<p>While DS was in the process of compiling his final list of schools this past month, it became abundantly clear that many schools have revamped their curricula over the past several years, the most popular transformations being the shortening of the pre-clinical period, the introduction of patient contact from Year or Month or even Week One, the addition (for more research-oriented schools) of a formal thesis, and the substitution of TBL/small group sessions for some seat time in lecture halls. For those of you immersed in the process, what have you heard from faculty and/or more advanced students regarding the wisdom of these transformations? Are you content with your schools approach?</p>
<p>D1’s school was the first to pioneer some these innovations. They have clinical hands-on experience from the first week onwards. They learn to perform standardized patient physical exams (including prostrate and pelvic exams) within the first 8 weeks of school and move on to do hands on patient care clinics (under supervision) by their second semester. </p>
<p>The results has been that the students at this school (which is not a particularly high ranked school, and one which has a lower-than-average MCAT) scores, as group, above the national average on Step 2. </p>
<p>The abbreviated second year has its disadvantages and advantages. </p>
<p>Disadvantages include the students feeling extremely pressured from the end of MS1 onwards because they take the STEP 1 so early (no later than end of February second year). D1 thinks that some students may score lower on their STEP 1 because of the early test date, but she has no empirical proof. </p>
<p>Advantages: Between having 2 extra clerkships and the practice of allowing students to start working in continuity clinics (students are allowed to choose any specialty, but slots are limited in competitive specialties and assigned by lottery) starting from their first semester of MS1, student have more exposure to a wider variety of potential residency fields before they start writing residency applications in fall of MS4. In particular, students interested in competitive specialties will have 2 slots for audition/away rotation at other medical centers in their potential specialty. (More letters of recommendation avaialble for residency applications.)</p>
<p>Her school also uses PBL–D1 enjoyed it but not everyone does. Some students are more comfortable with the familiar didactic lecture process. And the quality of the PBL specialty leaders varied great deal. I would put this under a “personal preference” category.</p>
<p>This school also requires a formal thesis from all students. Students are given a great deal of leeway in their choice of topic. It could be basic research or a public health issue or a clinical patient-centered study. Students get a some free time after STEP and before the beginning of clinicals in April to work full time of their thesis. Students are all expected to publish before graduation. This is an advantage particularly for students interested in competitive specialties (like ortho–which is D1’s current interest) since relevant publications are a consideration of residency directors during residency interview invitations and match offers.</p>
<p>Thanks for the thoughtful reply. I’ll pass along in particular the link between published research and choice in competitive residencies, as I don’t believe DS is aware of this. It’s a long way off, of course–first he needs to focus on admission to med school–but it doesn’t hurt to glance down the road now and then.</p>
<p>My school’s also quite PBL-heavy in the preclinical years, and I have a hunch it’s not too different than WOWMom’s D’s. </p>
<p>I too really enjoyed PBL, and my school has published numerous papers about the process and its results (PM me if you’d like a link). Seems to work well for us. </p>
<p>I’d say our curriculum is on the innovative side of the spectrum, and something I really like about it is how readily I can think about clinical problems as a result. I plan to be a clinician (private practice or academic medicine?) so working on clinical skills from the get-go has always been appealing to me. I also like the camaraderie and environment that PBL programs basically force on you–everyone has to work together and there’s essentially no benefit to undercutting your peers, which makes school fun and pleasant instead of a constant blood bath (which seems to be the case for friends at other schools). </p>
<p>So, to me, benefits of PBL heavy programs: 1) collaborative environment that focuses on building relationships 2) exposure to clinical thinking/decision making early and often 3) relatively flexible/student friendly in terms of time commitment 4) demonstrated success at my school, as evidenced by improved scores and happier students</p>
<p>Some drawbacks: 1) lack of competition can make people lazy 2) focusing on clinical aspects can mean spending less time getting to the real nitty gritty details of various topics 3) lack of structure can be unsettling for students who aren’t used to it or for students who prefer structure in their learning environment</p>
<p>Maybe I shouldn’t write this, but what does PBL or TBL stand for? Kristin, what does it mean when you say PBL-heavy? I’ll need to PM you, since I like to learn that curriculum stuff. I’m also trying to find that kind of information about the differences about each school and haven’t found much.</p>
<p>PBL = Problem Based Learning
TBL = Team Based Learning</p>
<p>What they mean is that the curriculum is less lecture oriented and more self-learning driven. How exactly it’s run can vary a lot. In one our diagnosis/clinical skills class we did TBL style sessions where a faculty member was there to moderate/guide when we got really derailed but one person was the leader, 2 people were “researchers” meant to look up any questions we had and one person was the scribe who would write everything down. The other 2 people had no specific job. We were given a case and had to work through what history questions we wanted to ask, what physical exam maneuvers in particular we wanted to do, what labs we would order, and finally end up with a differential.</p>
<p>MSAR/school websites are the best resource for curriculum.</p>
<p>Mine was much more traditional. Mostly lecture based with a fair helping of small group sessions. I guess these would be more PBL than TBL as the prof still ran the show but the teaching points were made by working our way through a series of questions. First year is largely “normal” stuff with 2nd year containing all the pathophys. I like this model over the newer systems based integrated models because in 2nd year you spend a day in each block reviewing all the relevant histo/physio/anatomy of first year whereas in true systems/integrated once you finish the cardio block you never talk about anything cardio related ever again. There is def no condensing of our 2 years at all. First year runs from beginning of september until the end of may, second year from the beginning of september until the beginning of may.</p>
