<p>I've been thinking about this lately. To me, it seems pointless to go to college for four years before entering medical school. The prereqs for med school are usually completed by the end of sophomore year....so why isn't it 2 years undergrad followed by 6 years medical school? I think that would be honestly better. Especially with medicine becoming more and more complex, there is going to be more and more to learn. What do you guys think?</p>
<p>You can apply for med school after you have the pre-regs, but according to the University of Oklahoma, “97 percent of those accepted attained a bachelors degree”.</p>
<p>You need to be educated in other subject areas besides just the sciences to be a better member of society.</p>
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<p>No, you can’t. The overwhelming majority of medical schools do require a degree (or at least 4 years of collegiate course work). There are a select handful that require only 90 credit hours, which would allow most to apply during the fall of their junior year for matriculation the following fall. However, the number of schools that only require 90 hours is very small.</p>
<p>As for the question from the OP…</p>
<p>What do you suppose the breakdown for those 6 years would be? How would you break up the material? Quite honestly, I don’t see how there would be any improvement in the process, or that going for 6 years would make better doctors at the end. As it stands now, the 4th year of medical school largely consists of vacation, easy electives and residency interviews. The 3rd year of medical school is important in establishing basic competency in the standard clerkships, but what would be gained by making students spend more time in those areas if they’re going into a particularly specialty? I’m a pediatrics resident and knew very early on I was going to peds - why would I want to spend more time on the OB/GYN service or with the Psychiatrists? As for the preclinical years…I really doubt that increasing the length of that time would result in significantly better doctors.</p>
<p>There are several issues that would also need to be considered if you were going to go to your proposed model, but I’ll hold off on those for the time being.</p>
<p>How about we just have a 5 year medical degree straight out of high school like the rest of the world? :D</p>
<p>I can see the pros and cons of both ways…</p>
<p>I can see having a 3 year undergrad program that includes required sciences, humanities and business courses…kind of like a real Pre Med major that prepares one for med school as well as the “business” end of the medical field.</p>
<p>We tried that, got rid of it 100 years ago. For a multitude of reasons, a full college education has been the tried and true standard of the number one medical education system in the world. Considering that even the 6 years BS/MD programs are not that popular, I don’t think there’s a lot of push to change. The inevitable result (on top of other less tangible things) of doing straight out of high school would be more drop outs, something that is not tolerable at the moment.</p>
<p>We have the best quality health care in the world. Notice I said quality. Don’t start a med system flame war…</p>
<p>Our doctors are simply the best in the world, overall. The way we have our medical schools set up is obviously working.</p>
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<p>^^^^ What do you mean by “quality”? If by “quality”, you mean overall level of health, then we offer terrible care. Sure in terms of responsiveness we are the best, but we also spend more than any other nation in the world, only to offer health care that is ranked 37th in overall performance and 72nd by overall level of health out of 191 countries. This study was conducted by the WHO. Read below.</p>
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The best quality and responsive health care for those who can afford it!</p>
<p>If the 2 year-6 year program was established, or even a 2-4 year program was established (in which case we would get more doctors, faster…and those two years off of the traditional 8 years will convince a LOT of people to reconsider becoming a physician…which we need), then I think our system will flow much better.</p>
<p>For the 2-6 year program, if established, I think the first 3-4 years should be pre-clinical. Especially since we have amazing simulation available now. The reason being is that:</p>
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<li>If medical schools have more time to teach the material, medical school wouldn’t be so stressful, and more material would be retained. It’s like learning Spanish. If you spent a year in Spain versus 6 months, you would retain much more information. </li>
<li><p>The curriculum being less stressful and demanding would encourage more people to become doctors. I know that in a way that might be bad, but I know some very intelligent people who don’t want to become doctors just because they feel its too much information to learn in four years.</p></li>
<li><p>This with the combination of longer internships will make the students better doctors. (not saying that our doctors are not amazing and the best in the world, but we aren’t perfect, so there’s always room for innovation) </p></li>
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<p>And someone also posted something about learning in other areas besides medicine. I can see that if a pre-med student was a art history major or English major, but most pre-med students are biology or biochemistry majors. Which you will cover pretty well in medical school.</p>
<p>As for the 2-4 year program, I think this might be a nice option too (even if I do prefer the 2-6) It would reduce the amount required or school from 8 to 6, which would attract a lot of students. And with the increasing population, doctors (if they aren’t already) are going to be in great need.</p>
<p>That sounded kind of bad. 
