The Student Room Group

Not learning enough fundamental science at medical school?

This is probably going to sound ridiculous, but here goes...

I am on an integrated course in London and I fear that because of the focus on clinical/communication skills, we aren't having enough lectures on the basics of physiology and biochemistry. As I am quite interested in becoming a research clinician, this really does worry me.

I saw a Youtube video from a Cambridge alumnus, Ali Abdaal, as he was preparing a physiology supervision for some first year students, and they were going into the history and experimental evidence of nerve membrane potentials - at my university, we've only gone into membrane potentials broadly and briefly!

Should I be exploring these kind of topics further, beyond lecture content to keep me up to date with what other medical students are learning?
Original post by Sugarandspies
This is probably going to sound ridiculous, but here goes...

I am on an integrated course in London and I fear that because of the focus on clinical/communication skills, we aren't having enough lectures on the basics of physiology and biochemistry. As I am quite interested in becoming a research clinician, this really does worry me.

I saw a Youtube video from a Cambridge alumnus, Ali Abdaal, as he was preparing a physiology supervision for some first year students, and they were going into the history and experimental evidence of nerve membrane potentials - at my university, we've only gone into membrane potentials broadly and briefly!

Should I be exploring these kind of topics further, beyond lecture content to keep me up to date with what other medical students are learning?


Hmm. Hard to justify.

Yes that stuff is absolutely normal at Oxbridge. Yes, Oxbridge do much better than anyone else in doctors exams and yes basic science and experimental methods may be important if doing some areas of research.

The problem comes with how self-learning this stuff is going to be effective and more importantly whether it's going to be more beneficial to you than just doing well on your course. The aim of learning basic science is not to have you memorise 50 different molecules or memorise dates of important experiments - its to build an underlying understanding of how the body works and how we know what we know about it. That's hard to do alone. Whereas doing well on your course... you'll have support in that.

There is also no reason why you can't get actively involved in research as an undergrad. There will be people who would love the assistance of an enthusiastic student with their work - just need to find them.

I would be more focused in your additional efforts, not just try to emulate Oxbridge.
Unfortunately this seems to be a recurring theme around the country where a lot of people completely underestimate how much a doctor needs to know about basic science and (patho)physiology. There is a also concurrent move towards a PBL style curriculum which - in my view - does not appear to be led by clinicians.

I can sympathise with your position but I am unsure if going elsewhere (oxbridge aside) would help that.
Original post by Anonymous
There is a also concurrent move towards a PBL style curriculum which - in my view - does not appear to be led by clinicians.

Have you ever done any qualifications/had formal teaching in medical education? It is amazing how many essays upon essays can be written about teaching techniques and theories of knowledge without a scrap of evidence anywhere to be seen. Whole 20 page essays with 100 references every single one of which will be... another essay. Sometimes by the same ****ing author.

However, what I will say is that whilst there does seem to be a movement away from very traditional course structures (e.g. Imperial recently), there is also a move away from your pure PBL. Most unis have brought in more traditional elements, sometimes re branding as 'CBL' or similar, to give a more mixed course.

We'll see what impact the UKMLA will have on all this over the next few years.
Original post by nexttime
Have you ever done any qualifications/had formal teaching in medical education? It is amazing how many essays upon essays can be written about teaching techniques and theories of knowledge without a scrap of evidence anywhere to be seen. Whole 20 page essays with 100 references every single one of which will be... another essay. Sometimes by the same ****ing author.

However, what I will say is that whilst there does seem to be a movement away from very traditional course structures (e.g. Imperial recently), there is also a move away from your pure PBL. Most unis have brought in more traditional elements, sometimes re branding as 'CBL' or similar, to give a more mixed course.

We'll see what impact the UKMLA will have on all this over the next few years.

I am at Oxford, but do you really think even the other 6 year courses e.g. Imperial, UCL and I think Kings has an option for it too aren't focused enough on science? I am just curious, because I thought that was the difference between a 6 year course versus a 5 year one.

I do definitely appreciate the tutorial system though! Definitely helps consolidate info and develops a deeper understanding.

Also curious: what evidence is there that Oxbridge students do better in post-grad exams? And what evidence is there that that improvement is due to their university education per se? I ask the second question because obviously Oxbridge students did better than most medics even at A-level so you might expect us to do better subsequently too.
(edited 4 years ago)
Original post by nexttime
Have you ever done any qualifications/had formal teaching in medical education? It is amazing how many essays upon essays can be written about teaching techniques and theories of knowledge without a scrap of evidence anywhere to be seen. Whole 20 page essays with 100 references every single one of which will be... another essay. Sometimes by the same ****ing author.

