First Year: lots of structured, didactic-style lectures. You're getting in most of the basic science you'll need for next year. Your classes are things like Microbiology, Gross Anatomy, Biochemistry, Genetics, Neuroanatomy, Physiology, etc. Most are optional, but there are required, scheduled lab times for both Anatomy and Histology. I think it was something like 30-40 hours of scheduled lecture, clinical skills, and lab time each week. You're learning how the body is supposed to work. You have to spend a lot of time watching lectures, taking notes, and going to lab to memorize all the body and cell parts. This adds up, so when I say a lot of time, I mean that's pretty much all you do. Add in some clinical skills experiences and learning how to do the core physical exam, and that's pretty much your first year. Lots of lectures, lots of lab, lots of passive learning.
Second Year: A LOT less time is spent in lecture, and no lab. We learned all of Anatomy last year, right? At most, we have eight hours of didactic lecturing, in four-hour blocks twice a week. We also have three, two-hour chunks of time devoted to Problem-Based Learning (PBL). Basically, work in groups of about 8 students with one physician preceptor and work through imaginary cases in the "Patient is an (age)-year-old (race) (gender) who presented in the ER with (symptom1symptom2symptom3)" style. We pick out "cues," formulate lists of hypothesis of diagnosis, and come up with learning issues (things we're not quite up-to-snuff on and need to learn better to be able to firmly diagnose the patient) - all on the first day. Then, we all put our hands in the middle of the conference table and shout, "BREAK!" before heading off to learn everything and come up with a concrete diagnosis. Right? Right.
In first year, we could completely rely on printed coursepacks created by CHM. If it wasn't in the coursepack, we didn't need to know it. Things are different this year. The coursepack helps serve as a guide to the topics that we need to learn, but it doesn't go into nearly the level of detail that we're expected to know. For that, we have supplemental readings and recommended chapters from textbooks. Apparently this first unit (Neuro) has a much more comprehensive coursepack than later units, as we've been heavily encouraged by M3s to enjoy Neuro while we can.
And that brings me to the structure of the second year. Aside from a half-semester Ethics class now (and a half-semester Epidemiology class later) and Clinical Skills, all we have is PBL, which is split up into domains based on body system. So, right now we're doing Neuro (3 weeks), which ends with one big test. The tests have about 30 questions for each week of domain length. So, the Neuro exam will be 90 questions - and that's your whole grade for the domain. If you get less than a 75% on the exam, you get one chance to take a remediation exam and get a "CP" (conditional pass) grade, which is acceptable, but doesn't look the best on your transcript. If you don't pass the remediation exam, you have to retake that domain, which means that you have to extend your medical education by a year.
Let's just hope that's not something I have to deal with, hey?
So there it is - we have a lot more "free time" this year compared to last year, but that just means we have to be even more self-motivated to study and READ everything that we need to learn. To give you some idea of it, the Neuro coursepack is 690 pages long, and mostly deals with the pathologies you might encounter in the central & peripheral nervous systems. Aside from a light review in the first couple days, we're expected to remember most of the physiology and anatomy from last year. Also included in the domain are many relevant "Bugs and Drugs," all of which either cause or treat those various pathologies of the nervous system. Lots and lots of supplemental reading, memorization, and time spend with your nose buried in books at home or sequestered in study rooms.
We have a lot more self-structured time in second year, but a lot more to learn in that amount of time. Speaking of which, this is turning into a rather lengthy post, and I have about 100 more pages that I'd like to get through before bed tonight. Probably not going to happen, but there it is. Today was spent differently than I would've liked, so I'm a little behind... 2 hours of Neuro PBL, 2 hours of Ethics, 3 hours volunteering, 2 hours of group review/study/case practice at the Secchia Center, and 2 hours of studying at home so far. Add in the time spent eating, ambulating, and trying to get Hobbes to stop peeing on the floor, and you've got a full day...
Back to the books. Wish me luck.