Alexander Worix, MS2

Southern Illinois University School of Medicine
University of Michigan, Ann Arbor, B.S. General Biology and Spanish
Age 25
From Crete, Illinois

What does your typical day of medical school look like?

Southern Illinois University School of Medicine is unique for being a pioneer of problem-based learning (PBL) so our schedule at SIU varied everyday. Every Monday, Wednesday, and Friday we started our day with a 3 hour session of what we call “tutor group” which is the foundation to PBL/self-guided learning curriculum. Tutor group consists of a small group of students (5-8 per group) and a tutor group leader (usually a PhD) who come together in order to navigate through a computer program called the Electronic Problem-Based Learning Module (ePBLM). This program contains virtual patients. For each patient we ask relevant questions to take a history, analyze physical exam findings and order ancillary testing for interpretation. From this process we narrow down our differential diagnosis list and develop a list “learning issues” or concepts that need to be discussed within the group for comprehension. We are also expected to relate the basic science concepts to the clinical findings of the patient. After spending the first day navigating through the ePBLM, the other two days are utilized to discuss and draw learning issues on the boards provided to us in the tutor rooms.

In addition to tutor group we would have pre-laboratory lectures for Anatomy and/or Histology as well. The actual labs would take place in the afternoon on either Monday, Wednesday, or Friday.

Tuesday’s are known to be dedicated to clinical skills. Sometimes we would have a lecture about a certain physical exam and/or have an hour long session to practice certain techniques that we learned. These clinical skill sessions are scheduled at random times and usually the class is split up between two consecutive Tuesdays. This means that half of the time there could not be anything scheduled and we would have a free day. This makes Tuesdays very relaxed and offers students an ample amount of time to catch up on learning issues and lectures.

Thursdays are known to be really relaxed as well since the whole morning will consist of “resource sessions” or lectures that would acknowledge our learning issues and confirm that the information we are learning in tutor group is the correct information. In addition to activities on campus we also have required hours to complete with our physician mentors. We have a minimum of 12 hours per unit to complete and students like to utilize Tuesdays and Thursdays to complete those hours.

How do your classes and lectures compare to those at your undergraduate institution?

Coming from someone that graduated from a very large state university, I would say the vibe is totally different from college in a positive way. At the University of Michigan I felt that I was just a number and I was competing with hundreds of students to “beat the average.” Now I am at a medical institution with only 74 students in my grade. There is a lot more one-on-one time with faculty and we are able to build relationships with them since they have roles as tutor group leaders. In addition, faculty want to see every single student become successful and make it through medical school. They would be willing to meet with you outside of class and sit down with you in order to explain concepts in a more clear and straight-forward manor.

I would say that my classes and lectures do not compare to my undergraduate institution at all. Previously stated, SIU SOM is centered on a problem-based/self-guided learning curriculum. At this school you can not rely on going to lectures every day to receive the information you need to know which is how I would describe undergrad; all lectures. But this curriculum provides students freedom to attend to their own personal learning style. We are not given a required resource list because they want us to use what works best for us. This means using books that have more pictures than text or vice versa, watching videos, listening to audio, drawing concept maps, etc. As long as we understand all the information the professors want us to know then that is all that matters at SIU SOM.

However, in terms of the resource sessions or “lectures” that we do get, I would say that they are pretty different from undergrad. I believe undergrad is all about weeding out people and having them compete. My undergraduate institution wanted us to learn every single step of glycolysis, every single step of the TCA cycle, the origin/insertion/blood supply/neural innervation/agonist/antagonist of every muscle, etc. At SIU SOM it is completely different. They only want you to know all the clinically relevant information. For example, we are expected to know the regulation enzymes in biochemical pathways and the points where certain pathologies took place or where medications work. 

What have you liked about the teaching practices at your institution? Alternatively, how satisfied are you with the class structure at your institution? Are there aspects that you would like changed?

I am very much an advocate of the idea of tutor group at SIU SOM. Tutor group gives us the opportunity to discuss high yield content. I always believed explaining concepts to others was one of the best ways to study the information and that is exactly what we are doing in tutor group. In addition, we are not only learning about concepts in tutor group, however, we are also building our clinical skills. By the end of the first year at SIU SOM I would say that the majority of my class and I feel confident on taking a complete and focused history, know how perform a comprehensive head-to-toe physical exam under 45 minutes while analyzing the pertinent findings, and have a good basis on what ancillary testing to order for a certain chief complaint.

