Before you can start classes, you need to understand that not everyone who enters medical school can be as cool as me. You’re going to run into a lot of a-holes, archetypes whose personalities are so extreme that you’d think that they are fictional characters from the latest Frank Miller novel. Here, I present a summary of the type of people you’ll encounter.
Assistant Dean = although he’s a student, he feels the need to direct student behavior, advocate particular punishments, and pre-emptively answer questions posed by students to faculty. If you’re in a PBL school, he will lead the discussion of the day’s topic, while a timid physician sits by. He could also be called the Policeman.
Laundry Day = this student will show up to class so horribly dressed that you will think he ran out of clothes and is doing laundry. He will then show up in a ratty T-shirt, sweat pants, and flip flops every day for the rest of the semester. He will typically shave only once a week for added effect. Then, on patient-encounter days, he will come in Armani and Gucci.
My Big Fat Greek Classmate = based on the father in My Big Fat Greek Wedding, this person will remind you regularly about the history of his grandparents’ culture. Mind you, he’s never actually been to the homeland, but he will gladly tell you about the unique cuisine, non-orthodox forms of Christianity, and the language that isn’t spoken by anyone else in the world—not even in Greece.
I’m Old Enough to be Your Father = the one non-traditional who really is old enough to have fathered a few of the younger students. This person will bring his children to school functions in attempt to introduce them to new friends. With all of his years of experience, he could easily qualify as the wisest person you know. Away from his family, he will be the most immature person in class.
Surgio = this person has such a one-track mind when thinking about career choices, he will quickly give up all other opportunities. He will show up to class in scrubs, even though he’s an M1 and not taking anatomy. At social gatherings, he will sit in the corner and practice tying surgical knots.
Once a Sorority Girl, Always a Sorority Girl = showing up to orientation with bleach-blonde hair, not much time is required for her roots to start appearing. She’ll use everyday as a reminder of when she used to go out as an undergrad—and then her true colors will start to appear. If you’ve ever seen Mean Girls, she’s all three of the Plastics.
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.
Continuing with the theme of picking a medical specialty, I present a summary of the most popular systems to go into, and how I was able to narrow down my list. Here is a transcript of a speech I delivered to the first-year medical students at my school.
First, stay away from internal medicine unless you enjoy sitting around a table and discussing abnormal lab values. Figuring out the cause of an electrolyte imbalance is mental masturbation to an internist. And low magnesium is girl-on-girl porn.
Preventive health is a great field to go into. It’s 9-5 and there’s no call. There’s never an epidemiological emergency. No one ever calls an epidemiologist at 2 in the morning to say, “We’ve got bird flu everywhere!” The preventive medicine doc will reply, “Okay, I’ll look into it next week.” The bad thing about preventive medicine is all of the public health and outreach service you might get pulled into. You’ll work with low income populations with lots of health problems and minimal education. These patients may not know much, but from the treatment they’ve received, I’m sure that they can spell “bigotry.” Well, probably not.
Pathology is also a great field. But men can’t become pathologists. I look at a slide and someone asks what I see. I say, “I see pink.” Then along will come some woman and say, “It’s not pink. It’s mauve.”
If you really want to impress people, go into dermatology. It’s not all acne. We learned during the dermatology module that the foreskins of circumcised men can be used to make skin grafts. But did you know that foreskins can also be used to make replacement eyelids? That makes me wonder: with all of those nerves now running to the eye, have you ever seen someone with erotic blinking?
If skin isn’t you thing, you can join the psychiatrists and might even become a regular guest on Oprah. When you take the psych class, you start to notice certain quirks about others. Like a man who rubs his beard whenever he’s nervous. “Hmmm… I don’t know the answer to that question.” Then he starts rubbing more of his face as situations get more intimidating. “I hope that girl will go out with me.” Finally it all ends with the job interview and full face rub down: “I feel that I would be a very valuable addition to this company.
Pediatrics? I can’t do pediatrics. It’s not that I hate babies, it’s just that newborns aren’t potty trained. You can’t housebreak them like a dog. You can’t rub their nose in the mess and hit them with a rolled up newspaper hoping that they’ll learn.
Help wanted. I need a babysitter to serve as a “problem-based learning” mentor. Your job responsibilities will include taking role, steering medical students into incorrect diagnoses, and making people feel inadequate for their presentations.
No experience necessary! When a student asks you a medically related question, you should reply, “That sounds like a good learning issue to me,” or, “First, tell me what you think.”
We have immediate openings. Starting pay is based upon lack of experience. Prior work as a fisherman or military drill sergeant is a plus. Inquire at 555-…-….