The Role of Physics and Math in Medical Education

[Topher925]

For what ever reason I was reading through some example practice problems that med students are supposedly asked on the MCAT's. To much of my surprise, a lot of these questions involved circuit analysis, mechanical problems such as harmonic motion, statistical mechanics, and some basic quantum mechanics which involved Youngs double slit experiment.

Are med students really required to know this much physics, math, and engineering to be doctors? I don't really understand how deriving differential equations for a RLC circuit is going to help someone be a doctor. I always thought that most of med school was just memorization and learning how to poke/stab in the right places. I have to say that if med students do need to know that much science and math, I have a lot more respect for them than I used to.

 

[Dembadon]

The human body is arguably one of the most complex systems on the planet. Having a vast knowledge of science is crucial to being able to analyze complex issues and come up with logical solutions. Many specialties within medicine also involve the use of advanced technology (i.e. Radiology).

I don't see how anyone can have anything but the utmost respect for medical professionals. Their education and training is extremely rigorous and lengthly. However, I think that using good science to improve, or even save, someone's life is one of the most satisfying things anyone could do.

I've been strongly considering a career in medicine for a couple years now, so perhaps I'm a bit biased ; it has been an incredibly sobering process to find out just how much these people go through during the application process alone, not to mention their 4 years in medical school and the residency (and maybe even a fellowship) that follows.

 

[bobze]

For what ever reason I was reading through some example practice problems that med students are supposedly asked on the MCAT's. To much of my surprise, a lot of these questions involved circuit analysis, mechanical problems such as harmonic motion, statistical mechanics, and some basic quantum mechanics which involved Youngs double slit experiment.

Are med students really required to know this much physics, math, and engineering to be doctors? I don't really understand how deriving differential equations for a RLC circuit is going to help someone be a doctor. I always thought that most of med school was just memorization and learning how to poke/stab in the right places. I have to say that if med students do need to know that much science and math, I have a lot more respect for them than I used to.

Yes, you have to know it. Understanding math and physics is important for medicine. Much of modern medicine is done through imaging (physics heavy for obvious reasons) such as MRs, CTs, etc.

Math is essential as well, whether we're talking about just calculating something simple--Like dosages, or something more complex--Like treatments with nuclear medicine. Clinicians are more generalists though, we're required to know an insane amount of information from many, many fields--The opposite to say a Phd who generally focuses on a narrow area of a single field.

 

[SW VandeCarr]

we're required to know an insane amount of information from many, many fields--The opposite to say a Phd who generally focuses on a narrow area of a single field.

When I took the MCAT, there was a section on general knowledge. I don't know if it's still on the test. There were questions on art, history, classical music, architecture, geography, literature, etc. Physicians were supposed to be "well rounded" (as an overweight cardiologist once told me).

 

[nismaratwork]

Oh, don't forget to check, "no" under, "Are you currently so high on stimulants that you feel like Charlie Sheen?"

Sorry, just... pre-meds...

 

[tk31]

I'm currently at medical school (first year), and unfortunately our training is much like you described topher, in that it is mostly rote memory work and figuring out where to poke. Much of the information we learn is very trivial and can be found through a quick internet search. In terms of the actual practice of medicine, the impression I get from practicing physicians is that much of medicine is pattern recognition and the ability to interact well with people.

I have experience both writing and teaching the MCAT. The stated “goal” of the test is to evaluate the critical thinking skills of the students. In reality however, this is simply a method of screening out the large numbers of applicants who apply each year. So no, we don’t have to know anything about circuits, quantum mechanics or anything else like that.

 

[SW VandeCarr]

I'm currently at medical school (first year), and unfortunately our training is much like you described topher, in that it is mostly rote memory work and figuring out where to poke. Much of the information we learn is very trivial and can be found through a quick internet search. In terms of the actual practice of medicine, the impression I get from practicing physicians is that much of medicine is pattern recognition and the ability to interact well with people.

I have experience both writing and teaching the MCAT. The stated “goal” of the test is to evaluate the critical thinking skills of the students. In reality however, this is simply a method of screening out the large numbers of applicants who apply each year. So no, we don’t have to know anything about circuits, quantum mechanics or anything else like that.

You say you're a first year medical student. Perhaps you might want to wait a few more years before you make any final judgments. The first year does in fact emphasize a lot of rote learning: gross anatomy and neuroanatomy in particular. Perhaps you think there ought to be some analytic short-cut, some equation that allows you to calculate why particular bone has such a crazy shape or why the brain has to be so unreasonably complicated without any rational plan. Well, that's just the way it is. It's a little premature for you to say what you might have to know or not know years before you complete your education.