The only thing I would like to change about the curriculum is making sure that the faculty and students in tutor group identify individuals with different learning styles. There is an expectation in tutor group that every student has to lead discussions during every session. Some students may have a quiet nature when it comes to academics and like to listen rather than contributing to a discussion. However, when everyone is evaluated as a tutor group member, it could be conveyed as if those students are “not good medical students” solely due to the fact that they do not talk as much as the dominant students.

Looking back on when you were applying to medical schools and deciding which school was the best fit, what do you think are the most important things to learn about a medical school when you are deciding which school is right for you?

When I applied to medical school I thought the most important factors were to be happy with the curriculum and the COST. I know a lot of students want to base their medical school choice off of location and/or rankings, but it is not worth the extra debt or dissatisfaction with the curriculum. One of my options included a state school in Michigan that was 1) close to my alma mater and 2) had more to offer than SIU. However, the cost for out-of-state students was $100,000 per year and barely offered any free aid. The first year of medical school at SIU SOM calculated a cost of $50,000 which included tuition, room, board, moving expenses, etc. I knew that the extra $50,000 per year would not be worth the stress. It made no sense to be in more debt in order to attend an institution that was going through a curriculum change and was placed in a more “exciting” area. At the end of the day I would be receiving the same type degree.

Also when applying to medical schools I was not going to get bogged down with medical school rankings. SIU SOM is an unranked institution but I chose them because they are nationally known for their clinical preparation. I always hear stories about a graduate from SIU SOM being picked to be chief resident solely due to the fact that they graduated from SIU. In addition, SIU students still attend really amazing residency programs all over the country.

In terms of academics, I knew that I wanted an organ-based curriculum, early exposure to patients and clinical skills, and a more relaxed schedule. SIU had all of that. The first year of the curriculum is separated into CRR (Cardio, Respiratory, and Renal), NMB (Neural, Muscular, and Behavioral), and ERG (Endocrine, Reproduction, and Gastrointestinal). It was essential for me to have this type of curriculum because it only made sense to integrate everything early before entering M2 year (the year of pathology) and for the USMLE Step 1. In addition, I knew that I would love SIU SOM for their clinical skills once I heard that students started to take histories with standardized patients on the second day of medical school.

Can you give us a brief description of the area surrounding your school? What are some things you like and dislike about the city/town you are located in as a student?

The first year at SIU SOM takes place in Carbondale, Illinois at the Southern Illinois University undergraduate campus. It is nice to have the first year on an undergraduate campus because it offers an environment that most students will be familiar with. It is a small town, yet it is a college town. Therefore it offers the basic essentials for the majority of students in the class. I am originally from the Chicagoland area and it indeed was a huge change to what I am used. However, I was able to adjust quickly since I was going to be very busy anyways. Carbondale also offers many different attractions like great hiking, beautiful wineries, breweries, restaurants, etc.

Once you make it through M1 year, M2-M4 year happen in the capital of Illinois; Springfield, IL. I personally was more excited to move out of Carbondale to Springfield because it is more of a city. However, a lot of people in my class are from rural Illinois and really appreciated the nature-like experience Carbondale had to offer. Also I believe that having Abraham Lincoln everything around is not as enticing to some people in my class as I would expect.

What organizations or activities are you involved in outside of your regular classwork? Additionally, are there any organizations (even if you aren’t a part of them) that you think are unique to your school?

With the first year of medical school being physically separated from the main SIU SOM campus in Springfield, it was very difficult to be involved in organizations. However, we still had volunteer opportunities, a “satellite” family medicine interest group at Carbondale, intramural sports teams, and other experiences. I do not think it is a disadvantage to not be as involved during the first year of medical school because M1 is pretty demanding and requires a lot of focus anyways. In general there are a lot of interest groups and organizations such as American Medical Association, Student National Medical Association, Latino National Medical Association, etc.

How much/well have you been able to develop clinical skills alongside your classroom work first and second year? What does your institution do to help you develop clinical skills before the clinical years?

