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At 11:07 PM -0800 3/5/03, wrote:

>We could stubbornly cling to the position that one must attempt to

>learn it all. that's the way they do it in china and its the way its

>always been.  but if the end result is less knowledge and

>understanding, what has really been accomplished.

--

[in answer, Rory wrote]

>Hmmmm...in my experience, Chinese practitioners trained in China know

there stuff much more thoroughly than the average here, so apparently

the overall outcome of their education is does not suffer.

 

Before we jump to conclusions, how do we know whether or not the

amount of material we expect right now is at the level of the greater

amount in the study. In my experience, there are students in our

programs who do very well with the amount of material. So the study

you refer to doesn't appear to be a guide as to what to do with

respect to these students.

 

Rory>

 

Having been a teacher for years, I have something to say here. It is true that giving American students less information seems to result in higher retention rates and vice versa. It is true that Chinese students seem to do a good job of retaining profuse amounts of information thrown at them. What's going on here?

 

The manner in which these two groups of students attend school is completely contextually different. American students are adults with dense fast-paced adult lives: full-blown relationships, often children, full-time or at least part-time jobs in an expensive country, fitting a professional-level college curriculum of Chinese medicine in at night and/or on weekends, and many of them are also simultaneously attending other training, such as naturopathic school, and they have to pay for all this out-of-pocket.

 

Chinese students, as I understand it, go to school eight hours a day, five days a week, and let's assume 40 weeks a year, for five years for a Chinese medicine degree, which includes a lot of Western medical training. At night they study. It used to be that no one was allowed to have any type of sexual relationship while attending college, and the government paid for all of the schooling. The relationship rules and total government payment have apparently changed somewhat of late, but not totally.

 

Add to this the fact that much of what is taught in Chinese is taught with culturally-significant, relatively easily memorizable mnemonic rhymes, and the fact that (do the math) the Chinese students are getting 8,000 hours of training versus 2,000-3,000 for American students, is it any wonder the Chinese students know their stuff better than American students?

 

Certainly some American students are going to thrive with lots of information in classes, but these are probably going to be those who have more background and/or less distraction in their lives. All this reminds me of the paradigm of medical training in the US. My doctor ex-wife told me that the philosophy with which they taught her in medical school was that if you throw enough you-know-what against the wall, some of it is bound to stick, so they shoveled the information out thick and fast. This produces learners who succeed by being good memorizers. As she put it, most doctors can't think their way out of a paper bag, because they aren't taught or expected to. They do cookbook medicine, and if the patient doesn't fit the cookbook, they refer them to a shrink. So I propose some sort of balanced information/critical thinking education package that doesn't constantly overwhelm the students' ability to memorize but does make the information interesting and thought-provoking should work best for American students, so essentially I agree with Todd's original contention.

 

Joseph Garner

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At 11:07 PM -0800 3/5/03, wrote:>We could stubbornly cling to the position that one must attempt to >learn it all. that's the way they do it in china and its the way its >always been. but if the end result is less knowledge and >understanding, what has really been accomplished.--[in answer, Rory wrote]>Hmmmm...in my experience, Chinese practitioners trained in China know there stuff much more thoroughly than the average here, so apparently the overall outcome of their education is does not suffer.Before we jump to conclusions, how do we know whether or not the amount of material we expect right now is at the level of the greater amount in the study. In my experience, there are students in our programs who do very well with the amount of material. So the study you refer to doesn't appear to be a guide as to what to do with respect to these students.Rory>The manner in which these two groups of students attend school is completely contextually different.

All this reminds me of the paradigm of medical training in the US. My doctor ex-wife told me that the philosophy with which they taught her in medical school was that if you throw enough you-know-what against the wall, some of it is bound to stick, so they shoveled the information out thick and fast. Joseph Garner

 

Dear Rory and Joseph,

Your comment, Joseph, regarding the differences in context is everything. As legislative representative of my medical school class at Univ. of Texas I got to see my own cohort pretty clearly. Then later working at American Coll. of TCM in S.F., CA, I got to see some pretty compitent OMDs. I worked directly under Dr. Ping Qi Kang who was the Chief of TCM at Shanghai Hospital #1. The capacities of those who come to be trained and the intensity of the training at top medical schools in China and the U.S. are similar. My observation is there is little difference in capacities between the graduates of top Chinese medical schools and top Western M.D. medical schools ... with one important exception. In China the people who are accepted are of a more rarefied percentile than here ... maybe only the top 5% get in over there. The people for the most part getting into American TCM schools occassionally but rarely have the credentials or the capacities to arrive at either an American medical school or a Chinese medical school. In my medical school the people who got in because they were family of an administrator or because of other exceptional reasons dropped like flies by the second year.

