As a premed, medical school was some mythical abyss that one descended into and rose four years later as a doctor. Like in The Dark Knight Rises when Batman goes into that pit, where he must train his mind and body to escape and conquer Bane. But instead of the batsuit and badass fighting skills, we supposedly emerge with expertise in medicine and a long white coat. Idealistically, medical school was a place of enriching education, state-of-the-art futuristic facilities, where one went and suddenly learned how to become a doctor.
I have friends at eight different medical schools in the United States – some I talk to weekly, others I see once or twice a year. Naturally, we talk about medical school. We rant about our administrations and curriculums. We rave about the things we love about our schools. I don’t hate my school, but it’s far from perfect. There are aspects I love, and others I hate (read more on that here). We have time-wasting mandatory activities, some pretty bad lecturers, and of course, we evaluate, evaluate, evaluate to death.
I have a dream. It goes like this…
In my perfect medical school, we received our letter of acceptance in a package which also contained a case of beer, delivered by a postman dressed in 1960’s attire. Like a poor man’s version of Hogwarts acceptance.
On the first day of orientation, we showed up to the lecture hall, where the administration surprised us with kegs & eggs. They said, “there will be time for seriousness and learning, but for now, let’s all have fun and get to know each other”. The administration at my perfect medical school understands the importance of morale. We drank and socialized, and after a few hours, everyone was properly acquainted.
The school’s mission statement reads…
Soze’s Perfect School of Medicine trains future physicians with a cutting-edge curriculum, in which students’ personal time and happiness are valued. We believe that anyone with excellent undergraduate performance who pays hundreds of thousands of dollars to attend our medical school is responsible enough to learn the way that suits them best. WE TEACH TO THE BOARDS.
During orientation week, we must attend a seminar on expectations and policies:
During this seminar, we given five question tokens valid throughout the year. This encourages students to think carefully about which questions they choose to ask, because once you ask five questions, you are not allowed to speak in class for the remainder of the year. You may email the professor, visit the professor’s office hours, or Google the answer – you simply cannot interrupt the class more than five times per year. Any such violation of the code results in a professionalism complaint in the student’s file.
Additionally, students are forbidden to talk about how much they are studying for boards, unless they are asked. The curriculum is designed to prepare all students for success on the USMLE, so unsolicited remarks about studying are not permitted. The first violation results in a warning. The second results in a professionalism complaint.
Moving on to the facilities. There is a medical student only parking lot, located just outside of the school. Classes are held in castle-style building, lined with marble floors and inspiring gothic architecture. The main lecture hall has mahogany desks, lush warm lighting, IMAX screens, and Herman Miller office chairs to ensure maximum comfort.
In the lobby, complimentary coffee is served, brewed from fresh Columbian and Guatemalan beans, which are shipped weekly. They also have a variety of snacks and baked goods, which are sold for the price of one quarter. (I don’t want to get too greedy).
The student lounge is located on the ground floor. There, they have a wellness room housing dozens of comfortable couches for relaxation purposes, which is illuminated only by Himalayan salt lamps. In another room, they have pool tables, ping pong tables, arcade games including Ski ball, Mortal Combat, Pacman and Frogger. This room also has a refrigerator stocked with water, red bull, and cheep beer (we need to stay realistic after all).
There’s actually a corner store right across the street from the med school, where they sell beer at state minimum prices. This corner store is owned by a man named Dave or Steve, but you can’t really remember. Every time you enter the store, he greets you with a smile and asks how your day has been. He’s an often forgotten, but key component in your happiness at the perfect medical school.
For post exam weekends, the school has a partnership with all the local bars for discounted drinks. They also host a cab service for students needing a ride home, because they know that after working hard, we deserve to go out & have a good time without worrying about cab fares.
In my perfect medical school, we are on a systems-based curriculum. Aside from anatomy lab, there are minimal mandatory activities. With our (affordable) tuition, the school buys every student a copy of First Aid, as well as subscriptions to USMLErx, Boards & Beyond, Pathoma, and Sketchy Medical.
