Traditional “clerkships,” as they are known, are two-to-eight-week-long clinical experiences in each of the many medical specialties taken during the third and fourth years of medical school. During these programs, students see patients and learn directly from the doctors responsible for their care. It’s a combination of structured didactic learning, self-directed experience and day-to-day grunt work. After the month-plus spent in, for example, neurology, students get comfortable thinking about common problems people seeing neurologists might have and the options for dealing with those problems … and then they move on to the next clerkship.
Medical education has remained largely unchanged since 1889, when a young William Osler was recruited to be the chair of medicine at the newly formed Johns Hopkins Medical School in Baltimore. Borrowing principles he learned at universities in Europe, he established the Hopkins’ residency model, originally named because doctors-in-training lived in the hospitals where they apprenticed. He also recognized the importance of bringing students to the patient’s bedside during their early training, understanding that basic scientific principles are better retained when applied to real-world illness.
Tick-tock. Tick-tock. The only clocks in the room were the digital, silent type, but still I heard it. The first hurdle to becoming a board-certified physician was looming as the ticking in my head grew louder. It is now the summer following my second year of medical school at the University of Minnesota, and students across the country have just taken the eight-hour-long, 308-question U.S. Medical Licensing Examination Step 1. Here I outline some of my experiences preparing for and taking Step 1.
Methods for letting blood out from a patient’s body to cure them of disease were described in ancient Ayurvedic texts from India as early as the 7th century B.C. and the practice was employed by civilizations such as the Mesopotamians, Egyptians and ancient Greeks. This treatment was based on the system of medicine known as ‘humorism,’ which posited that an excess or deficiency in any of the primary bodily fluids directly influenced a person’s health.