SIU SOM has a reputation with multiple residency programs for being a clinical-heavy medical institution and really preparing our students to train after graduation. We are even known to be pioneers of the “standardized patient.” Beginning from week one of medical school we learn how to take a complete history and perform a comprehensive head-to-toe (HTT) physical exam. Clinical skills are assessed through Objective Structured Clinical Examinations (OSCEs), Clinical Competency Exams (CCXs), and the end-of-year comprehensive physical exam where we have to perform the full HTT physical exam in under 45 minutes.

What I appreciate the most about the clinical curriculum are the CCXs. These exams require a medical student to take a focused history and physical exam on a standardized patient and retrieve all pertinent data in order to take to the computer lab. At the computer lab we generate a list of differential diagnoses, write up a history of present illness (HPI), compile all the pertinent positives and negatives, and order ancillary testing to rule out/confirm diagnoses on our list. It provides early preparation for USMLE Step 2 CK and CS early in our medical education.

In addition, I really love the physician mentor program. Everyone is matched with a physician mentor and you are required to complete 12 hours of shadowing per unit with them. The school influences interactions with real patients by having each student take a history, perform a physical, and complete an actual history and physical write-up on a real patient each unit.

What is one way your outlook on medicine or understanding of medicine has changed in your time at medical school?

Before starting medical school I thought that medicine was about memorizing information and learning about all these random facts that do not have any relationship to anything. However, in medical school I have learned that these random things do have a relationship with the science behind it. In addition, I have learned that multiple symptoms studied in clinical medicine do have a mechanism of action explained by the basic science we learn during the first two years of medical school. It was completely mind-blowing and pushed me to learn more in medical school.

I have also learned that medicine is definitely not all about the science when treating the patient. Communication and making sure you have the full trust of the patient is even more important. This allows a great physician to gain all pertinent information needed in order to provide the best healthcare to their patients.

  

Are there any resources that stand out to you as most useful to you in self-learning medical school material or for expanding on material taught in class?

I would say that having a USMLE Step 1 resource by your side throughout the first year is essential. Medical school is about teaching students Step 1 topics plus more detail and at times I found it hard to grasp the bigger picture. I did have First Aid around my first year but I barely used it. I am talking about resources like Boards and Beyond and/or Dr. Najeeb. I caught myself multiple times being lost in the details and began to memorize certain concepts. Boards and Beyond DEFINITELY helped me see the “bigger picture” to those concepts and allowed me to learn for comprehension and not memorization.

If a young undergraduate interested in applying to medical school came to you seeking advice about ‘which major is best,’ what would you tell them?

I would tell them that any major is okay. Just as long as you know how to balance the demands of being a pre-med student with other school requirements then that is fine. Even majoring in a non-science major could be more appealing to admissions committees and more do-able. However, I would also say that the major you pick should not be as demanding as taking a load of pre-med courses. My institution did not have a pre-medical track so I decided to major in General Biology and Spanish. If I was able to go back in time and give advice to my undergrad self then I would tell him to not be super ambitious and major in two completely opposite concentrations. My time at the University of Michigan consisted of me struggling to meet the requirements of the Spanish concentration, General Biology concentration, and the requirements of the college itself. It was really demanding and even had to stay almost every summer in order to make sure I graduated on time. It collided with studying for the MCAT for the first time and that did not end well at all.

What is your favorite event of the year put on by your medical school? Tell us a little bit about it.

Definitely the MEDICAL SCHOOL WINTER BALL! It was so much fun as a first year medical student because we were able to meet all the upperclassmen for the first time. It was also a good time to network, make new friends, dress up, and see everyone deviate from school mode in order to have some fun.

What do you wish you had known as an undergraduate and/or as a student in the medical application process?

I wish I had known that the admissions committee would judge your past academic performance just as much as your current academic performance. I was going into the admissions process thinking that they would look at me based on my most recent statistics from my post-bacc program but that definitely was not the case.

As an undergraduate student I wish that I knew that there was absolutely no rush to do medical school right away. There is a stigma in pre-med culture which says that the correct time to start medical school is right after undergrad. I do not think that any student needs to stick to that mindset. Because of this way of thinking I ended up taking multiple science classes at once and rushed the MCAT when I was not ready. It ended up being a waste of money and stress. On that note, I am so thankful for my post-baccalaureate program because it gave me the extra training and boost to my background knowledge. Without the two extra years I took to complete this program I would not 1) be in medical school at the moment and 2) be successful in medical school.

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