Phase 2: a balanced approach

to learning in Medicine

A/Professor Andrew M Cole

A New Way to Learn Medicine

Two Pillars for thinking:– Thinking like a Scientist – facts & stats– Thinking like a Doctor – people &

problems

Usual way to construct these pillars:– Teach Medical Science first – Teach Clinical Studies second

A New Way to Learn Medicine

Standard Combinations:– Graduate MBBS Study

• First degree in basic sciences• Second degree in Medicine

– Undergraduate MBBS Study• First part mainly basic sciences• Second part mainly clinical studies

A New Way to Learn Medicine

The two parts often do not fit together well

Complete split with a graduate MBBS UNSW MBBS integrative approach:

– Phase 1 – 90:10 basic : clinical sciences– Phase 2 – 50:50 basic : clinical sciences– Phase 3 – 10:90 basic : clinical sciences

A New Way to Learn Medicine

How do we make Phase 2 a good bridge?– Need to have a good basic foundation– Need to have good clinical skills– Need to design the bridge carefully

The UNSW Phase 2 bridge is unique

A New Way to Learn Medicine

Bridge Side 1 – Independent Learning– Thinking like a Scientist

• Assembling facts that are known• Asking a Research Question• Experiments to test this• Proving the new facts are true• Publishing the Research• Recognising what is true and what is not

true

A New Way to Learn Medicine

Bridge Side 2 – Integrated Learning– Thinking like a Doctor in clinical context

• A patient comes with a problem• Ask history & examine them to find

abnormalities• What possible underlying basic science

problems• What tests needed to make the diagnosis• What treatment principles might work

A New Way to Learn Medicine

Week 5 of 8: Falls in an Older Person– Basic Sciences: Balance, Standing &

Walking– Clinical Sciences: Falls causes (“DAME”);

Soft bones; Safe healthcare services– Examination: Joints, muscles & nerves– Tests: X-rays, blood tests, others– Communication: how to explain to the

patient

A New Way to Learn Medicine

Week 5 of 8: Falls in an Older Person– Monday pm – Clinical & safety lectures– Tuesday am – Basic sciences prac & lecture– Rest of week – Hospital-based teaching –

bed-side history-taking & examination; case-based & communication tutorials

– Patients themselves are your teachers– Learning is hands-on, not reading-based

A New Way to Learn Medicine

Case Method Teaching– Prepared Sample Case on the week’s Topic– Each student sees similar cases at hospital– Questions to guide direction of thinking– Case Discussion

• Warm calls – the lead students in the discussion• Cold calls – anyone else with ideas chimes in• Teacher – conducts orchestra, not a soloist

A New Way to Learn Medicine

Attendance– University requirements 80% of time– Individual responsibilities– Clinical experiences – needs hands-on

time Excused Absences

– Ask well in advance– For Faculty-approved reasons

A New Way to Learn Medicine

Focus on how to think about 32 significant basic issues in Medicine– Each context is different– Approach, information and reasoning

differs– The skill of a “Good Doctor”

Build thinking like a Doctor for Phase 3 Training to learn for rest of your life

A New Way to Learn Medicine

Thank you!

Any Questions?