Lazy Whiners

A post by JH, about coasting versus achieving excellence promted a post by
TMBTF, who complained about this current generation of medical students.

I've thought about the culture of laziness and complaining about the material in medical school (and my own part of it). I think that while both JH and F have definite points (and the youngsters in my class seem inordinately whiney at times), there are other sides to this particular coin.

I think that part of the problem lies in dashed expectations. Students are accepted into medical school, and take their seat in their first class with starry-eyed anticipation of learning cool stuff like they see on Greys or ER, or the gross but exciting stuff they saw while shadowing their second cousin who's a trauma surgeon. They open their books and notes, and realize that they're back in biochem and genetics. In my first semesters, nobody complained about having to learn anatomy (or even histology) or Physio. Most of the complaints were about the molecular stuff. I think some students have difficulty extrapolating the knowledge they're gaining in these courses to the global practice of medicine. And frankly, medical students, by virtue of the premed programs they have undertaken, tend to be students who are good at memorizing facts, but not good at seeing the big picture. (I often wonder what medical students would look like if you changed the prereqs. What about requiring an Ecology course? Philosophy?)

IMO, professors could do a better job of (at least initially) explaining why the material is being taught; that while we will probably never ever see a case of X vanishingly-rare-genetic-disorder, we will use the principles we learn while studying it every day of our professional lives. Of course, medical students are by-and-large smart enough to make these extrapolations, but many of them haven't been taught how to. I am constantly surprised by the narrowness of thinking some of my classmates display; as if they've never learned how to think outside the box.

I agree that a fascination with the way we work is key, but I also know that I've experienced a definite dampening of my enthusiasm while in medical school. I do my best to maintain my excitement at new knowledge, but it is difficult. Without making excuses, I do think that the stresses involved, and the sheer financial pressure to succeed can sometimes stamp out enthusiasm. I think that students and teachers share a responsibility to maintain the fascination with the subject matter. Learning for the sake of learning is wonderful, but I know in my case, that sense of joy and wonderment is often lost in the reality that is medical school.

I also suspect that this generation of students is far less idealistic about their lives as practicing physicians. Perhaps the cynicism has gone too far, but in many cases our view of life-long learning, as professionally and personally rewarding as that may be, is about learning to avoid a lawsuit, learning to keep ahead of the doc down the street, or learning to keep ahead of patients armed with google printouts.

I do think that while only studying for the exams is a problem, when faced with the larger picture of our work as practicing physicians, professors, schools, and the medical education establishment bears some blame here for allowing a narrow focus. A frequent refrain in many of my classes has been, "This isn't terribly important, but it comes up on Step 1 so we'll go over it." Teachers and school administrations are aware of what are on the tests, and teach to the tests. As students who want to do well on these exams (indeed, who want to do well in medical school), we have to learn how to take the tests, and what material is going to be tested. That's not to say that we shouldn't be looking at the larger picture, but it's easy not to. And if we ignore the smaller picture of exams and testing, we might just flunk out of medical school.

In medical school, there is a constant tension between needing to know everything and not being able to know everything. We have to know everything, but we can't possibly know everything. So in many instances, I think that the questions about the exam are not so much about just doing well on the exam, they are more about trying to decide what's important; if the prof thinks it's important enough to put on the exam, it's probably important enough to really focus on. Perhaps it's crudely asked, but students are often just trying to sort through the fountain of information being blasted at them. Studying for the exams is one way to do that.

As for disrespect, I do think this is a huge problem. I didn't notice it in the Anatomy lab, but in general, the conduct of many of my classmates leaves a lot to be desired. The generation following mine seems to be completely unaware of rules of civilized behaviour. Talking in class, arriving late every single day, asking obnoxious questions...some of these kids need a swift kick in the ass.