Teaching biochemistry to med students in the new year

steddyeddy

Hey guys I'll be teaching biochem to med students in the new year. I am a scientist at a PhD level of biochemistry and not a clinician so I taught I'd look for advice here. I know a lot of med students hate biochem so I thought I would ask what was wrong with the lectures and how it can be improved. What were your least favorite and favorite parts of the subject eg pathways, lab techniques, enzyme kinetics or basic biochemical principles eg protein structure.

challengemaster

Not a med, but I know more than enough of 'em to maybe shed some light on it. What I've found to be a pretty common thing with med students is they don't see themselves as science students, nor do they want to be science students. They're doing medicine for a reason and as far as most will be concerned, having to learn biochem is the 3rd level equivalent of irish being mandatory in the LC.

Clinically, biochem has almost absolutely no relevance to doctors, and they'd much rather spend their time and effort learning things that will genuinely be useful to them clinically. Lab techniques, enzyme kinetics and protein structure are of absolutely no use when you have a patient that needs treating. It becomes even more frustrating when you take into consideration the course structure, the amount of exams med students have, the higher required pass percentage, etc. It's just adding another unnecessary level of difficulty.


Also hated biochem myself, I think it takes a certain type of person to genuinely like it though. It wasn't that I didn't like biological sciences, considering I did stay within the biological sciences disciplines for my degree and masters. Personally I think my dislike was mostly because of horrendously bad lecturers that shouldn't have been in a job in the first place, and wouldn't be if they weren't funded researchers.

As for what you can do.. Being honest I'm not sure if you'll ever get med students to genuinely like biochem, the best you can aim for is them not completely hating it (there'll always be a few who are more interested). You might get better advice from med students, but I would say do not teach as if you're teaching to an actual biochemistry class who chose to study biochemistry and have an interest in it.

Taco Chips

challengemaster wrote: »

Not a med, but I know more than enough of 'em to maybe shed some light on it. What I've found to be a pretty common thing with med students is they don't see themselves as science students, nor do they want to be science students. They're doing medicine for a reason and as far as most will be concerned, having to learn biochem is the 3rd level equivalent of irish being mandatory in the LC.

Clinically, biochem has almost absolutely no relevance to doctors, and they'd much rather spend their time and effort learning things that will genuinely be useful to them clinically. Lab techniques, enzyme kinetics and protein structure are of absolutely no use when you have a patient that needs treating. It becomes even more frustrating when you take into consideration the course structure, the amount of exams med students have, the higher required pass percentage, etc. It's just adding another unnecessary level of difficulty.


Also hated biochem myself, I think it takes a certain type of person to genuinely like it though. It wasn't that I didn't like biological sciences, considering I did stay within the biological sciences disciplines for my degree and masters. Personally I think my dislike was mostly because of horrendously bad lecturers that shouldn't have been in a job in the first place, and wouldn't be if they weren't funded researchers.

As for what you can do.. Being honest I'm not sure if you'll ever get med students to genuinely like biochem, the best you can aim for is them not completely hating it (there'll always be a few who are more interested). You might get better advice from med students, but I would say do not teach as if you're teaching to an actual biochemistry class who chose to study biochemistry and have an interest in it.

I am a med student and I would agree mostly with this post, especially the BIB. Although I do see some of the use in learning fundamentals of certain parts of biochem that become relevant when we study clinical biochem.

Labs were wretched. Hated them. 3 hours of tedious pipetting and queuing up at the spectrometer and then plotting graphs by hand for some absurd reason. The worst thing was the way our labs were organised was so that we were doing experiments based on principles we had covered the previous semester and had mostly forgotten about or not paid enough attention to because the aim was just to pass the exam.

My advice would be to try and tie in as much clinically relevant stuff as possible. If you're going to be giving lectures on gene structure, genetics, cell signalling etc... it might be a bit tougher but giving a few examples of diseases and how the lecture ties in with them will go a long way. At the end of the day that's the only thing most of them will be interested in. If you're teaching something like inflammation then that's a bit easier because it's obviously important and relevant and will come up a lot in clinical situations.