I have and I totally agree. I totally accept that it is actually very hard to get generalisable evidence from studies in medical education, but the amount of faith/dogmatism people will put in either the most measly of studies or popular conjecture does often surprise me. For example, people raved about VARK for a number of years.. And yes, self referencing does sadly seem to be very common.

It will be interesting to see what the MLA brings. Whilst I suspect there will aways be the risk of ditching everything in favour of whatever makes the uni league tables look nice, an attempt to bring a standard for medical knowledge might have its advantages. Whether this will make schools teach underlying principles or MCQ word association will also be interesting to see.
Reply 6
Original post by HumblyBumbly
Also curious: what evidence is there that Oxbridge students do better in post-grad exams? And what evidence is there that that improvement is due to their university education per se? I ask the second question because obviously Oxbridge students did better than most medics even at A-level so you might expect us to do better subsequently too.


The data i.e. examiners reports breakdown of pass rates by medical schools.
When I was preparing for MRCGP (expensive, reasonable failure rate and my preparation was "suboptimal" because of life at the time...) I was looking at them and tried to reassure myself that no one from Oxford had failed yet so hopefully I wasn't going to be the first!

Haven't seen any evidence of the latter and would be surprised if there was... You could control for A level results I suppose but the old 'A grades' might not be sensitive enough really given quite a large % of medical school students would have had them.
I imagine it's a combined effect of the cohorts they take it and the training/exam skills.
Original post by Elles
The data i.e. examiners reports breakdown of pass rates by medical schools.
When I was preparing for MRCGP (expensive, reasonable failure rate and my preparation was "suboptimal" because of life at the time...) I was looking at them and tried to reassure myself that no one from Oxford had failed yet so hopefully I wasn't going to be the first!

Haven't seen any evidence of the latter and would be surprised if there was... You could control for A level results I suppose but the old 'A grades' might not be sensitive enough really given quite a large % of medical school students would have had them.
I imagine it's a combined effect of the cohorts they take it and the training/exam skills.

Obviously it would be cool for us who study at Oxbridge if it's the case that it's like a dichotomy of Oxbridge and the rest...

but kind of feel like it's a bit of BS. Like I have loads of friends at other unis and they seem on top of things more than many friends at Oxford. So kind of feel like it's pretentious BS by those who want to feel superior and perpetuated by those who feel insecure about their Uni or were rejected by Oxbridge. Not to say Oxbridge teaching is not good - I have really appreciated some tutors who have been amazing (some haven't but that;s life) but is it THAT much better than say Imperial, UCL etc... hmmm I doubt it.
Original post by HumblyBumbly
I am at Oxford, but do you really think even the other 6 year courses e.g. Imperial, UCL and I think Kings has an option for it too aren't focused enough on science? I am just curious, because I thought that was the difference between a 6 year course versus a 5 year one.

Erm, no? Its to do with whether you do an intercalated BSc or not. I suppose more scientific courses are more likely to consider a BSc important, but its not a must.

Also curious: what evidence is there that Oxbridge students do better in post-grad exams?


The stats released in the GMC's progression reports - you have to navigate through to progression reports, speciality exams, medical school.

And what evidence is there that that improvement is due to their university education per se? I ask the second question because obviously Oxbridge students did better than most medics even at A-level so you might expect us to do better subsequently too.


An analysis was done by McManus et al based on the MRCP concluding that 62% of variance is explained by pre-admissions results. No otehr variables correlated with a better score except med school.
Original post by No_fixed_abode
I have and I totally agree. I totally accept that it is actually very hard to get generalisable evidence from studies in medical education, but the amount of faith/dogmatism people will put in either the most measly of studies or popular conjecture does often surprise me. For example, people raved about VARK for a number of years.. And yes, self referencing does sadly seem to be very common.

Yeah exactly. You must acknowledge that these guys are working in a difficult (but not impossible) to quantify field, but some of the assertions made are just baseless, yet treated as if they are absolute dogma.

I did a Postgraduate Certificate in Medical Education - about the most frustrating thing I have ever done. But I quickly realised that what they would consider a good essay was just one that did a lot of name dropping so, easy Merit lol :wink:

...an attempt to bring a standard for medical knowledge might have its advantages. Whether this will make schools teach underlying principles or MCQ word association will also be interesting to see.


Those are definitely the biggest upsides and biggest downsides yes.