The difference in training is also profoundly different. In either case though the people are well prepared before their first day of class to deal with the information overload. I learned orders of magnitude more in the first two years of medical school than I did with a triple undergraduate major in chemistry, biology and psychology in undergraduate school. Yes, we're taught to "react" much like an athlete reacts to situations on the field. A lot of preparation goes into developing those reactions. By residency you have to far beyond the nature of reaction. People work in teams so if you're over your head in a given situation that requires acute treatment, you can pass the patient on. Eighty percent of M.D.s go on to further training in residencies which last an average of five years. Surgery is longer. Subspecialties of standard residencies add another three to five years to the initail five years. A board certified specialist can think very well indeed and not just react. A first year resident is like a freshman medical student and treated that way. Also the training at this point intensifies with clinical training. The real critical thinking comes in residency. Your do two 12-hour shifts followed by a third shift of 36 hours. Then 12, 12, 36, 12, 12, 36 .... for five years. I can't speak for the Shanghai or Beijing OMDs, but they also do residencies in major hospitals and rotate through the services. But like I said, these Chinese people are the very cream of the applicants.

It's in residency with accomplished professionals that you learn your trade in either realm of medicine. In my opinion the main detriment to the American Chinese medical training scene is the lack of residency training. Those of you that teach C.E.U.s are part of what makes further training possible. Other than that people just out of school must associate with practitioners of merit in lieu of residency. We are at the point in America it seems to me where in increasing number of hours of initial training will eventually lead to people with doctorates. I'm also seeing Chinese medical students stepping on to hospital wards in San Francisco. That's very encouraging. In addition there's an exchange program in San Francisco between U.C. San Francico Medical School students and American Coll. of TCM students. I don't know what benefits may accrue, but it's an encouraging thing to see. I hope American students of Chinese medicine will be able to train with the intensity that people do in China and also get to work on acute care wards. Perhaps one day this will be the case.

The irony of my own situation is that Chinese medicine performed by graduates of ACTCM in the late 70s and early 80s made my Western medical school training and later graduate school training possible. I am beyond grateful that my health continues to improve through the understanding and application of Chinese medicine. Jim Ramholz, I believe, said it well when he said yesterday to the effect that we learn more about ourselves and our own paradigm when we study the paradigm of the Chinese. Thank you, Jim. I couldn't agree more. Chinese medicine has guided my developing understanding of physiology in wonderful and profound ways.

Emmanuel Segmen

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But like I said, these Chinese people are the very cream of the applicants.

>>The cream go to western medicine in mainland china not TCM. Higher highschool scores are needed to get into technology, computers etc than TCM, at least when i was there

Alon

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Group,

 

You all may take different things from Emmanuel’s

post, but this it what I see.. a) if we want to be anywhere close to primarily

care physicians, have any respect, and actually know what we are doing than standards/

information should not be lowered. Yes we have to make do with what we

have, Todd’s point, which is well taken., but, looking at the future, If

we build the field the real players will come (i.e. serious students) This

shift has already happened in the last 6 years, from a majority of adult learners

(avg age prob 35) to younger, more energetic, eager to learn students, who will

memorize and actually learn the info.

Do you really think that just teaching the students to be

able to look stuff up effectively should be the end result? Again my experience

at school goes like this. IF too much information was required on a test

or for the course, the students complained, the teachers folded, all the while

the students are drinking maitai’s on the beach.

My observation and guess: The more our institutions reflect seriousness,

the more serious students will come, our profession will gain more respect

because the students actually have some stuff in their heads. And yes

maybe a single mom with 4 kids won’t be able to make it through the

program at the normal speed, but hey this is medicine.

b) I am sure we all are glad that TCM schools have more of a

balance than med schools and this is an important aspect never to lose.

 

-Jason

 

 

Dear Rory and Joseph,

Your comment, Joseph, regarding the

differences in context is everything. As legislative representative of my

medical school class at Univ. of Texas I got to

see my own cohort pretty clearly. Then later working at American Coll. of

TCM in S.F., CA, I got to see some pretty compitent OMDs. I worked

directly under Dr. Ping Qi Kang who was the Chief of TCM at Shanghai Hospital

#1. The capacities of those who come to be trained and the intensity

of the training at top medical schools in China and the U.S. are

similar. My observation is there is little difference in

capacities between the graduates of top Chinese medical schools and top

Western M.D. medical schools ... with one important exception. In China the people

who are accepted are of a more rarefied percentile than here ... maybe only the

top 5% get in over there. The people for the most part getting into

American TCM schools occassionally but rarely have the credentials or the

capacities to arrive at either an American medical school or a

Chinese medical school. In my medical school the people who got

in because they were family of an administrator or because of other exceptional

reasons dropped like flies by the second year.

The difference in training is also

profoundly different. In either case though the people are well prepared

before their first day of class to deal with the information overload. I

learned orders of magnitude more in the first two years of medical school than

I did with a triple undergraduate major in chemistry, biology and psychology in

undergraduate school. Yes, we're taught to " react " much like an

athlete reacts to situations on the field. A lot of preparation goes into

developing those reactions. By residency you have to far beyond the

nature of reaction. People work in teams so if you're over your head in a

given situation that requires acute treatment, you can pass the patient

on. Eighty percent of M.D.s go on to further training in residencies

which last an average of five years. Surgery is longer.

