“Drinking from a fire hose” is a common saying used to describe learning in medical school. It means that the amount of material that is taught and is expected to learn is overwhelming for most students.
Medical students have 3-6 courses per semester. Depending on the course, there might be a lab as well. Everyday, there is vast amount of material covered in classes. Usually, all this material is completely new to the students. Students are expected to learn this material by the end of the day. Even a below average student will tell you that you can’t miss a day of studying. If you do, then it will just pile up the following day, and you won’t be able to get it done. Weekends are usually reserved to completing house-hold chores, reviewing what has already been taught in the week, and doing practice USMLE questions. Some schools can be generous and give you these practice questions, while other schools (like the one in the Caribbeans) will not. Why you ask? Well, Caribbean schools are for profit organizations. The more people fail, the more they will repeat classes, the more the school’s profits. Doesn’t that hurt student education? Well, the world is not a fair place. Will the students passing and getting their MDs be competent? Yes! The national boards of America will only let people get their MDs if they pass the USMLE exams. So, the doctors who do enter the mainstream of US medical society meet their criteria.
How can people adapt to such learning environment? Many believe that no one can remember all of the material that is taught in class. To pass the exams, it is useful if you focus on “high yield” material. This material usually contains concepts that could be tested on exams. For instance, clinically related information, diseases, point in a pathway where drugs or other modifications can change the final result, etc. can be considered “high yield”. Understanding the rest of the pathways is important, but not really necessary for exam purposes. No one cares if you can recite the whole pathway with different interventions at each step. The only thing that matters in real life is if you know what could go wrong, and how to prevent it or treat it. This part is not discussed in medical school. No teacher will ever advise you about “high yield”. Many students suffer to the point of mental breakdown trying to figure this out. It’s not a easy thing for students who are hard-wired since early age to learn EVERYTHING to just focus on key points. That is one of the biggest challenge. Also, the “high yield” rule is not perfect either. You will miss the information sometimes, and then exam questions will ask some tiny detail you forgot. Is this your fault? Given the time constraint and the amount of information thrown at you, you should let this slide. You did your best. No one is perfect. No one can remember everything. Just try to remember the “high yield”.