It's Only Medical School

"It is a neurotic goal to try to learn everything. One must pick and choose." (Steadism #178, pg 57)

Last night we desperately sought to work through and understand the core concepts of medical research, and using evidence based medicine. My perspective of this material given my former life practice and teaching preventive medicine is that the approach is all wrong.  "They know not what they do." To memorize and digest gobs of equations that only statisticians, and masters and doctoral public health professionals enjoy is absolutely useless in clinical practice. We need to understand the literature... absolutely, but it is absurd to have to know how to perform the operations of statistics...the math. If you drive a car, you need to understand the laws, be capable at using the car everyday and know when you need to get a consult from a professional mechanic. But do you need to know how the car was assembled or how it was engineered? Absolutely not. This is no less valid in medical statistics. Tell me the "laws". Help me understand how it basically works. Teach me how and why to get a consult from a professional, but this approach is useless with a capitol U. I need to understand the literature and the value of a randomized, double-blinded (or even triple for the purists) controlled study, but do I need to be able to check the math? I don't think so.

So I'm standing at the board trying hard to understand the formula for the area under a normal curve distribution of a sample (I'm sure all physicians will recognize that they need this skill daily in the care of, say, diabetes...NOT). I'm stuck at the point of creating knowledge about the formula for area, and an upper classman walks in to assist us. He gives is a once over, puts his two cents in (very helpful I might add), steps back and say, "listen; don't worry about it, it's only medical school."

There was a certain magic in his words. It IS ONLY medical school and we can't know everything perfectly. This one point, likely never to be seen again after the next test (except maybe one on the USMLE boards) is not that important. Medical school is an exercise of sifting thru the volumes of material and realizing that you can't know it all. You cannot understand it perfectly...try and move on. He said something too that I've heard before..."What do they call the person who graduates medical school with the lowest test scores and GPA? - Doctor."  Now I have no plans to graduate last in my class...quite the contrary, but without some reminder of this fact and the cognition that it's only medical school, one would become neurotic eating this elephant. Sometimes you just need to know when to spit it out because you are down to bone, or when to add mustard for taste. While I do take this very seriously it is, after all, only medical school.