Looks like I'll have to stick up for the PBL/Hybrid system here. UBC, the school where I'm currently in first year, switched over from a fully didactic (lecture-based) curriculum to a hybrid (PBL/didactic) combination three years ago.
The word from a couple of third year students who decided to write the step 1 of the USMLE, done at the end of second year, is that they got slain on some sections, notably pharmacology, where UBC no longer has a didactic course.
However, these same third year students are apparently nearly indistinguishable from the fourth year students in terms of their ability to problem-solve, and reason out situations on the wards.
This is a huge over-generalization, but the fourth years generally have all the knowledge (memorized rote lists) but the inability to apply it. The third years in contrast, have less knowledge, but are more motivated to speak up, ask questions, and problem-solve out convoluted diagnoses with their tutors.
Myself, I really like this PBL/hybrid system. Stuff I learn in PBL really sticks because I had to defend my reasoning and interpretation in front of seven inquisitive and intelligent class-mates. In addition, PBL forces you to do research. People in my PBL group use Harrison's, the Merck Manual, an innumerable number of textbooks, medical libraries, journals, and the internet. And I'm only four months into the curriculum.
Contrast this to the spoon-fed lecture material, half of which has already been forgotten...
In my clinical years, I'm unlikely to remember or care that a zonula adherens cell-cell junction uses catenins as their plaque proteins, but I'm damn sure going to need the ability to research and reason out answers to problems I haven't seen before.
Now, back to memorizing...
Ian, MS1
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