What have I realised ? It is not until midst of year 2, I really found out "where am I" in my medical study. Year 2 in my school is always a chaotic change. New learning methodology with Problem-Based-Learning, No clear cut of subject like in year 1, everything need and ought to be integrated and MOST IMPORTANTLY i forgot what i have learnt in year 1! However, you can still argue that you have mis-learned your year 1 knowledge in such a way that it couldn't support your clinical appreciation of disease learning for medical purpose. This is quite a phenomenon among medical students. This is the result of un-thinking learning culture that exists and persists for a long time. There are few factors that contributed to the survival of this student trait by "unnatural" selection.
Students seldom curious about what they are learning, because all they need to do is to swallow the notes, every detail of it and vomit it out during examination to get a pass and even to get flying colors result. (I admit that I used to be one of them) Because what we want is to pass, but lets have a second thought, is it of any good to get pass but equipped with sparse knowledge? here we need to differentiate between knowledge and memory. In future we might be the physician who might responsible to take care of each other, their love ones , family member and so on. Wouldn't you would demand a better care?
The unthinking/mislearning culture is worsen by the ample slots of unguided self study session had in our schedule. (My junior batch having a new type of self study, which is guided self study. This is part of the adult learning encouraged by USM. hope my junior can perform better with proper guidance)Well, I am thankful to have objective books with me, but the objective books aren't able to better guide us to how we are going to apply our knowledge when times come. Often, people would assume things come together naturally when times come. Ya maybe but when? a very good example is to observe 2 different systems of biochemical reaction, one system is supply with catalyst while the other we let things to come into place when times come. Well, it is obvious to our "science-sense" that reaction with catalyst proceed better. But where is our catalyst in our study?
In addition, once, there is lecturer who told me that they are PROHIBITED to disclose clinical aspect of basic knowledge. I am not sure whose decision was...As a result, the students are kind of blind-folded for the whole year 1. Personally, i got culture shock by the abrupt transition and introduction of History Taking and Clinical Examination. We never been told of these aspects of learning in our year 1 study and we have nothing much to anticipate. We are always be treated like "well, cute little newbies, you're young, you'll know when times come" Now, I won't buy these words anymore cause I can tell you that It won't simply come when times come! you better prepare to welcome it's arrival. That's not even a placebo, it's a non-informed-decision/learning. hahaha.
Also I am so not prepare to bridge physiology with pathology and also not familiar with the learning approach of pathology. This is worsen by the perceived-uselessness by students about the subject and the PBL approach of learning pathology, where student can deliberately slurred the learning of pathology. well, Pathology is not simply slice slice slice everything into pieces by a serious-looking nerdy pathologist. (this is the general impression. The saying pathologist know everything but do everything late might sometimes be wrong.) It is late for the deceased one, but if we put in effort to learn from the experience and study pathology as a serious academic subject, we might have the chance to recognise a disease earlier in another patient which is not too late afterall. Plus, pathology has it's long history of establishment as a academic subject, we have already much (of course it is always not enough and complete) information about diseases around us, the idea of Doctor do not need to learn pathology is disastrous! Here again, i would also interpret this unlearning and unthinking culture as a result of failure to appreciate the usefulness of pathology in future clinical practice.
Talking about physiology bridging pathology and clinical medicine, i think i had discussed the level of physiology learning in previous post. Back in my year 1 , physiology is always a 10 points/key words/steps/sentence "knowledge" whereby we can score well when we do so. I never knew that i would use them to solve clinical problem someday. Again perceived uselessness and ignorance take place. Or I perhaps would naively think that there will be nice people explaining in detail all the patho-physiologic process to me. Again, i would tell you THIS IS NEVER HAPPENING X). (at least seldom happen on me before) However, i am very thankful to walk through the physiology learning pyramid to the level that enable and empower me to make sense of the clinical outlook of a disease.
In sum, i discovered that along my journey in medical school, i spend more time on curbing all my ignorance and perceived useless-ness on basic medical sciences, which comprise of Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, Microbiology, Immunology, Biostatistics and Epidermiology (I will discuss the last 2 in near future. For I started to perceived their usefulness during my end of year 2 holiday. I am new to those subjects , i have bought some reference books on these topics so that i can learn well). Honestly, learning will be efficient and fast once your perceived a subject as useful, interesting and relevant. Therefore, more time of mine are spent on realising their usefulness rather than actually learning them. So, don't be surprise if I tell you that "I don't know" for a very simple matter, because that matter simply won't click in my hippocampus, due to my ignorance and perceived-uselessness! And I am seriously Don't Know. -.- I am writing this out because I am older now, i hope my reader who are younger than me, my junior would take my MedSchool Encounter , may it be good or bad, as a reminder to oneself not to walk the same path as embrace by the once-naived me. I do hope my junior perform better than me cause i am older, having less potential now. hahaha (Now I am still quite naive in many field of knowledge that interest me, well who can pro-claimed he ever knows of any great thing? it is afterall ignorance!)
Now, i would like to share some of my humble experience and understanding as a Neo-Year 3 Medical Student who haven't undergone much clinical exposure on the subjects/topics of Basic Medical Sciences.
Hope these short slides show will make the distinction between basic medical sciences(especially pathology) and clinical medicine (especially internal medicine)
Clinical medicine in my understanding need something i called it as retro-grade thinking and retrospective observation/imagination of patient current condition. I am not sure how correct it is, After all i am a pre-clinical year student.
With Metta
Sabbe Satta Sukhi Hontu
May all be well and happy
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