Reflecting Back Upon Preclinical Medicine

Two years of preclinical medicine at University College London (UCL) are over. No longer will we be sitting in LT1, the place we have come to spend the majority of our time at medical school so far. After our exams there was very mixed emotions. These ranged from elation for completing what was foretold to be the second most challenging year of our medical school careers  (after finals exams), to frenzied panic that results would be coming out in two weeks. Fast-forward to results, and an atmosphere of relief filled us all. It’s so difficult to tell how well you’ve done – the single-best-answer format of preclinical exams at UCL makes any prediction of your performance impossible. Particularly scary was the formidable anatomy spotter. In secondary school, you could count on one hand the questions you are unsure about. In the anatomy spotter on the other hand, it’s a matter of counting on your fingers the questions you do know! Combine this with the barrage of pharmacology, neuroscience and others and you get an academic year that was undoubtedly the toughest I’ve ever had.

Thinking about the difficulty of this year lead me to ponder: how much of what we have learned will stick for clinical practice, and how much of it will be relevant for our future careers? Some lectures felt really relevant. However there we times when myself and others felt baffled as to how what we were learning was ever going to come up again. It was interesting speaking to my father, now an ophthalmologist, who graduated from medical school a significant time before some of the contemporary pharmacological interventions for hypertension were even in trial. Does this not mean that, much of the niche details we have learned in subjects such as pharmacology will become completely outdated and irrelevant by the time we graduate? I’m definitely not experienced enough to know or understand the importance of learning all these minor details yet, but it is definitely food for thought. Also of note is that most of the teaching material was given to us in the form of lectures, but is now strange to think all our lecture-based learning is effectively at an end. This style of learning really took me by surprise, and in all honesty, I’m never sure I quite got used to it. I used to love the school environment where the teacher goes at the pace of the class and students are welcome to request that the teacher alters the pace of the lesson. So it was definitely a challenge at medical school when our embryology lecturer would plough through the latest discoveries concerning the generation of axes and polarity in vertebrate embryos, as we sat there, baffled and mouths agape.

Having tons of material thrown at us did have some benefits. One of the big positives for me was my improved ability to learn the same amount of material in a shorter time. I remember back in my first year trying to learn the basics of embryonic gastrulation. This took me the best part of several days, however now picking up advanced concepts is a lot quicker. I suppose this occurs due to the adaptation of having lots of material thrown at you. One of the difficulties of trying to absorb this volume of information is that it becomes increasingly easier to miss important material. Imagine then, in an exam, this material you have missed comes up in the form of a question. All the rest of the material you’ve worked hard to memorise becomes useless for that one question, and if that topic doesn’t come up again in the exam.

Looking to the future, one element I really want to implement more in the future is consolidation. After all, what is the point in learning something in great detail in December, to forget most of it over the course of several months and be examined upon it in May? A tutor of mine recommended that, after learning a topic, a short-term consolidation should be made less than 24 hours after learning the material, and a long-term consolidation made less than 7 days after. This is time consuming and difficult to achieve, but if implemented consistently throughout the academic year you could be on to a winner.

Overall, I think it’s been a fun two years. It is strange to consider the sheer volume of people from a variety of backgrounds I have met in the last 20 months. Despite this, our year group is so large that I am still meeting people in my year that I haven’t met previously. It is strange to consider that some of the people in my year I may never see or speak to again – after 2nd year we have our integrated BSc degrees to undertake, following that are the small groups in which we will undertake clinical training in years 4, 5 and 6. It’s a stark contrast from my school environment where everyone knew who everyone was. As a result it felt much more easy to ‘fit into the crowd’ in preclinical medicine, without losing a sense of one’s identity. I have also forged some very strong friendships, and I hope these will be sustained and develop further as we venture into the clinical aspect of the course.

I’m very much looking forward to clinics. Speaking to older students it seems the case that we finally will get the feeling that we are doing what we came to medical school to do.