But I suppose the best thing you can do is to make clear, comprehensive lecture slides. Try and make them from the perspective of a student sitting down to study the subject that has no idea where to start. Logical sentences that are easy to read basically. I know this sounds really obvious but you would be surprised at some of the nonsense, unhelpful lecture slides I've had to trawl through in the subject before. It would have been more helpful if I hadn't read the slides in the first place in a lot of cases and just gone straight to youtube tutorials. Nothing worse than trying to study a topic and the notes are rambling and full of unhelpful abbreviations or gene sequences etc... Outline learning goals at the start of the presentation and then refresh them in the last slide. This actually goes a long way to helping students focus on what they need to retain for the exam.

Good luck with your class. The fact that you are actually looking for advice from meds on how to teach the subject is a great sign though, many of the lecturers I've had were clearly just beamed in as part of their obligation and had less than no interest in proper education.

Just Like Heaven

I'm in the non-clinical years of Med and whilst I kinda like Biochem my attitude towards it is definitely a bit more 'let's get it over with'. Lecturers who try to include a clinical aspect no matter how irrelevant it really is always go more appreciated. I suppose things like lab techniques and lectures on enzyme kinetics in particular leave people wondering why they're there.

+1 for just making clear slides with learning goals though. Biochemistry is the only module where some lecturers seem to talk off the cuff or use handwritten incoherent notes. Not sure if it's cause the lack of enthusiasm is mutual between some biochem lecturers and meds.

In my experience the supposadly 'bad' Biochem lecturers assume a lot of prior knowledge which is what makes the lectures and in turn the whole module frustrating and unappealing. Of course this isn't your problem at the end of the day, but by providing clear slides and maybe good extra reading sources to brush up on or in many cases learn for the first time the fundamental aspects of the topic you're presenting you'll probably help people out enormously.

Nonoperational

We had a great biochem lecturer. He made the lectures very simple and emphasised the main points and concepts instead of the nasty detail. You obviously have to cover the course in the required detail but it is possible to make it relatively interesting. He also did a tutorial style Q session after each main topic just to reinforce it and I thought that was good.

Obviously then there are topics that are amenable to adding bits of clinical stuff, biogenic amines and psychiatric disorders etc etc.

Biologic

Take a look at the biochem sections for "First Aid for the USMLE Step 1". They are some very clinically relevant bits, and are essential to anyone in your class who is sitting the USMLE (more people than you probably think). Also, PLEASE make it clear which parts of your lectures are needed for exams. Too many lecturers dilute their lecture slides by bloating it out with stuff they find interesting, but nobody else has time for. Finally, huge kudos for actually taking the time to try and find this stuff out.

steddyeddy

Hey guys thanks for the replies I'll be taken all the advice on board. The sentence below makes perfect sense to me:

Lab techniques, enzyme kinetics and protein structure are of absolutely no use when you have a patient that needs treating. It becomes even more frustrating when you take into consideration the course structure, the amount of exams med students have, the higher required pass percentage, etc. It's just adding another unnecessary level of difficulty

I don't see any necessity for enzyme kinetics or anything beyond basic protein structure i.e secondary and tertiary structure ect. The lab techniques are actually included in some lectures in the possibility that some clinicians might go onto lab research.


I won't be getting students to memorise pathways either really. I am going to try and make every lecture clinically relevant. I have to disagree with you when you say biochemistry isn't clinically relevant. Every disease has a clinical basis. Every pharmacological intervention has a clinical basis.

Dingle_berry

steddyeddy wrote: »

Hey guys thanks for the replies I'll be taken all the advice on board. The sentence below makes perfect sense to me:



I don't see any necessity for enzyme kinetics or anything beyond basic protein structure i.e secondary and tertiary structure ect. The lab techniques are actually included in some lectures in the possibility that some clinicians might go onto lab research.


