mead cohen berger shevtsova garfinkle michta grygiel blankenhorn
Not Time Served
Medical Schools Enter the 21st Century

Medical school is finally poised to undergo major surgery. The WSJ reports on changes to medical schools that are gradually gaining steam across the nation. Some schools are cutting down on classroom work and memorization to make room for more field training. Others are integrating new technologies into their programs. Basic but important developments like informing med students about price variations are also gaining traction. Here’s one of the most interesting possibilities:

“The reality is that most medical schools are teaching the same way they did one hundred years ago,” says Wyatt Decker, chief executive of the Mayo Clinic’s operations in Arizona, which include a medical school in Scottsdale, Ariz., that is scheduled to enroll its first class in 2017. “It’s time to blow up that model and ask, ‘How do we want to train tomorrow’s doctors?’ ” […]

Some schools are condensing the typical four-year curriculum into three years, to let students start their residencies sooner and graduate with less debt. The Association of American Medical Colleges is also studying ways to let students master needed skills and competencies at their own pace—an innovation that has come to medical residency programs as well.

These developments are all very much to the good. Medical school, like higher education in general, should move towards a model of education that prioritizes skills learned and knowledge gained rather than time spent in classrooms. That process will cut down on student debt, make schools more efficient, and gets doctors out into the world and job market faster. It could also increase the supply of doctors–more might be willing to become doctors if the process was more efficient and less costly—and bring down costs for consumers, because doctors wouldn’t have to pay down med school debts. Training doctors in price variations and instituting more programs devoted to service delivery—also mentioned in the story—could also help encourage doctors to improve our health care system. More of this, please, and faster.

Features Icon
show comments
  • Andrew Allison

    Enter? How about gingerly dip a toe into? Worse yet, as the Luddite op-ed regarding EMR in today’s WSJ ( demonstrates, it’s not just medical schools that are mired in 19th Century thinking.

  • Fat_Man

    I have had a chance at a front row seat at the arena of medical education over the past few years by watching and talking to my son-in-law and my nephew, who are now in the first and last years of their respective residencies.

    A couple of observations. First, Medical School is incredibly expensive. Tuitions run 20% or more more than the already astonomical tuitions at top tier private universities. It is made more expensive by the requirement of having a BA before entering Med School. The BA requirement is only minimally related to medical education. The Med Schools only require 10 undergraduate science courses (2 each, Biology, General Chemistry, Organic Chemistry, Calculus, Physics), and they do not have to be taken at the school that grants the BA (my nephew took them at a commuter college where the grade competition was far less intense than his Ivy League undergraduate alma mater) or even while the student is getting his BA. All the BA requirement does is to make sure that poor kids have a harder time getting into Med Schools than rich kids who can afford to waste 4 years.

    Another consequence is that the incredible expense, which may be in excess of $200,000, drives students to look for high paying specialties instead of becoming general practitioners, pediatricians, and other low paid direct contact with the patient specialists.

    The first 2 years of Med School are devoted to classroom work that could best be described as very dull. My nephew, who is a clever lad, discovered that he was better off not sitting through the lectures in darkened rooms falling asleep while the professor read his power point slides in a monotone. He set up two computers with three screens in his dorm room. On one screen he watched a recording of the lecture, and the power point slides that the school had placed online. On the second screen he took notes, and he used the third screen to find explanations for terms and concepts that were mentioned but not sufficiently explained.

    The third and fourth years of med School education are devoted to clinical rounds with attending physicians. It is the hands on experience that really starts to turn the students into doctors. Unfortunately the fourth year is carved up by dead times required to allow the students to find their post graduate positions as interns and residents. Oddly enough, the first internship year of post graduate life is more general clinical training. Although the interns get paid, and do not have to pay tuition.

    I think the country would be much better served by reorganizing the program. Undergraduates could easily take a half dozen more science courses. That would reduce the amount of time Med students spend sitting in darkened lecture halls and it would increase the value of their undergraduate degrees. Replace calculus with statistics so that doctors will have a better understanding of what research papers really prove.

    Hive off much of the remaining science classroom work to a new graduate program. It might be called Masters Degree in Health Sciences. Seriously folks, the amount basic science that supports modern medicine has exploded over the last 50 years. A huge advantage is that most of those courses could be taught in large lectures, or even as moocs. Admission requirements could be much easier if the program did not require clinical or patient experiences. The MS program would cover 10 out of the 16 course now covered by the first two years of Med School, six having been transferred to the BA. It could be done in 2 semesters plus a summer session. Alternatively, colleges could offer 5 year combined BA MS programs.

    After a more meaningful BA and an MS, Med schools could be three year clinically oriented programs that could lead directly to residency, rather than requiring an internship.

    • FriendlyGoat

      Makes us wonder if the osteopathic approach to medicine and medical training has been more correct all along.

© The American Interest LLC 2005-2016 About Us Masthead Submissions Advertise Customer Service