<p>They told us at our school that many of the condensed programs are thinking of going back to the full 2 years as there has been evidence that the shorter pre-clinical curriculum leads to lower step 1 scores.</p>
<p>PBL means “Problem-Based Learning” - it is a type of curriculum where the focus is on small group-based learning where the groups learn not by being lectured to, but by being given “problems” (usually clinical) that are designed to elicit certain information and having to solve them as a group. These groups are facilitated by a faculty member. </p>
<p>Personally, I hate PBL - my school had a generally traditional lecture-based curriculum, but incorporated PBL into certain courses, and I really didn’t like it. I can’t imagine having to do an entire curriculum like that - I would have torn my hair out by the second week haha.</p>
<p>Cross posted with Icarus.</p>
<p>I think PBL/TBL has a lot of potential but unfortunately unless everyone in the group buys into it it really sucks. I had certain courses where the small group sessions were awesome because everyone came prepared and contributed and others where it was absolutely painful to be there because almost everyone was totally checked out during it and the prof was basically pulling teeth to get answers to things from people who were visibly unprepared.</p>
<p>Thanks for the info brown & Icarus. Now I have to find details about where this curriculum is favored (or not favored). I know, I know. Get the MSAR book, which really isn’t a book.</p>
<p>I go to a lecture based school which I prefer. I have no real experience with PBL beyond the 2 hour blocks we had per week. Like other posters have said, it is a personal choice. The one thing I feel strongly about though, is that the first two years be pass/fail. I think that this promotes collaboration (vs competition) more than anything else, and helps lessen the anxiety of the first two years.</p>
<p>Should have noted in my original post: there’s a lot of “drinking the Kool-Aid” of PBL, and for better or worse, the culture of it is something that has really caught on at my school.</p>
<p>My longest academic day during first year would have been: 8-9 basic science lecture, 9-12 PBL session (8 students + 1 faculty member going through an authentic hospital case), 12-1 break, 1-3 patient care lecture. The other 4 days were 8-12 (alternating 3h anatomy sessions or 3h PBL session), with one additional afternoon from 1-3. My longest academic day second year would have been: 9-12 patient care lecture, 1-4 PBL session (8 students + 1 faculty member going through an authentic hospital case). The other 4 days were 1-4, with one additional morning 10-12. Toss in a few clinic days per 8wk block and there you go. We occasionally had days with an extra lecture; sitting through 4h of lecture was nearly impossible for me–I’d much rather be talking/discussing/working with my colleagues. </p>
<p>Whether Step 1 scores are directly related to med school curriculum is certainly worth debating; but, assuming it is (not entirely convinced it is!), it’s worked well for us–our group of students who averaged 30 on the MCAT now average 240 on step 1 (which is notably higher than the national mean of ~225, and arguably competitive for all but the most competitive specialties).</p>
<p>Which is to say: I’m glad there are multiple styles of curricula available. It seems like what works well for some students doesn’t necessarily work well for all students, and that finding a program that fits your style is worthwhile–which is why I always advise applicants to do some soul searching, figure out what styles work best for them, and pay close attention to crafting a school list based on such qualities. With the benefit of hindsight, I’d be a lot more picky about curriculum styles if I had to apply again.</p>
<p>Haha – and I always disagree with Kristin on this point. Application lists should be made to maximize the odds of admission. It’s 100% a strategy game unless you’re as supremely qualified as she is!</p>
<p>If you’re in the minority of applicants who got admitted to two places, THEN you can start thinking about curriculum. :)</p>
<p>Plus, Kristin would have been fine anywhere.</p>
<p>I would be careful about the interpretation of board scores (some people believe that schools manipulate their board scores to attract applicants, but I have no idea). In any case, most American schools have scores above the national average (the lowest 5 sit around 218). The people who don’t pass are often from international medical schools. The highest (according to USNews) sit around 241 (Baylor), Penn (240), Harvard (239), Wash U - St Louis (238), Johns Hopkins (237). This is newly available data from usnews this year though, and its unclear how accurate it is or from which years they got them from.</p>
<p>^entirely why I added those little disclaimers :)</p>
<p>Sorry! Wasn’t trying to criticize you at all. I tend to get caught up in the details at times :)</p>
<p>Board scores from USNews are from 2009, IIRC. So data is a bit stale, particularly for schools who have recently undergone a curriculum change.</p>
<p>And I have no idea how they obtained their data since those numbers are not typically publicly reported.</p>
<p>~~~</p>
<p>But I agree with krisin about crafting an application list which reflect one’s preferences. It’s one of the things that help shaped D2’s list for this cycle.</p>
<p>cadrie–no worries, and I think it’s always a good idea to point out potential for discrepancies.</p>
<p>(I’m going off 2012 data that was internally reported and presented to us by administration. “Just” the mean of their class’s scores; I imagine it was a pretty easy calculation, given their pass rate.)</p>
<p>No changes in D’s school. They have shorter pre-clinical, they are done with year 2 by March. I also heard that while the program is somewhat different in first year vs second year at some schools, it is the same at D’s school. They just go thru the blocks, blocks are system-oriented. the hardest was at the end of first year, it was heart-lung-kidney. While D. love kidney (since she loves Chem.), she did not care much about heart-lung, so it was somewhat harder material for her. The neuro block had much harder vocabulary, but D. is very interested in neuro-psych, so she did not mind to study a bit harder for this one. Averall, she was considering the difference in programs when she was choosing her Med. School. She withdrew from couple stating that their program seem not to match with what she was looking for.</p>
<p>To clarify my comment on board scores: My school was claiming to have internal data that was shared by other schools. My school is undergoing a curriculum revision and when asked why they aren’t condensing that was the answer they gave. Also to be clear, this was not a statement about PBL vs lecture, just full 2 years vs 1.5.</p>
<p>^hmm really? Most of the schools with 1.5 curricula have pretty high board scores. But those schools are also some of the top schools. It would be interesting to see Vanderbilt’s data in the future. Going from 2 yrs to 1.5 for the current class to 1 yr for the new classes.</p>