Pathopathology
Posted by enrico | Under Medical School Thursday Feb 8, 2007Thanks to the work of pioneers like the late Dr. Robbins in the middle of the 20th century, pathology turned from a banal study of morphological aberrations to a study of the origins of disease. Pathology didn’t begin at the morgue; it began when the patient got sick. Since almost every subject we’ve studied comes into play when studying pathology–microbiology for infectious diseases, histology for recognition of tissue/cellular aberrations, genetics for chromosomal anomalies, etc.–it stands to reason that pathology would be the pinnacle of learning in the first two years, the nexus of all the knowledge that has come before, finally synthesized into an integrated whole.
Bullshit. At least not at my school. I have never felt so cheated in my time here as I do with this class. I have been wanting to write about this for some time, but I can’t possibly begin with out speaking ill of my institution. Well, after many incidents where my school certainly didn’t have my back, I’m certainly not going to return the favor.
All of this started last year when a leaked exam (a true mistake–no foul play involved) got out and gave certain students who had it an unfair advantage over those who didn’t. Here at UAG? Big f-ing deal–that’s the norm. Almost all classes have an officially labeled “question bank” (really a “test bank,” as it’s not a dynamic mix-and-match of questions), and it doesn’t take a very smart monkey to figure out that if one amasses enough old exams, one can have a good shot at some of the questions on the exam–sometimes even luck out having the very same exam! I have learned from other int’l med students’ blogs that this is not unique to UAG, so I just shrug my shoulders. After all, if ppl want to go nuts memorizing old exams, that’s fine–and I certainly look at them when I get my hands on them–but the people who do just that are in for a world of hurt. Natural selection is a cruel bitch, and she’s already culled 80 or so from our class since August of 2005. And that’s before USMLE.
The problem is that because of said fiasco, the pathology department was ordered to throw away their question/test bank and start anew. That’s a good mandate from administration, but what they wound up doing was simply cut-and-pasting questions from the Robbins review book, WebPath, and other online sources. Not a single original question was to be found. Oh sure, they’d change a few words here or there, but they didn’t care. After all,the department head of pathology isn’t even a pathologist; he’s simply a general practitioner who worked as a government doctor for Pemex, the country’s gas monopoly for 35+ years. The second in command is a pathologist at least, but her contributions mainly lie in flashy presentations that offer no substance beyond what is literally cut-and-pasted from the textbook. I thought at least the figures had their own original labels, only to find out that no, the captions too are copied. At least she gives proper credit in the slides. In all cases, we are simply read to. No additional instruction, no help if you talk to them in their office, as it is clear that they are not able or willing to explain any concept beyond what the book says. This is not a language barrier, it’s sloth. The one practicing clinical pathologist who is on staff and was the shining light in our lecture series a year ago was removed from teaching all but the newbies. How’s that for smarts: take the most knowledgeable, practicing faculty member and tie his hands so he teaches the very basics rather than the difficult. But this is Mexico, and Mexico rewards who you know, not what you know. Imagine who the department chair has in his pocket to be chair for which he has no credentials in that very subject.
Right now, we are racked with all of CNS pathology and all of hematopathology–hundreds of pages of the textbook to be sure. At least it’s two big sections. The last test was–and I shit you not–skin, muscle, bone, eye, kidney and urinary tract. What kind of hellish composition is that?!? Again, sloth. Whatever fit in the kitchen sink.
Like most things here, we’re on our own. I don’t mind that for histology or for behavioral science. Even things like pathophysiology–a potentially great class, subject-wise–was a waste because of who taught it. But it’s OK. Pathology, on the other hand is too important to be treated as just another castaway class. All of our complaints and petitions, however, are drowned out in the “cha-ching” of the cash registers as they process yet another semester’s tuition.
All I know is that I’m offline until Friday afternoon when this sadistic shit is overwith. Liver rounds to commence shortly thereafter, so it might be until Saturday before I am up for a debriefing. Wish me well.
Sloth is not fact-checking your vitriolic and gratuitous commentary - one of the faculty (and certainly not the “shining light” that you mention), was a practicing pathologist with 20+ years of experience, is possibly the only one in the whole International Program who studied abroad at famous international institutions in Italy, has access to Nobel Laureates and renown figures in her specialty through solid contacts at the HMS and BU, to name a few, etcetera (you should help yourself to a dishful of her logros). Doubtless, if you were more keen to research your teaching professors, payed attention in class and attended it daily, and in general approached the subject with an open mind, you’d suck out more marrow than sour grapes.
In spite of the fact that I already knew Dra. G. spent time in Italy (in fact, I was the one who informed most of my classmates of this–I read all my professors’ CVs if available), there was no fact-checking needed; everything I said was true, as per my experience. My opinions are subject to debate, of course, but they are my own. Obviously, Dra. G. is a close friend/relative of yours, so you should know (and I speak 100% honestly here) that I like her as a person; over a glass of wine, many fascinating conversations could be had with much to learn–of that I have no doubt.
But this isn’t about her, this is about the class and how information is presented. She could be a Nobel Laureate herself–it doesn’t matter if it’s not shared. Good teachers teach; great teachers inspire–that’s my standard. It is sloth to cut and paste questions from known accessible resources rather than come up with questions oneself that correlate what was discussed in lecture. This cheats students of objective grading based on test-time rationalization, because then a hard choice has to be made: memorize questions like everyone else to keep up with the grade curve, or stick to reading the books on principle and risk [certainly] falling behind. If the playing field were level with original (at the very least, not PUBLIC) questions, this could happen.
You know nothing about my class attendance or whether or not I pay attention, so I’ll ignore that, but the point of going to class is not to be read to–it’s to have someone synthesize/ condense the material and give a perspective using THEIR words, DIFFERENT points of view, OTHER angles. Dra. G. did not do that. Dr. MS, menos. My main problem was with the course, and when you have a problem with the curriculum, you look to the department head. In this case, there is no surprise why the department is a sinking ship. It’s not personal, it’s business–MY business, as in my career, what I paid money for to learn.
But don’t worry–the rot that exists in the pathology department is simply a distant metastasis of the primary tumor that lies elsewhere, but there’s only so far I’ll go publicly. The point here isn’t to embarass, it’s to chronicle my experience. I don’t have to apologize for or justify that to anyone.