Subspecialties of standard residencies add another three to five years to

the initail five years. A board certified specialist can think very well

indeed and not just react. A first year resident is like a freshman

medical student and treated that way. Also the training at this point

intensifies with clinical training. The real critical thinking comes in

residency. Your do two 12-hour shifts followed by a third shift of 36

hours. Then 12, 12, 36, 12, 12, 36 .... for five years. I can't

speak for the Shanghai or Beijing OMDs, but they also do

residencies in major hospitals and rotate through the services. But like

I said, these Chinese people are the very cream of the applicants.

It's in residency with accomplished

professionals that you learn your trade in either realm of medicine. In my

opinion the main detriment to the American Chinese medical training scene is

the lack of residency training. Those of you that teach C.E.U.s are part

of what makes further training possible. Other than that people just out

of school must associate with practitioners of merit in lieu of

residency. We are at the point in America it seems to me

where in increasing number of hours of initial training will eventually lead to

people with doctorates. I'm also seeing Chinese medical students stepping

on to hospital wards in San Francisco.

That's very encouraging. In addition there's an exchange program in San

Francisco between U.C. San Francico Medical School students and

American Coll. of TCM students. I don't know what benefits may accrue,

but it's an encouraging thing to see. I hope American students of Chinese

medicine will be able to train with the intensity that people do in China and also

get to work on acute care wards. Perhaps one day this will be the case.

The irony of my own situation is that

Chinese medicine performed by graduates of ACTCM in the late 70s and early 80s

made my Western medical school training and later graduate school

training possible. I am beyond grateful that my health continues to

improve through the understanding and application of Chinese medicine.

Jim Ramholz, I believe, said it well when he said yesterday to the effect that

we learn more about ourselves and our own paradigm when we study the paradigm

of the Chinese. Thank you, Jim. I couldn't agree more.

Chinese medicine has guided my developing understanding of physiology

in wonderful and profound ways.

Emmanuel Segmen

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, " Alon Marcus "

<alonmarcus@w...> wrote:

 

 

> But like I said, these Chinese people are the very cream of the

applicants.

 

 

> >>The cream go to western medicine in mainland china not TCM. Higher

highschool scores are needed to get into technology, computers etc

than TCM, at least when i was there

 

 

> Alon

 

 

 

 

I agree with alon,

 

 

my understanding is that they are not top %... But most of them work

harder than us.

 

 

 

 

-JAson

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Do you really think that just teaching the students to be able to look stuff up effectively should be the end result?

>>>>Its not about looking stuff up, its about thinking. I can tell you that I know of at least one Med school (actually osteopathy school) that does this. Their students are considered the best as far as OMT. There is no question that one needs to memorize a certain amount of information but it is better for example to memorize well 150 herbs that are used daily than to try to learn 500 many of which are not commonly used etc. Also its much better to learn how the formulas work than to memorize indications. I do agree however that the expectations of students in US TCM schools is often way too low. I have seen a big difference when teaching MD's or LAc's in the threshold of mental exhaustion during intensive courses.

Alon

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Jason,

Thanks. This reply was pretty funny and probably accurate for a lot of people. I'm thinking back to 1988 at ACTCM. I did like the possibility of a relaxed lifestyle for the students. I was also pretty sad and frustrated when I saw a professor of some merit "fold" as you say. A lot of the faculty were in far worse culture shock than the students who could indeed just go out the door, and they were back in America.

On a positive note, there are a lot of clinical professors of great merit in China who face forced retirement at age 55, which I consider to be their prime. If there was a good American institution where they could come, you could get some of the finest of China's clinical professors to teach here. If they could stand the culture shock, of course.

Emmanuel Segmen

 

 

Group,

 

You all may take different things from Emmanuel’s post, but this it what I see.. a) if we want to be anywhere close to primarily care physicians, have any respect, and actually know what we are doing than standards/ information should not be lowered. Yes we have to make do with what we have, Todd’s point, which is well taken., but, looking at the future, If we build the field the real players will come (i.e. serious students) This shift has already happened in the last 6 years, from a majority of adult learners (avg age prob 35) to younger, more energetic, eager to learn students, who will memorize and actually learn the info.

Do you really think that just teaching the students to be able to look stuff up effectively should be the end result? Again my experience at school goes like this. IF too much information was required on a test or for the course, the students complained, the teachers folded, all the while the students are drinking maitai’s on the beach.

My observation and guess: The more our institutions reflect seriousness, the more serious students will come, our profession will gain more respect because the students actually have some stuff in their heads. And yes maybe a single mom with 4 kids won’t be able to make it through the program at the normal speed, but hey this is medicine.

b) I am sure we all are glad that TCM schools have more of a balance than med schools and this is an important aspect never to lose.

 

-Jason

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