Changes to medical school curricula

<p>I know. Just passing on what they said.</p>

<p>Re: vandy. I wonder what the single preclinical year would be like in terms of student experience. I feel like, after 2 years, I know a lot…but almost more than that, I’m starting to realize how much more I have to learn and how much I don’t know. I wonder what would have to be sacrificed in order to trim that much time from preclinical training, and I wonder if those sacrifices would be offset by the gain of a research year or an extra clinical year or whatever they’re planning to add. Obviously I have no idea and obviously each student can only experience one curriculum, but still. Interesting to think about!</p>

<p>Columbia is rolling out their shiny new curriculum this year. They are going call their final year curriculum as “Differentiation and Integration”. I guess it can be called as “calculus curriculum” :D</p>

<p>[Medical</a> School Curriculum | College of Physicians and Surgeons](<a href=“http://ps.columbia.edu/education/academics/medical-school-curriculum]Medical”>About the Curriculum | Vagelos College of Physicians and Surgeons)</p>

<p>“Most of the schools with 1.5 curricula have pretty high board scores”
-Score has almost nothing to do with curricula. It has everything to do with the individual preparation efforts. Every program is better in some areas than ohters. The facts are very well known. When preparing, certian area will need more effort than some others. This is from comments of my D. (MS3, just got her Step 1 score). They all buy ton of books specifically for board prep. I do not know if you would call her program 1.5, they were done with pre-clinicals by March. As far as I remember, they had only 2 blocks in the second year. But it was a not a recent change.</p>

<p>I disagree that curriculum has no impact. I won’t say that any one curriculum is best because I think individual preferences come into play in terms of how successful someone is, but the foundations laid during the coursework are absolutely critical for the final prep period.</p>

<p>The 1.5 year schools are top schools and thus accept top students who should do well. My school was implying that those schools have students who would score even higher if they were on a 2 year plan. They didn’t show us the data so I can’t personally say anything but I do have to consider the fact that these are the deans of my school vs you and your daughter.</p>

<p>Columbia’s recently graduated class of 2013 was the first to come through having had the new curriculum. It could well be coincidental but it is my understanding that their average board scores were the highest yet achieved at P&S. </p>

<p>D did mention early on that having come to med school with a humanities background (and having had fewer passes at the science material than those in her class who were science majors), she may have benefited from more classroom time. That being said, she has done just fine and has truly enjoyed the program…as much as anyone can enjoy medical school. ;)</p>

<p>Elleneast,</p>

<p>One thing to consider when examining board scores is that the national average increases every year too. I have no idea what the actual numbers are but as an example of how the increase might be “bad”: if the national average increased 4 points this year but Columbia’s average increased only 1 or 2 then one might be able to argue that the curriculum was detrimental.</p>

<p>“The 1.5 year schools are top schools and thus accept top students who should do well. My school was implying that those schools have students who would score even higher if they were on a 2 year plan.”
-You might have a different opinion about it, but I disagree based on D’s experience. The fact is that having 1.5 years allow more time for prep. for Step 1. And again, bsed strictly on D’s experience, the actual prep. made the difference, not lectures/curriculum. Every school is better in some aspects than others. it is known and recognized and if a student works much harder on the “weaker” part of her school curriculum, then she will do just fine. Again, D. based on just one person experience, but again, who is to say that she is not just another typical Med. Student (at least she calls herself “average” student in her class). Again, we all have different experiences, while students in some schools might rely more on theri curriculum, the ones in D’s class bought huge stack of new books and study them for Step 1 prep.</p>

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I would not have thought of that but of course you are right…honestly, all of this could make you crazy if you let it.</p>

<p>ok Miami, so you’re saying the schools curriculum like baylor and columbia with 1.5 preclinicals that take step 1 after their clinical year has no impact on their board scores.</p>

<p>Also the 1.5 years doesn’t necessarily mean more prep time. If the 3rd year starts earlier than they may not have any more time than 2 year folks.</p>

