TV and Medicine (Again)
Apparently the CW, famous for such teen dramas as Gossip Girl and One Tree Hill, is ready to tackle medical education with a series called "HMS."
If this is actually produced, I predict the show will be a new favorite amusement of HMS students poking at inaccuracies. This place looks nothing like our school! They don't have enough bags under their eyes! We don't sleep around that much! (as far as I know)
This may be indicative of an oversaturation of medical shows - ER, House, Gray's Anatomy, Private Practice, Scrubs - such that the process of becoming a doctor would actually be appealing. Who wouldn't want to see a version of the venerable Dr. House nervously botch his first patient interview?
I'm interested in seeing how they dramatize what issues they think medical students cope with. I also wonder how much of the medical education they will be able to show - dissection of a human cadaver in anatomy is one of the hallmarks of medical education, but is this even palatable to audiences?
As I've mentioned before, these shows have a responsibility to portray the field accurately as they mold public opinion. Portraying medical students as callous and jaded would almost certainly be detrimental to the patient-doctor relationship.
Some potential plot points:
-Student overwhelmed by the deluge of medical education resorts to Attention Deficit Disorder medications to catch up.
-Student brings emotions into the clinic (e.g. just had a bad breakup) and makes poor decisions.
-Leading to the grand finale when a medical student makes a mistake that costs a patient - or another cast member - his or her life.
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More About HST
As I've mentioned before, I am in the Health Sciences and Technology curriculum at Harvard Medical School. This is a joint venture between Harvard and MIT, and I thought I'd explain more about it here.
The primary goal of the program is to train physician-scientists. Ideally, the graduates will both manage their own laboratories while seeing patients, although some graduates tend to go entirely into medical practice or research. A large component of what we learn is therefore cutting-edge research in the field. Each week in all our classes we will probably have at least four scientists in the field explaining their work and the state of the field.
This means that what we learn is not directly relevant for medical practice or for our medical licensing exam, but the point is instead to train a system of thinking about medical science.
Within the rest of the medical school, the HST student is stereotyped as being nerdy, less attractive, and bookish. But this is OK, as we have fun stereotypes for the other programs as well.
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First Semester with HST
The HST program began its classes today. This term lasting until December, we will be taking four:
- Anatomy - The human body - nerves, muscles, circulation - through dissection of a cadaver.
- Pathology - What tissues look like and what can go wrong.
- Immunology - The development and maintenance of the immune system to fight disease.
- Genetics - Survey of genetic disorders - that is, caused by mutations in specific genes.
The HST curriculum always has concurrent classes, while New Pathway tends to study one block at a time. For instance, they will study anatomy for several weeks everyday.
While we have more variety day to day, we have a larger time commitment - we spend between 9AM-6PM each day in class. This doesn't include the work we have to do at night after class.
It should be fun, but it's also daunting. A number of students here are worried about balancing personal life, classwork, and sleep. We'll see.
Me in a month?
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End of ITP & Thoughts on Learning Styles
Today marks the end of our two-week Introduction to the Profession (ITP) and the beginning of regular classes. The two programs, New Pathway and HST, will separate here and reunite only in third year when we begin working in the clinic.
I wanted to take this chance to reflect on case-based learning, the mainstay of New Pathway and most other medical schools in the country. A patient's clinical case is presented, usually with uncertainty about the underlying disease. Uncertain parts of the case - test results, symptoms, X-ray readings, family history - are split among students to research, and upon reconvening each student shares his research with everyone else. Gradually the case is clarified with help from a supervising group leader, usually a doctor.
For me, this system was inefficient for learning. An entire two-hour session could be distilled into a single sheet of paper that could be read in fifteen minutes. Our group would also often branch into unrelated tangents on minor details, bringing up interesting facts that were irrelevant to the case.
I am not suggesting that the problem-based learning model is without merit. The benefits of this system are clear - it resembles real clinical practice in that the patient's condition is often unknown and requires gradual steps to figure out. Furthermore,it encourages collaboration between students, building the type of collaborative spirit central to medical teams in hospitals.
Ultimately the question is whether medical school is about learning the facts or learning the skills of becoming a doctor. Of course, it should be about both. But in these cases, the only skills we practiced were researching a narrow part of the overall case and presenting information to other students, both of which you either already have or can develop quickly. Once these skills are developed, future cases become inefficient in the learning you do per amount of time.
I would rather first build a solid foundation of knowledge through efficient learning, then progress to case work when I am not as clueless.
Medical students - how do you feel about case based learning?
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Two Doctors Walk Along a River
Today Katherine Treadway, one of the teachers at Introduction to the Profession, told a nice parable about two doctors walking along the Charles River, Boston's main body of water.
They're walking along chatting about their work when all of a sudden a man drifts by in the middle of the river, screaming for help. The doctors immediately spring into action, one doctor standing by the bank for support while the other dives into the river. He pulls the man, swims to shore, and they both climb out soaking wet.
The two doctors continue their stroll when a woman drifts by in the river again, just screaming for dear life. The doctors rush again, and they save the woman from drowning.
They walk further down the river until another man comes down the streaming river, at risk of drowning. One doctor immediately dives in, but this time the other doctor runs away up the river, inexplicably. The swimming doctor manages to save the man, and he waits by the side of the river for his friend to return.
When he does, the wet doctor asks, "Why in the world did you run away when I was trying to save him?"
The other doctor says, "I went upstream trying to see why so many people were falling in the river!"
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This is a cute story, but it also illustrates the multiple roles physicians can have in society. They can serve on the frontlines treating patients with what we currently know, or they can research the unknown about why diseases happen. Both are absolutely essential roles in medicine.
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