As far as pushing and poking, that's called a physical examination. A lot of money could be saved if physicians were better trained to do a good physical in order to get a better idea of just what diagnostic tests would be most appropriate. The fall back is the shotgun approach where you order every standard panel and hope something shows up. It takes a fair a amount of experience to do a good physical examination; something you obviously don't yet have.

 

[bobze]

You say you're a first year medical student. Perhaps you might want to wait a few more years before you make any final judgments. The first year does in fact emphasize a lot of rote learning: gross anatomy and neuroanatomy in particular. Perhaps you think there ought to be some analytic short-cut, some equation that allows you to calculate why particular bone has such a crazy shape or why the brain has to be so unreasonably complicated without any rational plan. Well, that's just the way it is. It's a little premature for you to say what might have to know or not know years before you complete your education.

As far as pushing and poking, that's called a physical examination. A lot of money could be saved if physicians were better trained to do a good physical in order to get a better idea of just what diagnostic tests would be most appropriate. The fall back is the shotgun approach where you order every standard panel and hope something shows up. It takes a fair a amount of experience to do a good physical examination; something you obviously don't yet have.

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[tk31]

VandeCarr, I feel your post is aggressive towards me and I honestly don't appreciate it. I find it very condescending and somewhat rude. It comes off quite a bit like a personal attack rather than a criticism of what I was saying. It seems rather unnecessary.

In discussing their practice with physicians, most of them discuss the importance of having a systematic approach to medical problems, or having templates for different sets of symptoms. The day to day practice (like many jobs) does not involve a whole lot of creative thinking/problem solving because there is a relatively limited number of ways in which certain diseases present. This is the process of coming up with a differential diagnosis for a patient’s symptomatic presentation. When you have to problem solve/analyze every patient it is not an effective way to practice medicine. Although I am still in the education process, I have been in the hospitals with doctors and patients and seen the practice of medicine.

I simply was trying to relate my experience as a medical student regarding what we need to know for medical school in relation to the MCAT. Topher asked about "harmonic motion, statistical mechanics, and some basic quantum mechanics which involved Youngs double slit experiment". My answer was that, no, we don’t have to know anything about these physics principles. The rest of my response was just me expressing my frustration with how I am finding the first year of medical school. As well, there are several different types of curriculum at schools across North America. Some schools cover normal anatomy/physiology in first year, then cover pathology in the second year. While other schools have a systems-based approach (this is becoming a more popular approach), that covers normal and abnormal of a single system all at once. So the statement “The first year does in fact emphasize a lot of rote learning: gross anatomy and neuroanatomy in particular” is, for the most part, not true at these systems-based schools.

In terms of the physical exam, much of it is quite ambiguous and open to subjective interpretation. The statement that "A lot of money could be saved if physicians were better trained to do a good physical in order to get a better idea of just what diagnostic tests would be most appropriate" is not founded on any evidence. Far too often the physical exam may be ambiguous and a physician will order lab tests in order to provide them with more information. Defensive medicine, where physicians order a test to avoid lawsuits, is a completely different issue and is a result of the legal system (more so in the United States than in Canada). It is generally not an issue of the physician’s competence at the physical exam. If anything, the evidence seems to indicate that the physical exam is not a very good indication of a patient’s disease. There is generally a move towards a more algorithmic form of medicine driven by evidence rather than by subjective interpretation (Clayton Christensen discusses this in his Innovator’s Prescription, where hospitals move from a solution shop to a factory model).

 

[SW VandeCarr]

VandeCarr, Far too often the physical exam may be ambiguous and a physician will order lab tests in order to provide them with more information. Defensive medicine, where physicians order a test to avoid lawsuits, is a completely different issue and is a result of the legal system (more so in the United States than in Canada). It is generally not an issue of the physician’s competence at the physical exam. If anything, the evidence seems to indicate that the physical exam is not a very good indication of a patient’s disease. There is generally a move towards a more algorithmic form of medicine driven by evidence rather than by subjective interpretation (Clayton Christensen discusses this in his Innovator’s Prescription, where hospitals move from a solution shop to a factory model).

You don't have to tell me about evidence based medicine, I was very involved in this movement. As far as the physical exam goes, I practiced EM for a number of years. It's hard to imagine evaluating critically ill or injured patients without doing a physical exam.

 

[tk31]

Agreed. If you did not do a physical exam on a critically ill patient you would probably be considered negligent.

