Favorite Quotes
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow ====
Nov - 15
Dec - 19
Jan - 21
Feb - 8
Mar -
Why the 4th year is worthwhile
26 Jun2009
Med School ‘Senioritis’ as suggested by FutureDoc in a tweet.
While Lyss-Lerman does not advocate getting rid of the fourth year, she said that it needs to be revised to be more useful. The study suggests a curriculum wherein students “have more authentic roles in patient care,” which, she said, will help them to develop their own identities as physicians and collaboratively practice the humanistic elements of medicine. Specific recommendations for fourth year curriculum additions include sub-internships in internal medicine, and rotations for critical care, ambulatory care, and emergency medicine. The idea is to make sure students are achieving competencies — a movement in medicine to assess students based on critical skills rather than memorized facts — even as they enter the home stretch of their education. The study suggestions were based on interviews with 30 residency program directors at San Francisco.
Having graduated in the 70s, I have heard the argument for 35 years. My medical school had a 3 year option while I was a student. Most students felt that the 3 year grads had missed important opportunities.
Now I have worked at 2 medical schools that have some 4th year requirements. All our students have to take a medicine AI. Invariably the students find this a very valuable experience. They have to take 2 other AIs during the year.
What does the 4th year provide? I believe that the competency movement has a flaw. It cannot measure wisdom and comfort. Being a physician is more than knowledge and more than skills. Being a physician requires wisdom.
Wisdom only comes through experience. Those who teach residents know that residents continue to grow throughout residency. They often can do well enough on the test as interns to pass the boards, but they still pale compared to senior residents when approaching patient care.
I believe the 4th year is a consolidation year. I agree with the need for required acting internships. I advise students to take some electives related to their field of interest and some complimentary electives.
Yes tuition is too high, but that should not become a reason to short change education. Students benefit from the 4th year. The 3 year experiments in the 70s were not great successes.
Related posts:
- In which at least 2 commenters miss my point
- Does IM training lead to decrease primary care selection?
- Graduate medical education and the Long Tail
- Is medicine worth it?
- Do we need a new Flexner report?
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- In: Medical Rants
1 Response to Why the 4th year is worthwhile
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June 26th, 2009 at 7:43 am
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