I think it was pretty ridiculous to go on without a standardised exam in the modern world though. Clearly it'll also be used for IMGs which again makes a lot of sense.
Original post by Elles
Haven't seen any evidence of the latter and would be surprised if there was... You could control for A level results I suppose but the old 'A grades' might not be sensitive enough really given quite a large % of medical school students would have had them.
I imagine it's a combined effect of the cohorts they take it and the training/exam skills.

Oh my god Elles posted the end must be near.

This has been done actually, as above! A little old though.

I agree that the best assumption is that its a bit of both. That seems to be the minority opinion on this site though, where most assert that its definitely all pre-admission factors.

Original post by HumblyBumbly
Obviously it would be cool for us who study at Oxbridge if it's the case that it's like a dichotomy of Oxbridge and the rest... but kind of feel like it's a bit of BS. Like I have loads of friends at other unis and they seem on top of things more than many friends at Oxford. So kind of feel like it's pretentious BS by those who want to feel superior and perpetuated by those who feel insecure about their Uni or were rejected by Oxbridge. Not to say Oxbridge teaching is not good - I have really appreciated some tutors who have been amazing (some haven't but that;s life) but is it THAT much better than say Imperial, UCL etc... hmmm I doubt it.

Definitely. Plenty of role for pre-admission factors, plenty of Oxbridge grads doing worse than other uni grads, plenty of imperfect evidence regardless, and plenty of scope to say that postgrad exams are hardly the only way to measure success of a doctor.

But I will point out that in terms of overall postgrad exam pass rates, the difference between 29th and 3rd is 20.7%, and the difference between 3rd and 1st is 13.3%. That's quite a jump :tongue: In this specific factor, it kind of is Oxbridge then the rest - not really any getting round that.

Will also point out that Edinburgh and Brighton out-perform Imperial.
Reply 11
Original post by nexttime
Oh my god Elles posted the end must be near.

This has been done actually, as above! A little old though.

I agree that the best assumption is that its a bit of both. That seems to be the minority opinion on this site though, where most assert that its definitely all pre-admission factors.


:hello: I lurk... Feel pretty out of date with admissions/medical school stuff now so have less to contribute - took my 3 children to the decade since graduation reunion at Osler House in the summer. :eek3: & saw a well-known TSR medic the other weekend! :biggrin:

Mcmanus paper is interesting - thanks!


About 60% of medical school variance was explained by differences in pre-admission qualifications, although the remaining variance was still significant, with graduates from Leicester, Oxford, Birmingham, Newcastle-upon-Tyne and London overperforming at Part 1, and graduates from Southampton, Dundee, Aberdeen, Liverpool and Belfast underperforming relative to pre-admission qualifications.



HumblyBumbly

but kind of feel like it's a bit of BS. Like I have loads of friends at other unis and they seem on top of things more than many friends at Oxford. So kind of feel like it's pretentious BS by those who want to feel superior and perpetuated by those who feel insecure about their Uni or were rejected by Oxbridge. Not to say Oxbridge teaching is not good - I have really appreciated some tutors who have been amazing (some haven't but that;s life) but is it THAT much better than say Imperial, UCL etc... hmmm I doubt it.


Yes, the force is strong thinking it's definitely all pre-admission factors - see what you think after finals & postgrad exams..?
I feel like aspects of the course at Oxford definitely honed my exam techniques (tutorials/small group clinical teaching = frequent mini vivas/OSCEs!) & sense of superiority obviously :tongue: which helped to not be too phased by post graduate exams.
Original post by Elles
Yes, the force is strong thinking it's definitely all pre-admission factors - see what you think after finals & postgrad exams..?
I feel like aspects of the course at Oxford definitely honed my exam techniques (tutorials/small group clinical teaching = frequent mini vivas/OSCEs!) & sense of superiority obviously :tongue: which helped to not be too phased by post graduate exams.

I mean the only way I can know is if I go to two different Universities. I suspect I won't care too much at the point of post-grad exams about how my alma mater is going to affect my career trajectory.

thanks for the data - actually quite cool!
Original post by HumblyBumbly
I mean the only way I can know is if I go to two different Universities. I suspect I won't care too much at the point of post-grad exams about how my alma mater is going to affect my career trajectory.

Well... its hard to know for sure, but I've done both part 1 MRCP and part 1 MRCPCH. In both cases there was a lot of really preclinical stuff. In particular: stuff that other people commented on that they'd never learned this before, whereas to me I'd definitely come across it before, and in some cases I considered it actually very basic knowledge covered numerous times in med school... and I passed first time when the pass rates for those exams were 40% and 28% respectively.

I also don't think PACES was particularly harder than Oxford finals - in fact I'd say the content was easier, its just the marking methods were harsher - whereas other people do not say that.

But like I say, hard to know for sure!

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