There are several major types of med school curricula. I found this article on "How Becoming A Doctor Works" which purports to speak for all medical schools as to what kinds of courses you take during the first and second years of med school: http://money.howstuffworks.com/becoming-a-doctor9.htm.
That article is wrong.
Ok, well, it's on the right track. The most "traditional" academic calendar is: first two years in the classroom, second two years on the wards, doing doctory shit (well, med student scut work shit). Year 1: physiology; how everything in the body is supposed to work. Year 2: pathophysiology; how it all goes wrong in disease. Year 3: head out into the hospital for your first year of clinical experience. Year 4: more clinical experience in the hospital, with the opportunity to do "away rotations" at other schools/hospitals, plus apply for residency. And some school's probably do it that way, but a lot of schools have evolved past that rather antiquated system. My school integrates coursework on clinical skills and arranges for on-site hands-on experiences throughout the first two years, for example. That way, we don't pee our pants the first time we're asked to touch a patient as 3rd years.
The major curricular advances of the 20th century were the systems-based approach and problem-based learning. I've never experienced PBL-style, but what I understand is that you spend a lot less time in lecture and a lot more time in small groups of students who work through clinically-based problems. You look everything up, check on the latest research in the field, work through the clinical reasoning, figure out what tests you'd need to order and how to interpret the results, etc. The one comment I've heard from a student at a top school that had recently switched to PBL was that you "live or die" by your group. When y'all are teaching each other and yourselves, it's critical that you guys can match up your learning styles and work together well enough to really get it done - without wanting to kill each other or yourselves. But, like I said, I've never really done school that way, and it was just one student's evaluation. I have to admit I don't know much about it, and I don't really have an opinion on PBL as a pedagogical model.
Recently, however, I have decided that a systems-based approach makes the most sense. We do not do it that way here, but I wish we did. Instead of learning all of gross anatomy, and then having a course on cardiovascular physiology, and later having a class cardiovascular pathophysiology, and at some point during your pharmacology course learning alllll of the drugs that treat the heart (and, oh boy, it's a lot of them), you have one all-encompassing Cardio class in which you learn the functional anatomy of the heart, it's physiology and pathophys, the cardio drugs, how it all fits together. That sounds much preferable to me than learning it all in bits and pieces and trying to reach way back into your memory to recall basic physiology when you're attempting to learn all the new, complicated pathophys a year later, and even later learn the drugs in a different class, out of context.
Like I said, at my school we don't do a systems-based approach. As such, I'm not familiar with its possible shortcomings and pitfalls. But throughout 2nd year, I've become increasingly convinced that it is a more logical and seamless approach, and that it's a better way to really learn all of this stuff, instead of just memorizing things and then forgetting them 5 minutes after the exam. When it comes to studying for The Boards (duh duhhhhh), I will be using a systems-based approach as I organize my 5 weeks of self-directed study.
I should point out that PBL is a way to structure course time and systems-based is a way to structure the overarching curriculum. They are not mutually exclusive, and there may be med schools that teach a systems-based approach in a PBL format.
Finally, a few schools have switched to a totally different calendar. They've shrunk the first two years of book learnin' down to about 18 months. That means that students at those schools take The Boards (duh duhhhh) earlier, and start rotations earlier. They have more time gaining clinical experience, can do more electives, and they can feel cool cause they're all different and special. It sounds like it's also a bit more of an intense approach. UVM and UPenn both have different versions of this type of curriculum.
One more thing to consider when it comes to judging a school by its curriculum: what does it say about the general approach of the administration? Is this a school that considers itself a vanguard of tradition, and which is confident that its model has worked for 50+ years and so will continue to work? Does that mean that that school will probably also foster more of the old-school strict hierarchy and intense competition? On the other hand, are schools that adopt new curricula or develop their own novel approach more progressive in general? Will they be more modern, flexible places with a more responsive administration? Or are they just trying to find some way to distinguish their school from the rest in order to improve rankings and admissions yield?
On a day-to-day basis, the grading system your school employs probably makes more of a difference in your quality of life. The classes you're taking are the classes you're taking, what you really care about is how you're doing in them and whether/where you're ranked in the class. You probably won't spend much time pondering the possibilities of a different curricular schedule. But as a 2nd year with The Boards (duh duhhhh) looming over me, inspiring me to reflect on the totality of my medical education thus far, I wonder how I might have learned more or learned better had my school organized the basic curriculum differently.
