The hard sciences of chemistry, physics and especially human biology have traditionally been a large part of medical courses. It had been known that sufficient understanding of human biology was required to be able to treat patients in a satisfactory manner. However, due to criticisms that medical courses in the past focused too much on the science and not enough on the softer aspects such as communication, ethics and population health, there has been a trend towards adding more of these aspects of medicine into medical courses at the expense of science.
Some doctors now comment that certain medical courses do not teach enough science, putting too much emphasis on the other components. I wouldn't be too surprised if that was true in some universities. I hoped that Melbourne got the balance right though.
So far though, a quarter of the way into first year, I don't feel that they have overemphasized the aspects other than sciences in our course. In our subject of Foundations in Biomedical Science (we don't have separate ethics subjects or population or personal development subjects; the other two subjects for first year are Principles of Clinical Practice 1 and Student Conference 1), the vast majority of our lectures are about biomedical science as the name suggests.
There are a few lectures of population health. One type of "population health" lecture is about evidence based medicine (EBM), encompassing a limited amount of biostatistics and some things about appraising studies, which would be quite important in medicine in terms of keeping up to date with current best practice. We don't actually learn that much about how to calculate the statistics too, unlike in first year biomed. I think EBM definitely has a place in the course.
The other type of population health lecture is about social determinants of health, including global health. We also haven't had many of these lectures so far either, so I don't feel that it has been overemphasized in the course at Melbourne.
Surprisingly, we have only had one ethics lecture so far, which was more of an introduction, in foundation week. Maybe they couldn't cram everything into the one preclinical year, so they decided to mainly give us the foundations in science to learn, and delayed the teaching of other things until later in the course. But in any case, I am pleasantly surprised that Melbourne hasn't seemed to have overemphasized the non-bioscience aspects of the course from what I have experienced so far. Then again, Melbourne does seem to have a reputation of being somewhat "old-school" in that regard, and that does seem to be the case to me.
Sunday, April 8, 2012
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I have been wondering about this as well. Is one year of non-clinical enough? I don't know how much material is covered in other schools in the first year who have a two year non-clinical period.
ReplyDeleteDoes second year anatomy, physiology and biochem really cover everything that other colleges teach in their 1st year?
I mean just three years of clinical is better than two, and any student would prefer clinical to non-clinical (I know I would) but my impression was that students would need to know everything from anatomy down to structure of enzymes to ethics to diagnosis before they start in hospitals...is it all covered in 2nd year college subjects? Can it be covered in the single non-clinical year? Is it all taught in the clinics? Internship? Residency?
There is still so much I do not know about something I want to do.
Second year anatomy, physiology and biochemistry would not be worth one year. As a rough estimate, at second year level they are three subjects (out of 8 in a year), so they would take up about 3/8 of a year.
ReplyDeleteIf you read the documents about MD curriculum planning, (http://meu.medicine.unimelb.edu.au/development/coursedevelopment/planning.html), you would find that they also tried to integrate as much of the science as possible in the clinical years to facilitate learning. For instance, the bulk of pathology will be taught in clinical years. From the documents publicly available, they don't appear to have cut a lot out of the old course. Whether integrating more of the basic science into clinical years works as well as they want though remains to be seen.
Hmmmm not much info available on the link provided. But if there isn't a lot of college classroom teaching in the clinical years then how is one supposed to learn? I agree to clinically oriented subjects such as pathology being taught in the clinical portion like you said. But does that also include theory based subjects as well?
DeleteWhile its true that pretty much all the subjects have some clinical aspect (obviously). It would be interesting to see if they indeed pull this course off. As far as I know they started this in 2010? So the first intake would graduate in what? 2013?
From the link provided, you can read the summary reports of workshops 1 to 8; a pdf link near the bottom of their brief statements on the pages. Of course, they don't have all the detail though, and it seems like certain recommendations were not followed, such as the recommendation of assessing the MMI as pass/fail instead of part of the final weighting.
DeleteThere is some classroom teaching in the clinical years. At Melbourne, there is a main set of tutorials that all schools need to give (with a standard set of slides). Different clinical schools at different hospitals can give varying amounts of extra. In Metro 1, it seems like St Vincent's is known for giving a lot of extra tutorials, which is why I put them first on my preference list for clinical schools (but I don't know if I'll be there yet).
They'd probably try to teach a lot of the subjects which are hard to teach in the clinics in first year.
The first MD intake at Melbourne was for 2011, and they will graduate in 2014.