Medicine, according to many, is about lists. According to my Med School, it's about first principles. Of course, the answer lies somewhere in the middle; both are essential. Overall, it's about question and answer; it's about the big picture.

First principles make you think; "What's the mechanism for that?" is easily the most popular phrase uttered in first year medicine. That deep knowledgable understanding teaches you to work things out from the bottom, up.

Lists hold the answers; "List the Cardiac causes for acute dyspnoea? Acute Pulmonary Oedema, PE and Tamponade" (Thanks again, On Call) Lists have fast answers and form strong but flexible management plans.

I reckon almost every other health profession is about lists. The practical, no nonsense stuff that leads down a path, somehow. In Pharmacy, it's WWHAAM;

Who's the patient?
What are their symptoms?
How long for?
Actions taken?
Allergies?
other Medication?

For the Ambos, it's DRABCDE;

Danger
Response
Airway
Breathing
Circulation
Disability
Exposure

For Dentists, it's the above/below rules;

Is it above the nose? Yes? Not my problem.
Is it below the jawline? Yes? Not my problem.

And so forth. Rarely, the Med School teaches this well, as in DRABC above. Other times, such as certain aspects of history taking, the school fluffs about. We're effectively made to recite the DRABC mantra until it sticks. Comparatively, though, when it comes the questions for, say, a Cardio history or a systems review history, we're given a few references and told to 'go fetch'.

This all becomes quite frustrating, when one line of teaching isn't as forcefully taught and you consider them to be of similar importance. I do, of course, appreciate the utmost importance of DRABC, but my point here is more that being taught the exact information to elicit on a history is taught in less detail than, say, the biochemical basis of thallassemia major. I'm pretty sure which one is higher yield. Especially considering that said biochemical basis of thallassemia major has a whole chapter in each of Robbins, Harrisons', Davidsons' and Kumar & Clark.

I know my course is all about 'Self Directed Learning', and the strengths and weaknesses of the system. And yeah, getting the questions is the students' prerogative. But as I've mentioned above, the emphasis is skewed. Being direct in taking histories is something that can be taught.

Of course having the basic line of questioning, the automatic thing you do or ask, is great for 'basic operators'. That's not me hating on allied health, that's the acknowledgement of different scopes of practice. The 'best practice' lists and plans are at the top of the knowledge tree; it's the science underneath that makes them work. Penultimate and Final year med students and, to a point, interns, would benefit from having the big picture properly 'hammered home' early in the course, in addition to the finer points of the system.

Some hard and fast lines of questioning, just as a wee bit of ammo, would breed confidence, both from within if not without. And if there's dissonance, then we'll know to ask a guru, to keep everyone safe, and teach ourselves something. But, hell, having a solid system of what to ask when would be a great first step.

After all, we don't need to know how to land in a snow storm, at night, on a helipad, in a jumbo. We just need to have some lists thrashed into us.