It's been almost 36 months since I last attended a non-mandatory classroom lecture, longer still for most of my peers. I remember the enormity of the lecture hall, or rather its emptiness. Like scattered stars on a moonless night, very few of us – stars in our own right – remained to illuminate the vast auditorium. Our numbers down by three since last week, no doubt enlisting into the enviable “stream team." Can you blame them? It's 8:15 a.m., 139 slides left to review within this hour block. Three more of the same until lunch break, and more of the same after that.
“Lectures are the appendix of medical school, always there but nobody knows why.”
The quote above from a fellow student has floated over my head for a couple weeks now. Never mind the appendix being a significant structure both for its early immune capacity and more importantly an excellent pimping question for newly minted M3s, the saying correctly summarizes the views of most, if not all medical students on the importance of preclinical lectures.
Orly Farber of STAT put it best when she stated, “the future doctors of America cut class”. They cut not because of the difficulty of the topics taught nor the quality of the esteemed professors who teach, but rather the ease of obtaining, learning and retaining the same information better and faster outside the lecture hall. Medical school forums such as r/medicalschool and Student Doctor Network are chock full with discussions regarding improved performance in academics, physical and mental health after foregoing active participation in pre-clinical classroom education.
Gone are the days of lugging heavy, expensive textbooks for six to eight hours of grueling lecture after lecture each day. Now, days are spent at home in pajamas or the comfort of the local coffee shop in front of a screen, viewing recorded lectures and supplementary online videos. For some, these online resources, though still expensive, have replaced school recommended textbooks and lectures as the primary source of medical information during their pre-clinical years. Songs of praise and oaths of success are sung and sworn on the ever-growing library of online tools, videos and question banks.
Why, you ask? Because it's been informally proven. Word of mouth has gone a long way in increasing numbers within the stream team. However, speculative conclusions can be inferred based on pre-existing data. The AAMC Year 2 Questionnaire reports a jump from 16.8 percent of respondents in 2014 to 26.3 percent in 2018 who almost never attended in-person preclinical lectures. NRMP Charting Outcomes shows an increase in mean Step 1 score of matched applicants from 230 in 2014 to 233 in 2018. Whether these findings are significant remains yet to be determined. As medical students, we place importance and value on any resource that improves our chances of matching, no matter how little. Correlation does not make for causation; however, crude analysis shows that there may be something there.
As it is with the appendix, can we do without attendance to preclinical lectures? Would cutting class help to cut costs in medical education? Barring courses on clinical skills and labs, is classroom education still needed within the pre-clinical curriculum? Past lectures are being used today to supplement other online resources medical students use during their education. Little, if any, novel breakthroughs in pre-clinical research have made it to the slides we sift through during lectures. Those that have are adequately covered by the multitude of question banks that aim to stay up to date and relevant. The questions of this long-debated topic are still yet to be answered. One thing is for certain at the moment however, much like the appendix, in-person live lectures are here to stay.
Chika Anyanwu is a fourth-year medical student pursuing a career in the surgical field. He enjoys all thing sports, anime and sleep-related. He has no conflicts of interest to disclose.
Image by Minimallista / Shutterstock