Sunday, October 21, 2012

Anatomy

Anschutz Medical Campus (CU Denver) 

Last year, when I was interviewing for medical school, a second-year student told me about his typical schedule: "Generally, we have classes for 4 hours in the morning, and then I study for 4-5 hours in the afternoon." It wasn't like undergraduate education, he told me, where one has several breaks during the day in between classes. "You have to think of it like a full-time job."

At the time, I was working full time and attending classes on the weekend. I didn't respond to the student's advice, but I remember thinking, "Oh, so it's not like having a full-time job and going to school? Medical school is going to be easier than I thought." That was the thought that got me through my master's program: I just have to finish this, and life will be easier. Life will be easier in medical school.

Then I started anatomy. To give a bit of background: the curriculum at CU School of Medicine is organized in blocks. Rather than studying anatomy, physiology, molecular biology, epidemiology, and pathology at the same time over multiple semesters (in a manner similar to undergraduate education), courses are covered one at a time. That is, during the anatomy block, we only study anatomy. All of our lab, small group, and clinical skills curricula are focused entirely on the memorization of anatomical structures. Afterwards, we move on to the next block (molecules to medicine), where we study only molecular biology (and a little epidemiology). And so on.

Rembrandt's representation of a 17th-Century anatomy lesson (take away the pointy beards and ruffled collars, and add some halogen lights, and it's not too different from 21st-Century anatomy at CU)
The anatomy course ran from August 13 to October 15, two months that succeeded in destroying my expectations of a more facile existence in medical school and humbling my rather lofty estimation of my learning ability. I should have known better.

You see, anatomy has never been an educational strength of mine. Ten years ago, I took anatomy as a college freshman, hubristically confident that my high school academic success would easily transform into community college A's. Unfortunately, my brain did not seem built for the easy comprehension of the differentiation and identification of human body structures.

The first three units of the class went fine. Then came the muscular system. Though I studied more for that unit than I had for any previous class I had ever taken, in groups and and, with cadavers in the anatomy lab and with textbooks at home, it was overwhelmingly difficult for me to learn all of the muscles' names, origins, insertions, relative locations, and actions in the time allotted for the unit. When the exam rolled around (all too soon), I passed it, though the score was quite a bit lower than my previous ones.

The score had dropped enough, in fact, that the professor approached me before class and asked if everything was all right. "You know," he told me, "mid-semester, a lot of students start planning for their missions and begin to lose focus in school." Taken aback by his comment, I didn't tell him that my drop in score wasn't mission-pining so much as muscle-perplexion. In fact, I don't remember responding with anything at all except for "Okay." (That professor actually wrote one of my letters of recommendation for medical school. I've since wondered if that was related to the fact that it took me 4 tries to get accepted.)

Unfortunately, my difficulties did not end there. In the lab, I found it difficult to recognize the difference among some tendons, nerves, veins, and arteries. Over the semester, through hard work and some helpful mnemonics, I was able to drastically improve my understanding of the subject, and I ended up passing the class with a decent grade. However, I left the class still feeling unsure and unsteady in anatomy.

I should have anticipated that med school anatomy would also be difficult. Needless to say, this block did not pan out as I expected it to. I spent multiple nights and weekends in the lab and at home. Until now, never in my life have I studied out of fear of not passing. And studying out of fear is much less fulfilling than learning out of interest in the subject.

Well, last Monday I took the final anatomy exam . . . and I passed, with a margin actually a bit larger than I expected. I have now began the Molecules to Medicine block, which we have been told is less taxing than anatomy. I'm beginning to see a pattern, though, in what we medical students hear about our future studies: a better life is just around the corner. Working, studying, and applying to medical school is difficult, but just get into school and things will be easier. Anatomy is a beast, but make it through and the next coursework will be more manageable. Just make it through course work; life during the third and fourth year clinical rotations is better. People hold out "grass is greener" lifelines to us, and we students are desperately gullible enough to grasp on.

But it's getting us through. So far I've found Molecules to Medicine to be manageable, and I'm enjoying the subject matter we're studying and learning. Next week I get my first chance to be out in a clinic and actually interact with patients. Things are definitely looking up. Anatomy is finished; long live Molecules to Medicine.

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