Every instructor on staff has gone through a very rigorous vetting process to ensure several things: First, they are experts in their respective fields. Second, they have a passion for teaching, as well as a gift for being able to explain concepts in a manner that is easy to understand. Third, they recognize that we are medical students, not PhD candidates, and they masterfully balance the marriage between basic sciences and clinical significance. And finally, they do teach to the boards.
Every lecture is streamed online, and comes equipped with concise and aesthetically pleasing powerpoint sides. Along with the lecture, the professor lists relevant First Aid pages that correspond with the material. The online streaming service is powered by the finest software, which never freezes or buffers.
Every week, the school releases practice quizzes consisting of NBME questions. They understand that testing on irrelevant minutiae does not result in a better educational experience. In addition to the NBME quizzes, our complimentary USMLE Rx question bank provides us with more board-style questions to actively learn material. We receive Kaplan’s question bank at the beginning of second year, and UWORLD in the second semester.
The school operates on a pass-fail grading system and truly does not rank students. The goal is to teach students that their only competition is themselves, not anyone else. Consequently, students can study according to their own goals. Because the school operates on a pass-fail system, without rank, and without mandatory activities, students are actually happy to be learning medicine. Without the unnecessary BS of other schools, students here have incredibly high morale and satisfaction with their school, which actually leads to more productivity.
Even on those Saturday nights when you have to stay in and study, the comforting rhythm of rainfall trickles outside of your windows, infusing the atmosphere with its calming earthy smells, while offering you solace as you learn medicine devoid of the feeling of missing out on the youthful joys of yesterday.
While nothing other than anatomy lab is mandatory, the school does host PBL sessions twice a week for those who benefit from this style of learning. During these PBL sessions, students in groups of five are given real cases. From there, the students must make their own differential, choose which tests to order, and lastly discuss appropriate treatment and management options. A clinician guides the group, but does not demand any degree of participation. Again, this is completely voluntary.
Once per semester, the school hosts a Specialty Fair, in which specialists from every flavor of medicine have their own booth, where they greet curious students. Every booth comes complete with an infographic, which lists how competitive their residency is, their yearly salary, their hours worked, and a ranking of their overall job satisfaction (they were hooked up to a lie detector while answering these questions to ensure transparency). They also must be prepared to give a presentation on their normal day-to-day life, including call schedule, procedures performed, common complaints, and patient population. If a certain specialty interests you, you are given the phone number and email of a doctor in the field who will answer all questions you have (they are paid by the school to do this).
After choosing a few specialties that pique your interest, you are given the opportunity to shadow relevant physicians. Students are highly encouraged to shadow more niche specialties during first and second year, because they will be rotating through the basics third year. Furthermore, if a student takes particular liking to a certain field, they can set up an ongoing once-per-month shadowing experience with one specialist, who will become their mentor.
After four shadowing experiences, if the student is still highly interested in the field and wishes to pursue it, their mentor will find research for them.
This is done so that students have exposure and knowledge of different fields, which they may not have had the chance to see third year. In addition, if a student takes a liking to a particularly competitive field (derm, ENT, urology, etc), they can start building their resume early on. And like everything else at this perfect medical school – this is completely optional.
To prepare us for clinical years, instead of incorporating mandatory clinical seminars into our weekly routines, this school holds a one week clinical bootcamp at the end of second year. On the first day, you learn the basics of the History & Physical exam. In the afternoon, you see you your first patient, but only take a history & do a review of systems. Each day, you add one or two skills to your toolbox – neurological exam, musculoskeletal exam, pelvic exam, etc. This is concentrated into one week at the end of your preclinical years, because the administration knows that it is important to not waste time listening to the heart before you even know what a murmur is or how the cranial nerves function.
Also at the end of second year, the last block of the preclinical education is focused on preparing you for Step 1. And for the big surprise, this block is taught by none other than Dr. Edward Goljan, who ties all board relevant material together in his charming, educational way.
As you can see, this is the ideal environment to learn medicine, avoid burnout, and promote mental wellbeing, while giving you the best possible preparation for boards and matching into your dream residency. Your time is never wasted, as you are granted the privilege to learn medicine in whichever way is best for you personally.
I’ll leave it in my dreams.