“First Aid For The USMLE Step 1 — cost: $45, format: reference book.”
“Pathoma — cost: $99 (1-year subscription), format: video explanations + reference book.”
“SketchyMedical — cost: $150 (1-year subscription), format: cartoon video memory device.”
Our naïve MS2 eyes were glued to the screen as our noble MS3 predecessors clicked through the slideshow, pausing to talk about which third-party study resources were “super high yield” and which were only “moderately high yield” for the USMLE Step 1 exam. Nobody was texting. Nobody was on social media — we were here on business.
It was where we would learn which Step 1 resources to buy and cram into our brains over the next seven months. The collective concentration in the room was unrelenting until the entire lecture hall burst into laughter as the final slide appeared on the screen. It read: “Our Medical School MS2 Curriculum — cost: $42,226 (1-year subscription), format: lectures + labs + exams.”
Not aware that the First Aids, Pathomas, and SketchyMedicals of the world are threatening the existence of traditional medical education by lecture?
Just come by our med campus any day to find me and the other seven regular lecture attenders in a hall that seats 200. Every department head, world-renowned researcher and expert clinician who comes to talk ponders at the expanse of empty seats and asks the same question: “Where is everyone?”
The answer is everyone is at home, learning. Despite my attendance loyalty, I, too, am mostly learning from home. When the lecture is over, I go home and succumb to the same third-party educational cookie cutter as 99 percent of all medical students across the country. With a sigh, I open up First Aid, listen to “Pathoma,” and watch “Sketchy” with a full recognition that I’m being cut into the same generically shaped cookie like everyone else. Despite hailing from diverse communities, backgrounds, majors, and universities — which was so enriching in the early days of our med school education — my classmates and I are now walking replicas of each other when it comes to our medical knowledge. And it’s no different when I call up my friends at med schools across the U.S.; we laugh about all the same cheesy “First Aid” mnemonics that we couldn’t forget if we tried.
How did this happen?
I came into medical school with a fervent passion for exploring every nook and cranny of biology. But as I became increasingly aware of the endless expanse of the cookie dough bowl that is medicine, it became obvious that I needed a cookie cutter to outline what I needed to learn and cut out what I didn’t.
Enter third-party study resources, which are professionally designed to efficiently pound facts into a student’s brain in a way that even the best lecturers can’t compete with. Students then wonder, “Why go to class and be confused by a lecture on antihistamine drugs when I can passively let a 15-minute SketchyMedical cartoon called ‘A Midsummer Night’s Diphenhydramine’ burn itself my brain forever?”
These resources are no joke — they work. Content covered in the lecture then ends up just repeating what we have already learned at home. And worst of all, the pressure to cover all necessary topics prevents faculty from enriching the content with what they know best: cutting edge research, case examples, and clinical pearls.
I don’t have a problem with third-party study resources threatening traditional medical education lectures, especially when they more efficiently teach us the basics of what we need to know to be good doctors. I have a problem, however, with the fact that almost every medical student is being shaped by the exact same cookie-cutter made up of First Aid, Pathoma, Sketchy, and a few other products. How will we collaborate to solve complex cases when all anyone has memorized are the same figures in First Aid? Who is going to pioneer a breakthrough myocardial regeneration technique when Pathoma tells us heart tissue can’t regenerate, and everyone treats this as the word of God? I worry about our collective ability to solve complex medical problems in the future when, for example, we forsake the lecture on induced pluripotent stem cells and tissue regeneration (delivered by a leading expert) in favor of listening to Pathoma at home.
Perhaps the rise of generic, cookie-cutter students is not so terrible as long as medical school curricula better promote our decoration in ways that are unique and important to each of us. I can think of no better way to do this than eliciting the full power of our diverse faculty. Recognizing that First Aid, Pathoma, Sketchy, etc. cover most information bases, instruction in class ought to be more focused on interactive activities, applying knowledge in the real world, developing and acting on differential diagnoses, studying social determinants of health, and considering the trajectory of current research — encouraging us to delve in deeper when a subject sparks our interests.
My medical school, like many, is currently in the process of redesigning its curriculum to better meet the unique demands of education in the present day. I have seen my school already take great strides to modernize our education with the implementation of problem and case-based learning, simulation training, and standardized interviewing. The next step is to address the lecture problem. I urge curriculum designers to acknowledge the widespread use of third-party study resources and use the cookie-cutter template they provide to free our instructors to augment our education in ways they know best. Instead of approaching reduced attendance with even fewer lecture hours, which further handcuffs lecturers with the basic information they need to cover, attention should be placed on the delivery of higher-level, real-world content that outside resources lack. I believe this would go a long way in ensuring that the doctors of the future are less like a sleeve of identical Oreos and more like an assorted platter of holiday cookies.
Grant Schroeder is a medical student.
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