In second year, we had a class called Mechanisms of Disease.
I have only just now, after reviewing this post, noticed I actually made a post on that class before. I just forgot to delete it from my notes so I wrote another one, but what I talked about there was totally different anyway.
It was explained as a way of getting our feet wet with clinical thinking. Even though we had no knowledge of diseases, pathology, or treatment, we were given weekly cases, a lab relevant to the case, and sort of guided through it. It didn't work super well, because every case was presented by a different clinician--some were really helpful, others had completely forgotten what it is like to know absolutely nothing about medicine.
We were divided up into groups, and every group was assigned one case. You didn't have any knowledge of what it would be about until the week of, and then you put together a presentation on the diagnosis for the Friday. They were big groups so this totally sucked. Some people had ten thousand words on their slides, some people repeated what other people said, the formatting was completely crazy on the powerpoints, and there was no coherence to what anyone was trying to say. Then of course when it is your turn, it is absolutely impossible to get 10-ish people to do their research and pool it together into a reasonable form by the end of the week. In our case, the professor in charge of us did a really unhelpful intro lecture, and to guide us in our presentation he told each person to pick what most interested us about the topic and talk about that. That is a good idea, but it results in a less-than-comprehensive discussion of the disease or diagnostic process, and a lot of inane details. Overall, I think the student presentations deserved an A for effort but were useless for learning.
In retrospect, we learned way more in that class than I thought we did at the time, and it was mostly because of the labs. That class was basically mini-medicine class. For instance, that class was the first time we ever read an ECG or looked at a urine dipstick. Now, in fourth year, our level of learning is that we would be expected to diagnose and work up the same sort of cases all by ourselves from start to finish--so it's interesting to think back and compare my mindset. We were so clueless back then!
I remember the first case reasonably well. It was a dog with hair loss, pot belly, and drinking and urinating excessively. The professor asked us what disease this was most likely to be and I had no clue. There was the one person who timidly asked, "Cushing's?" and the rest of us are wondering what Cushing's even is. If someone asked our class that now, it would be too easy. It's like the free points question.
More importantly, back then we especially had no clue on what to do to figure anything out. So I didn't know the specific disease name, but I also got stuck there. What do you even do? I guess bloods--doctors always take bloods for stuff. For the longest time, "bloods" was such a vague, I-know-we-should-do-this-but-not-why answer (then... enter the mysterious world of clin path).
Throughout third year, we had a class called Clinical Studies, and it was the next step up. We didn't have cases or anything like that, but it was essentially almost-medicine class. That's where we started learning things like how to do a physical exam. They hammered in clinical thinking techniques. Along with pathology, we were getting an idea of what diseases are out there, but I'd say we were still completely useless at medicine in general. What is the first thing you do? Take a history! Perfect. Problem is, there's no "Take A History" button, you have to actually think of the questions that you want answers to. Similar to "take bloods", the "take a history" response is more of a reflex than anything else.
Now we kind of sort of know medicine. The process to get from there to here was something like putting thousands of pages into a blender, opening up your brain, and pouring it in. It is coming out of our ears and we have a lot more to go!
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