Why Comrade PhysioProf Loves Teaching Medical Physiology

Comrade PhysioProf–while mostly focused on prosecuting his research program and mentoring the trainees in his lab–also spends a substantial amount of time teaching physiology to medical students. During the academic year, I lead a 1.5 hour tutorial session every week in which a break-out group of the first-year students and I discuss the physiological principles presented in that week’s lectures. I fucking love this shit!

I consider my task two-fold. First, medical students–not suprisingly–are motivated by the desire to treat patients. They frequently view the basic sciences as an irrelevant obstacle to be overcome, so that they can barely pass their basic science boards and get to the clinics. I strive to demonstrate to them that a deep knowledge of human physiology will enable them to be better clinicians. What’s my sales pitch?
Well, medical students learn–if they don’t already know–that practicing medicine is 99% pattern recognition as soon as they set foot in the medical school bookstore and see the racks and racks of pocket cards and pocket guides that are all organized around identifying defining combinations of characteristics of particular pathological states and then reading off the relevant diagnosis, prognosis, and intervention. Deep knowledge of physiology doesn’t help physicians recognize patterns.
But if physicians become solely pattern recognition machines, then they become helpless in the face of unrecognizable patterns. And this is where deep knowledge of all the basic sciences is important. And for internal medicine, physiology is paramount. I passionately advocate to my students that really getting down and dirty with physiology is the only way to handle their clinical cases that don’t match the patterns they have learned, or that are on their pocket cards/guides. Through the application of physiological principles, novel presentations can be understood, and reasonable interventions proposed.
And all the evidence suggests that my Comrade PhysioProf’s sales pitch is effective, as both student feedback and top-down administrative feedback is that Comrade PhysioProf is very effective at motivating his students to work their asses off at the medical physiology curriculum.
OK. So the first aspect of my task, just dealt with, is to motivate first-year medical students to give a shit about physiology. What’s the second? Well, they gotta actually learn the shit!
Physiology, by definition, is a quantitative discipline in which the mathematical relationships between interacting biological variables are examined, both empirically and theoretically.
We have students who are all intellectually brilliant, but with a very wide range of disciplinary backgrounds, ranging from applied mathematics majors to history majors. As you can imagine, these students have greatly different abilities to deal easily and intuitively with complicated mathematical formulae.
Some of my fellow senior faculty respond to this diversity with dismay, and even disdain for the our admissions process, and rue the days when medical students were all hard science majors with extensive quantitative backgrounds. These faculty refuse to let go of their equations as the primary means for conveying physiological principles.
Comrade PhysioProf prefers to take a much more intuitive and teleological approach to conveying physiological principles to medical students. I explain to them that the vast majority of the mathematical formalisms of physiology are more or less complicated versions of Ohm’s law. And I ask them to imagine how they would design a system to perform the task at hand: keep cardiac output constant, keep the membrane potential constant, maintain body fluid and solute homeostasis, etc.
Without getting too technical, for our non-physiologist readers, my overriding pedagogical principle is that I am much more interested in inculcating in my students an intuitive grasp of the relationships between physiological variables than I am in exact mathematical formulae. I want them to feel in their guts the reason why when extracellular potassium increases, the membrane potential becomes more depolarized. I am less concerned with their ability to write out the Nernst equation.
I derive a huge amount of pleasure seeing the transitions of my students’ faces from “HUH!?” to “AAAHH!!” And I hope that my pedagogical efforts eventually lead to some sick patient who might have otherwise died surviving, because one of my students was excited and educated by my tutorials.