Widgets Magazine

OPINIONS

The Wikipedia University School of Medicine

At the bottom corner of each page in our 400-page syllabus, there is a small note warning us to “share only with Stanford School of Medicine.” After all, it would be a shame to make our learning material publicly available when we are charged nearly $60,000 in annual tuition to gain access to it.  

But rest assured, administrators. Our current syllabus is so shoddily produced and the content so scattered that even if it were made publicly available, there would be little, if any, rush to pirate it. At least not when we, as medical students, can resort to other resources that teach the material with better efficiency and clarity.

Here’s the hard truth: If we do not come together to design a better curriculum within the next few years, classroom learning at Stanford Medical School, and perhaps at most medical schools, will go extinct. Right now, our curriculum is already on life support.

Only a paltry dozen, if not fewer, out of a class of 90 students attend lecture. In fact, a close classmate of mine has not attended class since the fall of his first year, and he has learned the material as well as the rest of us, if not better. At this rate of attrition, our professors will soon be lecturing to an empty classroom.

In an age when the world is as flat and hyperconnected as ever, and the term MOOC is a part of our daily lingo, any and all information can and will be shared freely, and medical knowledge is no exception. Stanford should be all too familiar with this revolution, as it is one of the major proponents.

And so we find ourselves attending Stanford Medical School, but learning much of our medicine — disease symptoms, organ physiology, anatomy and even performing a physical — by relying on material that anyone in the world with an Internet connection can access.

We must ask ourselves if Stanford, or any medical school for that matter, can create a better curriculum than the combination of Khan Academy, Pathoma, Lippencott’s, Goljan’s Rapid Pathology Review, First Aid, Strong Medicine, Kaplan, USMLE World, SketchyMicro, FireCracker, Doctors-In-Training, Picmonic, UpToDate, MedScape and even Wikipedia.

These resources, none of which require taking out a student loan and are multiplying every year,  are only a small sample of what Stanford Medicine must contend with in order to keep its students in the classroom.

Nevertheless, Stanford has tried to stem its hemorrhage of student interest. The main strategy, it seems, is to make learning medicine less of a bitter pill to swallow. Our curriculum is studded with lectures emphasizing cutting-edge research. We have professors boasting impressive resumes and administrative titles as lecturers. Instead of PowerPoints, we have animations to help us learn pharmacology and microbiology. Many of our classes are taught in a flipped classroom model to encourage participation.

But learning medicine was and will be never easy, and it is not intended to be. Shortcuts do not exist. And this reality cannot be buried underneath all the latest educational trends and fancy gadgetry.

So what can Stanford Medicine do instead? It must emphasize its resources that cannot be reproduced through an e-book or a YouTube video. It must focus on its research and clinical training.  

Stanford should do away with the traditional two years of preclinical training, an outdated tradition that was adopted more than a century ago. For a university that is proud of innovation, it’s ironic that its medical school curriculum has its foundation in a report that was written before sliced bread was invented.

Instead, Stanford can start preclinical classes in the summer of its first year and end in following fall. What we lose in the preclinical time is inconsequential to what we would gain — the freedom of an entire year dedicated solely to research and an earlier start to clinical rotations and electives. And in order to eliminate the discontinuity and inefficiencies of the preclinical curriculum, we need a dedicated team of lecturers with backgrounds in pathology and physiology whose primary interest lies in the classroom rather than in the laboratory or the clinic.

The mission of Stanford Medical School aims not only to produce future physicians but also to train leaders who one day will leave their footprint on medicine. That will not be accomplished by teaching microbiology through cartoons. Don’t forget that we came to Stanford Medical School for its research and hospitals. It’s time to give us the opportunity to take advantage of them.

– Steven Zhang

 

Contact Steven Zhang at sezhang@stanford.edu 

  • RV

    I do agree with a lot of what you have said about medical education, but I feel like a lot of your statements are slightly out of rage and not fully realistic.

    The medical curriculum at Stanford and other schools has trained countless physicians over the years. The burst in information available in apps/other resources is a relatively recent phenomenon (Picmonic 2011, Firecracker 2009, etc.), and their popularity amongst students has skyrocketed over the past few years. Curriculums are constantly being revised, but understandably, it takes a lot longer to make drastic changes. After all, these are curriculums that are preparing future surgeons/doctors. No change can be taken lightly, and often requires evidence in the form of trials/pilots.

    There is something to be said about the preclinical curriculum. As someone who has actually experienced third year, I feel like my clinical exposure to certain diseases has cemented my book understanding of it. Although a lot of schools are moving to shorter preclinical curriculums, I guarantee that if I ask my classmates if they would have preferred 1 year over 2 years, there would be mixed feelings.

    We all have experienced that one lecturer, or one tutorial leader, that made a medical concept crystal clear- better than any book or app could. Do we need more of those experiences in medical school? Yes. Do we need less research heavy talks and more basic physiology/pathophysiology courses? Yes.

    Literally every medical student will have qualms about his/her curriculum. Be thankful that your medical school is one of the few that has the resources to try and revolutionize medical education in a way that will pave the way for other schools. I guarantee you they are trying. Hang in there!

    – Anonymous, but concerned medical student from another school

  • Jim Downfield

    “Be thankful that your medical school is one of the few that has the resources to try and revolutionize medical education in a way that will pave the way for other schools”

    The phrase “revolutionize medical education” is thrown around quite a bit when it comes to curriculum reform, and that phrase reflects the very essence of what’s so wrong about things as they stand. The author seems to be saying that the way in which Stanford’s curriculum is being modified currently is not the only path forward (ie, flipped microbiology being taught with videos). As he states, “learning medicine was and will never be easy…reality cannot be buried underneath all the latest educational trends and fancy gadgetry.” At Stanford, as at other medical schools in all likelihood, there is pressure to “revolutionize” and “modernize” medical eduction…and often at the expense of making the core changes that would have actually improved the curriculum (hire dedicated lecturers, etc.). Throwing around buzzwords and making fancy learning interfaces is no substitute for quality instruction. Our predecessors successfully learned with chalk and a blackboard–we can do better, but a wholesale “out with the old, in with the new” mentality is a hollow shell of a model for curriculum reform–looks shiny on the outside, but has no substance to it.

  • Brian

    Great writer, but very naive in thought

  • dkp

    absolutly right Brian! Try being a patient in Stanford Hospital w a ton of entitled and stupid med students who have no idea about privacy and patient care! My experience was that they were a 100% nuisance.

  • dkp

    Amen, Jim!