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August 21, 2018

Nearly 1 in 4 medical students 'almost never' attends class. (They're too busy studying for exams.)

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    An increasing number of medical students are skipping class—but it's not to slack off: They're making time to study for a grueling exam, Orly Farber writes for STAT News.

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    Why med students are skipping class

    About 25% of second-year medical students last year reported "almost never" attending class during their first two, preclinical years in school. That's up by more than 5 percentage points from 2015, Farber reports. "At one school, attendance is so bad that a Nobel laureate recently lectured to mostly empty seats," Farber writes.

    Often, students are focused less on what's being taught in the classroom and more on studying for Step 1, an eight-hour exam taken at the end of the preclinical years that significantly influences what medical specialties students can pursue after school and where they can pursue them.

    Many students believe they're not being taught what they need to know for Step 1 in class, Farber writes. Ryan Carlson, a third-year student at the University of Washington, said his school is focused on teaching "what they thought was important for a physician to know." But students have to know more than that to succeed on Step 1, as the exam covers rare diseases and a range of obscure facts, Carlson said.

    Lawrence Wang, a third-year student at the University of California, San Diego, and NIH, said, "There were times that I didn't go to a single class, and then I'd get to the actual exam and it would be my first time seeing the professor. Especially, when Step was coming up, I pretty much completely focused on studying outside materials."

    In response, some medical schools have changed their curricula. Harvard Medical School has mostly done away with lectures, favoring online learning and mandatory small group sessions for students, Farber writes. Similarly, Johns Hopkins University has cut down on lectures and increased classes that require more participation from students.

    The rise of online study aids

    Wang isn't the only one relying on outside resources to study for Step 1. The practice has spawned a whole industry of online study aids, Farber writes. According to 2017 data from the Association of American Medical Colleges, 25% of preclinical students watch educational videos daily.

    One of the most popular study aids is SketchyMedical, which produces visual memory aids to help students retain the information they need to know for their exam, Farber writes. Andrew Berg, Saud Siddiqui, and Bryan Lemieux, who co-founded the company, said sketching pictures and pairing them with stories helped them memorize what they needed to know in school. "We were just bombarded with different names of bacteria, viruses, and fungi, and we were having a tough time keeping them all straight," Berg said.

    SketchyMedical's illustrations have been made into narrated videos that help teach students drug names, mechanisms, and side effects. Other videos cover topics ranging from microbiology to pathology.

    Professors aren't sold

    While these resources are popular with students, some educators are critical of them. Richard Schwartzstein, director of education scholarship at Harvard, said the resources' reliance on memorization and pattern recognition are a weakness. "You don't have to actually teach pattern recognition," he said. "We all are born with the capability of recognizing pattern." Instead, Schwartzstein recommends his students use videos and recommended readings developed by Harvard.

    Nancy Hueppchen, associate dean for curriculum at Johns Hopkins University, said the resources "may have value in day-to-day studying, they may have value in studying for Step 1," but they haven't been vetted by Hopkins, so she doesn't recommend them to students. The resources have also not been endorsed by the National Board of Medical Examiners, which administers the Step 1 exam.

    According to Berg, his main goal is to bring a little joy to studying. "I think … what I hope to contribute the most is making studying more fun," he said (Farber, STAT News, 8/14).

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