You say, "Forget it...move on...learn something new every day." I agree with the on-going learning and your comment that "What one learns at med school son becomes ALMOST irrelevant as medicine advances and at an ever-increasing rate." And, you are correct, we MUST stop "living in the past" and change the way we teach medicine now. To continue to allow non-clinical PhD's to teach future clinicians IS living in the past: as dictated by that now, outdated, Flexner report.<br /><br />Time for a new Flexner report. Time for an overhaul of medical education. We ARE living (and teaching) in the past.<br /><br />By the way, I need to go fill my car up today with unleaded. . .but I'm not quite sure how to calculate that octane rating. I'd better ask the attendant. He'll know.<br /><br />:)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-17660653953478351832014-05-28T20:09:12.384-04:002014-05-28T20:09:12.384-04:00One wonders why people can’t let this go and get o...One wonders why people can’t let this go and get on with the job in hand. What one learns at med school soon becomes almost irrelevant as medicine advances and at an ever increasing rate.. One doesn’t really start learning till one gets into practice and the learning leaves med school far behind. Stop squabbling about what you studied at med school and soak up current information, you cannot live in the past. Med training may well be totally different anyway since most of the complainants attended med. Further if the training was so wrong how come there are so many good Drs out there? Simple really they got on with soaking up experience and adapting to new ways. More than anything studies are to prepare one for the future and to develop the ability to research and work things out to a positive conclusion. Who cares what some PhD taught you a med every time you get someone ell using your own self taught skills. For Gods sake I completed training in the 60s and nobody taught me genetics / sequencing I had to seek the training for myself many years alter. My training made it much easier to grasp the intricacies of the subject than had I not had training that allowed me to develop skills later in life. Then came computing and what will come next.<br />Alastair<br />Anonymoushttps://www.blogger.com/profile/01560377580152318228noreply@blogger.com