Learning vs. Reality

Regularly we attempt to learn content that is constantly in flux and subject to change, even before we learn it. This phenomenon is built into the system of education that is medical school. There is a built in delay from reality, to national board testing that almost requires that we learn "old" information in the first two years so we can "pass" a board exam that was effectively written, validated and released during the past 2 years. Confused? When I sit for my Part 1 USMLE board exam in early 2010, that information being tested will have been "current" in 2007-08...it's just how the system works to write, review, validate, test, store and assemble questions and exams.

Flash to now...I'm learning content that is both text based (in itself 2-3 years old via publishing standards) and trying to integrate that with my current knowledge and new knowledge about patient care that we read about everyday (about the only reason I'm sorry for the Internet). So as we learn about the disease of ovarian cancer, the data is in continuous flux. Today I read....

Investigators disagree about value of combination screening to detect early-stage ovarian cancer. (3/20) reported that researchers in the UK, who are conducting "the largest randomized controlled trial of ovarian cancer screening to date," are saying that, used together, "both the cancer antigen 125 (CA125) blood test and trans-vaginal ultrasound might be capable of detecting early-stage ovarian cancers." But, researchers at the University of Alabama-Birmingham maintain that the screening regimen "fails to discover the cancer in its early stages and often results in unnecessary surgery," HealthDay (3/20) pointed out.

The question is what will be current knowledge on my board exam in 2010 when I am taking the most important test of my life to get to the next stage of my medical education...rotations? This guessing game of sorts, and preparing for an exam is understandable, but a bit bizarre and more about the test than anything else. I'll learn how to be a practitioner later.

The next Bozo instructor that tells me he or she is not teaching to the test should be fired right on the spot. It's ALL about the test! I can't move to the next phase of this educational process without passing that exam. I'll learn about current ways of thinking after Step 1 (and then unlearn it a few years when I have to take Step 2). I'll learn about doctoring in my residency. In the meantime, focusing on the massive amounts of "old" content is enough. If you give me one more cutting edge study or minutiae point of information that has nothing to do with anything but showing me how much you know (or test me on it, God forbid) in this part of my education, I'll SCREAM!