Oh yeah, that school thing...

People keep asking me, "So what about school, how are your classes?" Since I'm already half-way through the first term, here's the scoop...

During the ten-week fall term, my track (Control of Infectious Disease) takes both general courses on public health stuff and a core series on contagious agents and their control. Monday morning is basic statistics; Tuesday morning is basic epidemiology. For Monday through Wednesday afternoons, we got to choose two of three offered classes - health economics, and two different versions of health policy. Wednesday, Thursday, and Friday we have lectures on different diseases and their control.

Obviously, the latter half of all that is what most of us came to this program for! The other classes are variously interesting and/or necessary, but we have to sit through them all. Fortunately, most of this is stuff that I've at least vaguely heard before, so it's alot less challenging for me than for the good portion of my classmates who have not only never had this material before, but are also studying it in their second (sometimes third) language. I had a class in stats, though almost ten years go. Epidemiology was covered in a breakneck few sessions during the first couple years of med school, economics I had a couple courses in way back when (as in, back in my brief stay at UC Santa Cruz), and health policy is just sort of something I've had to live and breath for the last couple of years, so that's nothing particularly new (especially since the Oregon Health Plan - the state's unique version of Medicaid - is given as an example of one thing or another in at least every other class).

Anyhow, stats and epidemiology are dry but duly necessary. Health econ is largely review for me (drawing supply and demand curves - not exactly rocket science, though it would be alot to learn for the first time on top of all the other classes right now), but the lecturers are generally quite good enough to keep it interesting. The health policy course that I chose out of the two is interesting in that it is actually taught down at the London School of Economics. Apparently, some students choose it so that they can brag that they took a class at LSE (apparently that has some sort of reputation that is lost on me); I took it for the simple reason that all courses are required to describe ahead of time how much group work is assigned (a practice that I think should be made mandatory in the US on pain of forcible, unanesthetized toenail removal), and this one listed less group work than the others. And I was correct: any class that advertises Group Work inevitably ends in the dreaded Group Project - a little exercise that, in my unhappily large experience with such things, usually ends in annoyance, unequal distribution of work, and the hasty end of friendships. In any case, the LSE class is interesting, as well as having a minimal amount of group work: many of the lectures are presented by Julian Le Grand, who is apparently famous in some circles, having recently worked as the advisor to Tony Blair on matters of national health.

The weak spot in all these classes is, unfortunately, the seminar sessions that accompany the lectures. I think the problem is largely driven by the fact that big universities have loads of PhD students who are qualified to TA masters level classes. But LSHTM has a low PhD student to Msc student ratio, meaning that they appear to scrounge up anyone with a pulse to teach the seminar sessions. My stats TA is good, but tends to go around the room explaining the same thing to each person individually rather than to the whole group, making the session go til the very last minute when the exercises only take about half that. Epidemiology seminar is one of those unfortunate experiences where I understand it all when I walk in, and walk out totally confused; it also moves so slow that there is never enough time to finish even the most straight-forward exercises. Health econ seminar is taught by a young-ish woman who really just needs to put some spine behind her teaching; she is very sweet, but so unsure of herself it's almost painful to watch. This is not helped by the fact that there is one member of my class group who likes to talk, pretty much to himself, for 10-15 minutes at time, while everyone is forced to listen; she doesn't quite have the gumption to redirect him back on topic, much less tell him to can it as the rest of us are about to do. This guy has also been known to ask around class if there are any members of particular ethnic groups present, and when there are none, he proceeds to make bigoted comments in front of all regarding the health practices of various minority groups. Which is made even more odd by the fact that he's Asian; I'm tempted to make a few outrageous comments about Asians just to see if he even notices what a dumb**s he sounds like when he talks like that.

In any case, that's the early part of the week. The rest of the week is the infectious disease/ID stuff, and so far I've been very impressed with the quality of the lecturers. We certainly had a higher proportion by far of atrocious lecturers at OHSU than I've encountered here. There have been a couple of rather sleepy lectures (including, apparently, one that I missed when I left for Paris - glad I didn't miss the TB conference for that!), but most have been very good. Also, this is the side of ID that always interested me - weird contagious things that spring out of the rainforest (or out of the desert, or the beef industry, or other sundry sources). I decided against being in ID doctor when I realized that most of what they do is a) manage hospital infections and b) rule out infectious disease when no one can figure out what a patient has. If I could chase ebola around Africa or track leishmaniasis in the Middle East, I'd suffer through an internal medicine residency and an ID fellowship in a heartbeat. As it is, I think I'll get more front-lines ID experience as a family medicine doc, since infectious problems tend to concentrate in poorer populations, and usually family practitioners are about the only doctors that poor people get to see. That's one reason why I'm happy with this program - it puts me back in touch with the ID world, but without having to redirect my entire career for it.

Overall, I'm quite happy with the program. As I had hoped, it's very interesting but not too terribly challenging. Which means that I think I finally officially qualify as overeducated. I'm having a great time and wouldn't trade this year (or the debt that comes with it) for anything, but at the same time, I do have to acknowledge that this is more fun than serious work. It's definitely more of a process of filling in gaps than racing over new territory. Which is good, because while I have really like medical school all along, I really don't feel the need to repeat that kind of stress and that kind of mind-bending information cram that characterized the first two years.

Which also brings up another aspect of this program, one that makes it a little more challenging: in med school, we had no cumulative tests - every two to three weeks we'd take an exam, and that was the end of that material. In this program, we have no exams or graded material at all until the spring; all of the fall courses are graded by written exams taken in June. June? You mean, I have to remember all this stuff eight months from now?! Apparently so. That is something I'm not particularly looking forward to, as well as the fact that those exams consist of three-hour essay-writing sessions two days in a row - something that I'm not sure I will do so well at with the way my wrists get stiff and sore and a little numb when I use them too much.

So that's the long description of my classes - more than anyone who asked actually wanted to know, I'm sure!