Clinical Medicine: The Bane of My Second Year Existence

What Is Clinical Medicine?

The clinical medicine course makes up a very large part of the second year. If you read my overview of the second year of medical school, you will already know that I did not particularly like this course.

But before I get ahead of myself, let me first give you an idea of what the course is about.

The clinical medicine course is basically an internal medicine course. Since internal medicine covers a very broad scope, you will be learning about diseases, screenings, and treatments from the top of the body to the bottom of the sole.

You will learn about the following topics:

  • Prevention: epidemiology and biostatistics
  • Neurology & Orthopedics: central nervous system, musculoskeletal system, and anything else that does not fit in the other sections (strangely, the people in charge threw vasculitis into this section)
  • Endocrinology: hormones
  • Cardiology: heart and vessels
  • Pulmonary: lungs and airways
  • Nephrology: kidney and related structures
  • Gastrology: esophagus, stomach, and intestines
  • Hematology & Oncology: blood, lymph, and various cancers
  • Obstetrics and Gynecology: women’s health from giving birth to sexually transmitted diseases

Clinical Medicine in My School

In my school, there was a very large emphasis on the clinical medicine course for the second year. First, the course spanned for two semesters. Each semester, it comprised of at least 50% of the total class time. So it basically made up at least half of the second year education. Second, it has the highest requirements to pass:

  • your semester average grade must be 65 or higher (like other classes)
  • you cannot fail more than one block per semester (unlike other classes)
  • you must attend, prepare for, and participate in the weekly or bi-weekly cases (unlike other classes)

If you fail to meet the requirements, you will be forced to remediate the class. Some of my classmates were forced to remediate, so do not think you are above that.

Small Group Cases

The cases take up a lot of work and a lot of time. Yet, they only comprise of 10% of the course grade. Still, the cases are one of the better aspects of the course if you have a physician to lead, because you will learn a lot. If you have someone who is not a doctor leading the group, you will not learn as much. If you fail to attend, you may have to make up for it by attending the case in another day or you may have to write a report. I am not too sure about this because I did not miss any cases.

There are times when the cases will cover diseases that you have not learn about yet, so just be prepared for that.

You will have to come up with differential diagnoses, even if you never learned the diseases yet. This is more common in the beginning of second year. A good way to save time on establishing the differential diagnoses is the symptom checker from Mayo Clinic. You are welcome. I just saved you a bunch of time.

Why I Very Much Dislike the Course

The most important thing you should know about clinical medicine course in my school is that it is the most poorly taught course as of the first two years.

clinical medicine - poorly taught

This picture summarizes my main complaint against the course: it is poorly taught.

Apparently, for many clinicians (at least the ones who are teaching us), teaching second year medical students is not a priority. Sometimes they would come in half an hour late, saying that they were not aware they had to teach. Lots of the slides they used to teach were not tailored for second year medical students but were made for residents. It is also very common to learn about treating a disease even before knowing what a disease is. Talk about putting the cart before the horse. The clinicians assumed that we already learn about the diseases in another class while the other class assumed we learned about it in clinical medicine.

The main reason it is so poorly taught is because the course does not have one main teacher to teach the whole thing. Sure, students can complain about poor teaching and poor exams, but since almost every lecture is taught by someone new, there is no incentive to change. The blame of poor teaching could be placed on someone else. And because no one takes responsibility, no changes are made. Students have been complaining about the course in previous years. Even my upperclassmen friend who is 3 years above me recalls how horrible clinical medicine course was.

If you compare the attendance rate of second year to the attendance rate of first you, you will find that the second year’s attendance rate is much lower than that of the previous year. Why should students waste their precious time when the teacher could not care less about teaching well?

Clinical medicine is good for everyone but the students. The school gets to boast that they teach clinical medicine in the second year. The school also gets more than $35,000 per student. The clinicians gets another impressive title for their resume: professor at UMDNJ.

To be fair, a few lectures were taught well. A few blocks were taught well, namely cardiology and women’s health. The good teachers are the exceptions to the norm though. Still, I will give credit where credit is due.

How to Succeed in Clinical Medicine?

I do not know if anyone honored the course. I am sure there are people who scored in the 90’s on their exams, but I doubt they can do so consistently. I would guess that even the top students in the class only high-passed the course.

For this course, success would mean passing. In the first semester, I was able to high-pass the course. In the second semester, I only passed the course.

If you value your time, I would recommend you to skip this class and get notes from your peers or from upperclassmen. My class shared notes freely. But if your class is less generous, I would spot the person who takes good notes and pay the person for the notes. Once you have the notes, spend about 3 days before the exam and cram everything in. It is doable. That is what I have done in the second semester. If I was to do this course all over again (oh, please, no), I would skip all clinical medicine lectures and cram. The time spent on clinical medicine is not worth it.

With the extra time, you can properly learn clinical medicine from a better resource.

Study Tips

  • skip class
  • get notes from classmates or upperclassmen
  • cram before exam

Additional Clinical Medicine Resources

If you want to learn clinical medicine well, I would strongly recommend that you get an additional resource. An additional resource is not needed to pass the exam, but I believe it is needed to learn the materials well.

Book(s)

For a few of my blocks, I did use Step-Up to Medicine. It is an excellent book that gives you a general overview of internal medicine.

I am not sure if you can solely use Step-Up to Medicine to pass the exams but it will definitely give you a strong foundation to internal medicine. Between this book and class notes (or presentation slides if you went to class), they should be enough to pass the exams.

In addition, this book will make preparing for the small group cases much easier.

I would highly recommend you to get this book; but again, it is not needed.

Visit the medical school books section on books that you will need.

Online Resource(s)

As I have already mentioned above when I was talking about the small group cases, the symptom checker from Mayo Clinic is very useful in establishing the differential diagnoses. It will save you a lot of time as you prepare for the cases.

Hey, you! Do you want to know how an accountant, without a science background, made it through medical school without any difficulty? Do you want to know how I memorized a sea of information without cracking my skull in half and dumping the books into my brain? No, I did not slave away all night studying in the library either. If you want to know my complete study system, check out The Secret of Studying.

This article is part of the How to Survive Medical School series. Click on the link if you want more tips and hints about surviving academic hell.

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