I won't be getting students to memorise pathways either really. I am going to try and make every lecture clinically relevant. I have to disagree with you when you say biochemistry isn't clinically relevant. Every disease has a clinical basis. Every pharmacological intervention has a clinical basis.

Have you looked at the Clinical Biochemistry MSc in trinity? It is taught by consultant biochemists and aimed at doctors with an interest in biochemistry. I would think undergrad med lectures should be preparatory for this MSc? There is an emphasis on case studies on subjects from seemingly simple electrolyte imbalances to metabolic conditions due to enzyme kinetics (due to mutations not detectable by commercial/kit PCR assays)

steddyeddy

Dingle_berry wrote: »

Have you looked at the Clinical Biochemistry MSc in trinity? It is taught by consultant biochemists and aimed at doctors with an interest in biochemistry. I would think undergrad med lectures should be preparatory for this MSc? There is an emphasis on case studies on subjects from seemingly simple electrolyte imbalances to metabolic conditions due to enzyme kinetics (due to mutations not detectable by commercial/kit PCR assays)

No I haven't looked at that course but it's something I will be doing now. Surely a biochemistry course should be tailored with an exclusively clinical slant.

Enzyme kinetics is important for example isozymes of the same enzyme will operate at different rates or have differing affinities for substrates dependent on histological context.

I didn't know that enzyme kinetics was taught at all to medicine students if I'm honest. How much detail do you go into?

Dingle_berry

steddyeddy wrote: »

No I haven't looked at that course but it's something I will be doing now. Surely a biochemistry course should be tailored with an exclusively clinical slant.

Enzyme kinetics is important for example isozymes of the same enzyme will operate at different rates or have differing affinities for substrates dependent on histological context.

I didn't know that enzyme kinetics was taught at all to medicine students if I'm honest. How much detail do you go into?

Sorry I'm neither a med student or studying the MSc, I just know people who are.

If you have time something else that would be beneficial would be to give your students a solid understanding of reference ranges. I've encountered clinicians that use them as concrete laws.
When discussing analytical methods the actual steps may not be essential but an understanding of how two different methods may not be comparable is important.

Just Like Heaven

I've had three or four lectures and a lab on enzyme kinetics. I think there's more though.

steddyeddy

fewtins wrote: »

I've had three or four lectures and a lab on enzyme kinetics. I think there's more though.

Ah right have you had to derive any equations?

challengemaster

steddyeddy wrote: »

I won't be getting students to memorise pathways either really. I am going to try and make every lecture clinically relevant. I have to disagree with you when you say biochemistry isn't clinically relevant. Every disease has a clinical basis. Every pharmacological intervention has a clinical basis.

I'm all too familiar with disease pathology and how biochemistry is often heavily involved in the process. Maybe I didn't explain properly what I meant, though.

To any doctor in any hospital treating any illness, you can be sure that biochemistry is probably the last thing to cross their mind. Most by that stage won't even remember the basics. Most of their training is very disease(signs/symptoms/treatment) and technique based.

While biochemistry is most definitely relevant in terms of understanding the pathology, and the development of therapeutics, in the clinical treatment of diseases it doesn't get a shoe in the door. That's what I meant by not being relevant

partyatmygaff

steddyeddy wrote: »

Ah right have you had to derive any equations?

Deriving equations to help explain a model is fine. Asking people to commit it to memory for an exam is a waste of time as far as i'm concerned. If you need to work with an equation in a "real" setting (research for example), you're not going to rely on something you half-remember from your 1st/2nd year exams. Actually knowing the model itself well is much more useful and is more likely to stick with you.

Taco Chips

We had to derive equations for the exam and draw graphs illustrating them. Found it a waste of time and I've already forgotten them. I doubt any Dr. on the ward will be able to recall an enzyme kinetic formula if you asked them.