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I have taught medical students for nearly 40 years in many contexts – on hospital rounds, during patient appointments, running small group discussions, and teaching large classes. In the current system, with the convenience of recorded lectures, I was on my own to keep on track with the material and it was easier to fall behind. In addition to allowing for discussions and getting to know professors and fellow students, it would give some regularity to my schedule. Other days would be devoted to anatomy lab, clinical skills practice with standardized patients (patient actors) under the direct supervision of faculty, shadowing in the hospital, and non-structured time for other activities like research, advocacy and community service. Then, I would have an hour or two of required in-person case-based small group discussion with my professors and classmates where we focus on the clinical applications of that medical science by discussing hypothetical patient cases. In the flipped classroom scenario, my typical day might involve a morning of watching short, targeted medical science modules, with pauses in between so I could draw diagrams, study online flash cards, and read and watch other resources. Virtual learning made it much easier for me to incorporate non-lecture resources into my study plan, too, such as flash cards, web tutorials or lectures by third parties. Pausing, rewinding, re-watching, and speeding up the talks was a great way to focus on my weak areas and save time, and time was my most valuable resource as a medical student, given the sheer volume of information to be learned. Let me start by saying, I did enjoy advantages of virtual lectures. A medical student's perspective - Alexander Philips This, in essence, embraces the virtual lecture trajectory but requires actual attendance for small group hands-on learning. Activities such as anatomy lab, patient interviewing and physical exam practice and special guest lectures would remain in-person.

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We suggest starting with a series of virtual modules to prepare for case-based small group sessions held in person.

In this model, the in-person lecture all but disappears, and students learn most of the classroom-type material on their own before in-person time - hence the flip. Our proposal is this: employ the ' flipped classroom' model extensively for preclerkship medical school lectures.

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Gruppuso and I started talking and we have a few thoughts on how to change the medical education system to mitigate these downsides while supporting students in a decision they have already made to learn on their own time. Student-teacher relationships, one of the parts of medical education I was most looking forward to, became much harder to cultivate. I was unable to ask questions of a prerecorded lecturer. Virtual learning during these critical first two years for me had some significant downsides. It includes dissecting a human body in anatomy lab, practicing how to interview a patient and conduct a physical exam (typically using patient actors) and numerous small group discussion sessions connected to specific lectures. It includes lectures in medical science - anatomy, embryology, physiology, pathology, and pharmacology - and health system science – ethics, professionalism and public health. Preclerkship medical education is where students learn the technical elements of being a doctor before seeing patients. The first half of medical education ( traditionally the first one to two years, which are also sometimes called the preclerkship years) prepares students to succeed during the second half of medical school, clerkships, where students work directly with patient care teams. Medical education is changing rapidly, and the change is being driven by students - so how do schools incorporate the reality of virtual learning while training them adequately for the huge responsibility of patient care? 'Flip' the classroom for the first two years This absence from the classroom has a lot of people in the medical education system wondering how this will affect future doctors, and has precipitated wide discussion among medical institutions. Instead, they opted to watch the recordings at home on their own time. Even before the COVID-19 pandemic, first- and second-year medical students regularly skipped lectures. Philip Gruppuso, says in his 40 years of teaching, in-person lecture attendance is the lowest he's seen. In fact, I estimate that not even a quarter of medical students in my class consistently attended classes in person. Many medical students do not attend lectures in the first two years, instead opting to watch recorded classes on their own time.ĭuring my first two years as a medical student, I almost never went to lectures.