When do I get tenure?

May 5, 2007 at 9:03 pm (1st and 2nd year)

Everytime I glance through the pre-med forums on SDN, I’m constantly amazed at how many college students want to jump into problem-based learning. My real concern is the misunderstanding that many people hold about PBL. For one, how do all of these people know that they’ll be happy in PBL if they’ve never experienced it before?

My school uses a mixture of lecture and PBL—and PBL has got to go. While some lectures are painful to sit through, attendance is not required, and therefore, I can always opt out of going to class. PBL, on the other hand, is absolutely mandatory. In fact, our whole grade is based upon participation. We don’t even have to get the diagnosis right; we just have to learn “the process.” I’m not so sure patients would be comforted by the thought that I can’t diagnose their disease, but at least I know how to make a PowerPoint presentation of a differential diagnosis. Summary point number 1: you will spend lots of time writing a presentation on one illness, when you could be studying dozens more during that same time period.

What’s more, your faculty mentor may not be a specialist in the particular case that you’re studying. This past week, I had a patient with diminished senses in her extremities, but intact motor function. She was also hyperreflexive. I quickly came up with a differential diagnosis that included multiple sclerosis and vitamin B12 deficiency. I even stated that this patient in no way had ALS (Lou Gehrig’s disease). Unfortunately, our facilitator is not a neurologist and had not seen a neuro patient in many years. You can imagine my annoyance when she stuck me with ALS as my presentation topic. But hey, I got to learn “the process.” Summary point number 2: your faculty mentor may not know what he/she is talking about.

Instead of having experienced faculty to write lectures with direct objectives of particular information to teach, medical schools get students to run lost through a sea of information with no idea of what’s pertinent. Many times, I’ve given and seen presentations where important steps of pathophysiology or treatment are omitted because I (or other students) were ignorant of the salient points. Summary point number 3: PBL is the blind leading the blind.

I’ve come to realize that PBL is the biggest scam that medical schools can run. Instead of the universities paying professors to teach, the students pay tuition so that they can teach each other information that may or may not be important, pertinent, or even correct. With all of the lectures that I’ve given, I demand that I be given a faculty appointment with tenure. Also, I should get my own office. I hold office hours by appointment only.

Luckily, I’m not alone in my frustrations with problem-based learning. Some students at Upitt came up with this video of their PBL sessions. It mimics The Office and is very funny.



  1. Susy Cat said,

    Saw that vidoe, it’s hilarious

    I’ve looked into it and I don’t think my med school has PBL sessions. But, you never know, they might sneak them in there…I agree that it sounds very lame. Good idea, bad execution.

  2. halfmd said,

    Case-based learning is a very effective learning tool when there are stated objectives and when the facilitator is (1) an expert in that area and (2) can direct the group to learning a particular set of concepts. PBL falls flat because neither of those criteria are necessarily fulfilled.

  3. Parcho, MD said,

    The Office: Med School Style

    “I don’t need to study. I’m Asian.”
    I’m with these guys. The PBL idea is great as an idea. In practice, it’s miserably boring.
    (via HalfMd)

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