Physician Assistant School Pearl, Focus on the Roots

Published by UCPAP Faculty and Staff, April 19th, 2012

There are two major approaches to learning medicine: Content-centered and principle-centered. Knowing the difference is critical. A content-centered approach may allow you to pass your courses. You may even pass the boards, get licensed, find a job, and function just well enough to perform at a basic level and stay employed. However, you will not find much satisfaction in your career, your understanding of medicine will be limited, you will consistently find yourself frustrated, and you will never be able to grow into an outstanding clinician. A principle-centered approach, on the other hand, will provide the foundation you need to truly have a remarkable career, one where you consistently feel stimulated, where you challenge yourself to develop further and further. Consequently, you will stand as a tall, full, flourishing oak of knowledge and ability.

Here’s the difference. A student who is content-centered focuses on the individual leaves of the tree while the student who is principle-centered focuses on the roots. When learning about coronary artery disease the content-centered student pulls out the list of typical symptoms and management options and tries to memorize, whereas the principle-centered student seeks deeper understanding of involved pathophysiology and fundamental pharmacology in order to make sense out of why those symptoms occur, and why we choose certain treatments over others.

When learning about physical examination the content-centered student learns the techniques so she can perform well enough to be checked off the list during her practical exams. The principle-centered student wonders why certain techniques are performed the way they are performed. She asks, “Why do I need to use a bracing finger when using an otoscope?” or “Why is it important to listen to the apex of the heart with the bell of the stethoscope while the patient is in the left lateral decubitus position?” And not only does she ask, she seeks out the answer, even though that practical exam is only going to assess whether she performs the technique correctly, not whether she understands its purpose.

There are two major advantages to choosing a principle-centered approach. The first is that when you make sense out of the material, you retain the information much better. Secondly, when you strive to understand principles, you start to see connections everywhere. Oftentimes the principles underlying one disease process or treatment approach also apply to many others. In other words, focusing on the roots allows your knowledge base to be connected to every leaf of the tree whereas focusing on the individual leaves supplies no such connection. That student who sought to understand principles during her physical examination course will learn much more once she begins her study of cardiology.

Always ask “why?” Make sure you attach meaning to everything you learn. To the extent possible, master as much physiology, pathophysiology, anatomy, basic pharmacology, and laboratory medicine possible. These are the roots. Nourish them. Before you know it, you will be enjoying the fruits of your labors.