I have a BS in Computer Science and have been in software engineering and IT for about 28 years, but remember nearly no differential equations, linear algebra, and some other foundational material. Once a medical doctor has been in practice 10 or 20 years, do they really need to know all the organic chem and other foundational material that they have to learn? Does my internist really remember all the chemical processes that happen in a muscle fiber, if he’s not a specialist in that area, or does he just keep up on new treatments? Could he still name every bone in the human body?
I’m 4 1/2 years out from medical school, 1 1/2 from residency.
I doubt I’ve retained 10% of what I learned in medical school. It’s probably nowhere near that much. Hell, I doubt I have a quarter of the information in my head that I needed to pass the medical boards in August of 2005. I don’t think I’m that unusual.
This isn’t necessarily a bad thing. I think it’s important for a doctor to have gone over everything once, and to learn things systematically up front, but there isn’t a whole lot of utility for most of it at this point.
Doctors do have to retake the boards every ten years, so they do have to review all the stuff that’s relevant to their specialty. IANAD, but I don’t think that the boards cover basic anatomy or biochemistry, at least for most specialties.
I would imagine that the organic chem and anatomy and the like is so intuitive after a few years of practice that a class would be moot. When there’s new procedures my friend’s hubby certainly is back in class, but what he needs to know on a daily basis is rote for him by now, 8 years out.
Good point, I didn’t mean to imply that it was bad. I had just come from a doctor’s appointment when I dreamed up this question, and was wondering if my orthopedic hand specialist just sort of forgot everything not related to his specialty. Then I thought of my own background. I don’t remember diffie-q because I just don’t need to. So I was figuring that doctors wouldn’t really be any different than any other professional.
As another CS grad, I have to figure that doctors are a lot like we are; we forget some of the less immediately useful stuff (like calculus, linear algebra, etc…) but become much better at some of the other aspects.
For example, I can program rings around my earlier self, and I’m also a lot better at decomposing problems and choosing the best algorithm for a task.
I also comment my code much more than I used to. 
Doctors probably forget a lot of the biochem & stuff like that, but become much better at diagnosis, or surgery techniques, or in prescribing the best drugs for the job.
As an engineer, I fondly remember FINALS meaning F***! I Never Actually Learned S***! I’m still in grad school, but I’ve forgotten many equations that I don’t use anymore (yet somehow remember some I’ll never use again). In my field, it’s the concepts that matter. There’s a reason doctors, lawyers, and engineers have bookshelves in their offices. I don’t remember how to select a shaft diameter or weld size, but Shigley’s ME Design book is within my line of site. I don’t remember how to calculate an earthquake load, but my structural dynamics book is right next to it.
To elaborate on what DoctorJsaid, once you’ve reviewed and learned the material, looking it up again is relatively easy, and much quicker. And although (s)he claims (s)he has forgotten 90% of what (s)he has learned, I’m sure a quick glance at some reference materials would jog that memory pretty quick.
I’m a lawyer almost 15 years out of law school and the Bar exam. Other than the areas that I touch on in my practice, and some really random bits from law school that inexplicably stuck in my brain, there are whole swaths of what I studied that I don’t remember much at all.
However, I do remember some of the general concepts and ideas underlying those areas, usually enough to look the subject up if I need to find out about it.
More important, I retain enough to know what I do not know – and to recognize when a client has a problem in those areas to consult with somebody who specializes there. For instance, I took several trusts and estates courses in law school, but I know that this is a specialized area with fast-moving tax law changes, so if somebody asks me about a will, can generally discuss what is involved, but for specifics I will refer him or her to an estate law expert.
I imagine it is the same for a doctor. They have to know enough about the body and disease so that they can recognize when they are getting into an area outside their specific expertise and call in somebody who practices in that area.
When I was fresh into my first job as a pediatric ICU nurse one of the docs told me that you don’t learn to be a doctor in med school. He said they bury you with a taste everything, and then you go into residency and actually learn your job. He was a smart guy too, double certified in peds anesthesiology and peds internal medicine.
I said that nursing school was similar, but there’s no formal residency, my OB and psych rotations are a bit of a blur to me now.
I know that “Continuing Education” is required by Doctors in Califorinia, and probably in most States, once a year. Getting through Med school and residency seperates the intelligent from the not-so-smart. It teaches future Md’s how to learn. Of course learning is what it’s all about. Most learning comes from experience, thus “Practicing Medicine”. Almost every MD I’ve ever encountered have been highly intelligent and capable of learning and remembering medical “Stuff” continuously. Bless 'em. Saved my life several times. (So far)
Absolutely! Why, I could rattle off every reaction in the gluconeogenesis pathway, if I really wanted to, not to mention a thousand other biochemical fripperies that in reality virtually every budding doctor forgot within a few weeks after finishing the course in med school.
There are vast reams of basic science stuff you madly cram in during med school and never use again.* An orthopedist (excuse me, orthopaedist) will be dynamite on joint anatomy but get hopelessly lost navigating the paranasal sinuses.
As noted, you relearn what you need of the basic sciences in later years. And what you don’t run into every day, you look up (this goes for clinical medicine also).
*It’s debatable how useful much of this bulimia-style learning really is.
But doesn’t this suggest that medical education, except in the areas where you are going to practice, is unncessary? I’ve found myself wondering more and more about this point.
Not at all. Formal schooling has allowed me (as an engineer, not a doctor) to know how to solve problems. Just because I don’t know an equation, doesn’t mean I can’t look it up. Sure, life is open book. But if you’ve never seen the book before, you can’t throw it in the air, have it land on the right page, and point to the answer while blindfolded. Again, I stress learning the concepts, some of which are impossible to fully understand withought a strong foundation of science to support them.
I’m not sure I ever knew all the chemical processes that happen in a muscle fibre. How much you retain after med school depends on what you do and how much you read and review. I think generalists would retain a much greater percentage than specialists (they use more knowledge at the “medical school” level). But you really learn during residency and in your first years of practice.
Isn’t the AMA considering adding a substantial new continuing education component?
Something about requiring doctors to stay at a Holiday Inn Express four times a year.
FWIW: I finished law school in '04, took and passed the NY bar on my first go in Feb. '05. I never went into practice, so never looked back. However, I’ve recently considered retaking the bar to expand other business prospects. Looking through my notes, I’m amazed at the volume of information that’s already been lost – and also how quickly it comes back.
I don’ t know how much you’re interested in anecdotes, but here’s one:
My girlfriend is in her third year of med school. Her father is a general surgeon and her mother is a GI; both of them graduated med school 25+ years ago. When I am with the three of them, they constantly discuss my girlfriends lessons. I’ve never seen either parent stumble over even the smallest factoid that their daughter brings up; they seem to have nearly perfect retention.
Granted, they’re both exceptional prodigies. But rest assured that some doctors remember all that useless crap.
Um…sure they do.
Next time you’re over their house, ask your girlfriend’s parents to reproduce this chart from memory (I knew most of it for a brief shining moment up to and including the Biochemistry final exam).
They’re prodigies - they should have no problem at all*. 
*don’t try this if you’re seriously interested in their daughter.