<p>At first glance, I’d agree with Brown here. I think curriculum impacts boards performance. Having recently taken boards (like last week!), I can tell you that practically every question is a clinical vignette that requires deeper thinking than “just” recall of facts. A school with a curriculum that emphasizes clinical decision making and regularly tests students using a strategy like boards (ie clinical vignettes requiring deeper thinking) should logically turn out higher mean test scores than schools with a fragmented curriculum that mostly test fact recall. </p>

<p>I also have a hunch earlier clinical experience is beneficial insofar as I can’t imagine it being anything but beneficial in the setting of a test that requires you to think clinically for the majority of it.</p>

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Another question is whether attending a school with P/F grading policy in the preclinical years impacts boards performance.</p>

<p>Talking about the board test (step-1), is it possible that every tester may get a test which includes a different set of the test items, even if they are tested at the same test center at the same time?</p>

<p>Some of DS’s classmates seems to claim this is the case. But I am not sure whether it is true.</p>

<p>It’s true about all the tests being different for Step 1.</p>

<p>The protocol for multiple choice sections has a computer program randomly select questions from a database. This, plus the fact that new questions which are being normed and beta-tested are randomly inserted into Step 1 sections means it’s quite possible, likely even, that no two testers at the same site sitting at the same will have exactly the same exam.</p>

<p><a href=“http://www.usmle.org/bulletin/test-preparation/#testformat[/url]”>http://www.usmle.org/bulletin/test-preparation/#testformat&lt;/a&gt;&lt;/p&gt;

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<p>Also some questions are sequential–that is they all refer back a case presented. Once you choose an answer to the first question, the next question displayed will depend on how you answered the first question. The third question will depend on how you answer the second…and so on.</p>

<p>^More than 2 sequential questions is news to me. While some questions do indeed require you to answer one before moving to another, I’ve never encountered a situation where there were more than a pair of questions, and I have never been convinced my answer to the first one impacted anything about the second one. I believe I had 2 sets of 2 sequential questions across the entire exam. Wouldn’t be the first time I’m entirely mistaken though :)</p>

<p>Kristin, remind me if I’m remembering correctly: In sequential questions, the second question will almost always tell you the correct answer to the first question. For this reason, “first in a series” questions are the only ones where you are “locked out” from returning to them afterwards.</p>

<p>I’ve been told that Step 3 is much more advanced and will actually depend on certain answer choices, although they then give you the chance to double back. E.g.: “(1) What is the most appropriate lab test? (2) The results are negative. Now what is the most appropriate lab test?”</p>

<p>^I’d say that was true for many practice questions, but neither of the sets on my real exam “gave away” the answer to the previous question. Maybe you could have eliminated some of the answer choices for #1 based on the set of answer choices for #2 (had you been allowed to go back), but it wasn’t like “blah blah what’s the diagnosis?” followed by “He was diagnosed with X. What’s next?”</p>

<p>In fact, I have no idea why those 2 sets were chosen for sequential questions. As far as I could tell, the questions had almost nothing to do with each other (with the exception of being about the same patient, whose demographics were introduced in the first question).</p>

<p>I had one that gave it away. I had one where the first question asked what test to do and then the 2nd question was “you do test x here are the results, what’s the most likely diagnosis”</p>

<p>With p/f I think the impact of the curriculum is based on you respond to it. If not having grades means you slack off then it’s bad. If not having grades means you’re more relaxed and you can focus more then it’s good.</p>

<p>“Another question is whether attending a school with P/F grading policy in the preclinical years impacts boards performance.”
-did not impact my D., that is all I know. She said that the greatest impact was opportunity to study for a longer time than 4 weeks available at other Med. School. I personally never took the Step 1, I can only tell from her experience. Another interesting comment was our discussion about being calm, actually unusually calm before exam. D. said that it was an effort on her part all along preparation, including staying away from “intense” people. That second part was another very important positive impact.</p>