What aspect of EBM were you involved with? That's one of the things in medicine that looks extremely interesting.

 

[SW VandeCarr]

Agreed. If you did not do a physical exam on a critically ill patient you would probably be considered negligent.

What aspect of EBM were you involved with? That's one of the things in medicine that looks extremely interesting.

I was involved in continuing medical education for EM physicians and EMTs; helping to set up EB protocols and algorithms for emergency care management. These concepts are particularly germane to the EM practice environment. Later, after further training and a stint in government (NIH and FDA), I was involved in pharmaceutical R&D which is all about generating evidence of efficacy and safety of drugs and devices. I have a strong interest in statistical methods and inference which is necessary if you are going to be involved in evaluating scientific evidence. I'm a fairly regular poster in the stats forum here in PF.

 

[bobze]

VandeCarr, I feel your post is aggressive towards me and I honestly don't appreciate it. I find it very condescending and somewhat rude. It comes off quite a bit like a personal attack rather than a criticism of what I was saying. It seems rather unnecessary.

In discussing their practice with physicians, most of them discuss the importance of having a systematic approach to medical problems, or having templates for different sets of symptoms. The day to day practice (like many jobs) does not involve a whole lot of creative thinking/problem solving because there is a relatively limited number of ways in which certain diseases present. This is the process of coming up with a differential diagnosis for a patient’s symptomatic presentation. When you have to problem solve/analyze every patient it is not an effective way to practice medicine. Although I am still in the education process, I have been in the hospitals with doctors and patients and seen the practice of medicine.

I simply was trying to relate my experience as a medical student regarding what we need to know for medical school in relation to the MCAT. Topher asked about "harmonic motion, statistical mechanics, and some basic quantum mechanics which involved Youngs double slit experiment". My answer was that, no, we don’t have to know anything about these physics principles. The rest of my response was just me expressing my frustration with how I am finding the first year of medical school. As well, there are several different types of curriculum at schools across North America. Some schools cover normal anatomy/physiology in first year, then cover pathology in the second year. While other schools have a systems-based approach (this is becoming a more popular approach), that covers normal and abnormal of a single system all at once. So the statement “The first year does in fact emphasize a lot of rote learning: gross anatomy and neuroanatomy in particular” is, for the most part, not true at these systems-based schools.

In terms of the physical exam, much of it is quite ambiguous and open to subjective interpretation. The statement that "A lot of money could be saved if physicians were better trained to do a good physical in order to get a better idea of just what diagnostic tests would be most appropriate" is not founded on any evidence. Far too often the physical exam may be ambiguous and a physician will order lab tests in order to provide them with more information. Defensive medicine, where physicians order a test to avoid lawsuits, is a completely different issue and is a result of the legal system (more so in the United States than in Canada). It is generally not an issue of the physician’s competence at the physical exam. If anything, the evidence seems to indicate that the physical exam is not a very good indication of a patient’s disease. There is generally a move towards a more algorithmic form of medicine driven by evidence rather than by subjective interpretation (Clayton Christensen discusses this in his Innovator’s Prescription, where hospitals move from a solution shop to a factory model).

I think it really depends on the school you attend. Lots of the electrical theory and other parts of physics are very relevant for physiology and biochemistry (though some schools don't even have biochem in their curriculum anymore, which I believe is a mistake and a whole other can of worms).

Of course, even though some of that terrible physics information isn't required as you progress through medicine, it is nice to have an understanding of the ground work for relevant physics during physiology years.

It also depends, not only on your medical school, but the field of medicine you'd like to participate in. If your hopes, dreams and aspirations are to be a family physician or GP then most of that stuff will never be that relevant to you--However, if you want to do something like say epidemiology then all that math and those stats classes will have come in handy. Likewise, for a career in something like nuclear medicine or radiation oncology or radiology etc, then that understanding of physics will probably be more useful to you.

I am of the opinion (being a medical student myself, and getting to talk to other medical students in my state fairly often) that not all medical educations are created equal though--Especially when venturing outside the states, but even here as well. This is regarding your first year woes. The school I am attending, we have a very hands on clinical approach, which often creates excessive stress for me and my peers, but starts getting us relevant clinical experience right away. Our classes have been (except for somethings unavoidable) very conceptual based and more than just rote memorization.

While I agree that EBM is really clutch, I disagree that physicians are doing a good enough job on physical exams. I think SW's point was spot on and I think modern physicians really have a tendency to over rely on imaging (MRs, CTs etc) for things that would have once been routinely detected by physical exam test.