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Medical Education - Page 15


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5. While attaining high grades is commendable, developing a competent grasp of
the material presented should be the prime goal. This involves developing a pri-
ority system of study of the wide-ranging subject matter and the various topics,
focusing on understanding concepts, and fitting the details into the conceptual
framework so as to facilitate their retention.
6. Development of an objective approach to clinical problems should begin during
the first year. This involves beginning to establish a flexible emotional balance
between excessive sympathy for patients and exaggerated detachment.
7. It is important to avoid a feeling of complete isolation in an endless sea of infor-
mation, some of which is esoteric and apparently irrelevant to your specific
career activities. To avoid losing one's perspective, it is useful to set aside some
free time for clinical observation, such as attending rounds or conferences.
8. Although difficulties and setbacks may occur, they need not necessarily lead to
failure. They should be placed in the context of your many successes.
9. Emotional self-care, using such methods as having planned breaks and regular
exercise, utilizing preventive stress management techniques, and maintaining
personal relationships, as well as providing oneself with rewards, is important.
10. Prompt help should be sought if signs of trouble, in the form of depression, rela-
tionship problems, and increased use of alcohol or drugs, become evident.
11. To offset the decrease in overall physical activity due to the considerable time
spent in the classroom and laboratory, an exercise schedule, even if at quite a
limited level, should be maintained.
12. To help ensure good physical, mental, and emotional health and stamina, proper
attention should be paid to nutrition, diet, and getting enough sleep.
Finally, it should be kept in mind that, while there frequently is an increase in stress
as the freshman year progresses, there is also a tendency for the ability to cope effec-
tively to improve. Associated with this improvement is a betterment in health and mood.
Along with these changes comes a heightened enjoyment of medical school, with feel-
ings of greater competence and reduced uncertainty about entering a medical career.
Second-year Guidelines
The second year marks a turning point on the student's road to becoming a physician. The
focus is drastically altered, from what heretofore has been almost exclusively the normal
state of the human body, to a consideration of the disease process, its consequences, and
modes of therapy. While conceptual thinking continues to be required, the volume and the
content of the information presented place a heavy premium on memorization. This year
represents an equalization in potential between premeds and nonscience majors.
For obvious reasons, pathology represents the key transitional course from the nor-
mal to the diseased. It is usually taught by means of formal lectures, exercises in the lab-
oratory, seminars in clinical problem solving, and autopsy exposure. The interplay of
anatomy, biochemistry, and physiology with pathology provides the intellectual chal-
lenge inherent in this subject. The linkage of clinical observations with autopsy findings
as revealed in clinicopathologic conferences (CPCs) provides dramatic insights into the
effects of the disease process.
Pharmacology complements pathology, since the actions of individual drugs and
drug families can be learned in the context of the diseases they treat. This course stimu-
lates a review of relevant basic science topics and, while heavy on memorization, also
demands conceptual understanding.
A significant course of the upper sophomore semester is physical diagnosis. This is
usually taught by formal lectures, at hospital teaching rounds, and by individual hospital
assignments. This course provides an invaluable base upon which to build for the com-
ing clinical medical school years and postgraduate training.
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