Sorry, typed it on my phone.</p>
<p>And if the 2-6 year program was proposed, I also think the USMLE standards should be raised. If you have more time to learn the information, you should perform better.</p>
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<p>Please tell me how this is currently a problem. Last I checked, more than half of all applicants to medical school get rejected from every single school they apply to. The medical school applicant pool is DEEP. There are lots of very talented people who never get into medical school, yet would have been phenomenal physicians. And as it is, the AAMC is encouraging its member schools to expand class sizes as well as encouraging state governments to add new medical schools - however (and this has many people VERY worried) we are not seeing an expansion in the number of residency spots. It’s a ways off, but without an increase in post graduate training positions, we may be graduating physicians into an environment where they are shut out of the required training because there’s not enough positions.</p>
<p>As for being less stressful…no, that’s not a good idea. Simply put, being a physician is a high stress job. We deal with things the lay public can’t even imagine. You want to know what’s been my biggest stressor this week? The fact that a patient I picked by helicopter with diabetic ketoacidosis was so sick that by the time I was able to bring them back to my hospital’s pediatric intensive care unit, the swelling of the brain was so horrible that it herniated through the base of the skull and the patient is now brain dead. The damage had been done before my team and I got there, but this should have been preventable. Tell me how spoon feeding medical students is going to improve their ability to cope with things like that. There’s a whole latent curriculum in medical school that in many ways is FAR more important than the manifest curriculum covering the science. Exactly because medical school was such a crucible, this incident hasn’t affected my performance in the slightest. Medical school develops those coping mechanisms, allowing us to do our jobs. </p>
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<p>LONGER residencies? Yeah good luck with getting people to sign up for extra years of working 80 hours a week for what amounts to about 12 bucks an hour. As it stands right now, with the new ACGME work hour rules that are supposed to go into effect in July people are already afraid that it may extend many residencies by a year - particularly in the surgical fields because they can’t get enough case volume. There are many people in pediatric and internal medicine residencies who want to do fellowships to become subspecialists but just don’t want to spend another 2-3 years in training…so they’re becoming generalists. For as much as you think changing medical school will attract more people to medicine (which I assure you isn’t the problem), altering the structure of residency will more than likely cause far more impact in the other direction.</p>
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<p>I think you have a grave misunderstanding of where the overwhelming bulk of growth occurs in the career of a developing physician. I think without a doubt to a person, every physician in the US would point to their third year of med school and their intern year of residency as the points in which they grew most. That would be the first year of consistent patient contact, and the first year of real responsibility when caring for patients. Simulation while useful is limited. It’s often said that patients don’t read text books. For all the time spent in preclinical studies learning about how diseases should present, the art of medicine is picking them out when they don’t show up in all the expected manners. And the only way to really develop that sense is to see lots of patients. Simulation can be useful but it’s absolutely not enough. Are you really going to tell me that you’re going to try to simulate a standard clinic day for me? Is seeing 6 viral upper respiratory infections, 3 cases of viral gastro, 3 well baby checks, 4 ADHD visits and 2 asthma checkups really going to be feasible in simulation? In fact for the most part, the difficulty is not in figuring out what’s the matter but in managing to answer all the questions and give the proper advice to meet each patient and parent’s needs. Unless you come up with all those scripts, you’re never going to simulate what, by definition, real patient contact provides.</p>
<p>I definitely think that if they were going to expand any part of medical school, it would be the clinical year. I doubt it will happen though.</p>
<p>To Bigredmed, </p>
<p>Well first I would like to say that I admire you. 
I want to be an ER/Trauma Physician as well. </p>
<p>But, to your first statement, I believe that yes we should expand the medical school class size and create more schools, but that is another problem. I know that over half of the medical school applicants are denied, but that is usually due to an uncompetitive application. But…(correct me if I’m wrong), most medical school applicants are accepted if they have a 3.5 GPA, reasonable MCAT’s, and show that the really want to become a physician for the good reasons. A lot of my friends got denied to schools like Rice and Stanford because of their essays. I had slightly lesser standards (3.7 GPA, 32 ACT) than them and got accepted into Rice because my essay showed a true passion for medicine. If you don’t have a true passions for medicine, then I don’t think you should become a doctor. If you are lacking signanficantly in any of those three areas, I can see why medical schools deny you…and even if the class was expanded, those students still shouldn’t be accepted. You have to:
- Be able to handle the curriculum (high gpa, high MCAT)
- Be dedicated to medicine (good essay, good interview)</p>
<p>I know from experience that 25-35% of pre-meds wants to become doctors because of the money involved or just because of family and peer pressures…and the admissions committee can see through this. That’s why over half of the students get denied.</p>
<p>I am in EMT training (not that it compares to the knowledge of a doctor, just a point). I am a high school junior/senior (3-year grad) and throughout the entire three years I’ve been in this program, we have been spoon-fed the information. Needless to say, on all of the NREMT exams that I take, I score extremely high. Since I had 3 years to learn the information rather than the general six months, I not only retained much more of the information, but I feel more confident with my skills (due to simulation). I understand in a way, how the stress of the medical school curriculum prepares you for the stress in the field, but I’m sure you’ll get a good dose of stress during internships. As far as I know, you are only required to score 50% on the USMLE? I think if the pre-clinical curriculum was extended, the score range should be no less than 70%-75%. I know a lot of doctors (for some reason I always befriend doctors when I meet them…) and some of them don’t retain all of the information. Like on of my favorite doctors forgot the steps of cellular respiration…while I was shadowing her, there was a patient that came in and was complaining of extreme muscle pain while he was running and I brought up something about lactic acid fermentation and how his muscles might not be getting oxygen readily so his cells go straight to anaerobic respiration (which was completely wrong. I just like to think :D). I don’t blame her though, it’s so much information to know…but if she was spoon fed the material rather than being drowned in it, I think she might have retained more information. </p>
<p>And no not longer residencies, longer internships. Believe me, I’m already dreading residencies and it’s still 7 years away…Also, you stated that residencies might be a little longer? Well, if medical school was 2 years-6 years, then you will already have so much experience by the time you graduate that it wouldn’t really matter if the amount of time residents can work a week was reduced.</p>
<p>I don’t know…to me the last two years of college are pointless. I know it’s the last two year to party and get that out of your system, but academically, it’s pointless. Next year I will be classified as a sophomore (I take practically all of my classes at a community college this year), and I’m just stunned at my degree plan. After Organic Chemistry and Physics next year, I will be done with the pre-medical curriculum, and yet I will still have 2 years of coursework? I will be a biochemistry major, and all I will take is ONE biochem class. ONE. The rest are just electives and classes like genetics and molecular biology…blah blah blah…all classes that I will cover in medical school. I just really wish that:</p>
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<li>Medical schools would require more pre-requisites… or</li>
<li>They allow students to apply after the 6 pre-requisite courses are complete. Because I don’t want to be in college longer than I have to.</li>
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<p>NREMT practice exams…sorry :P</p>
<p>Tulane has a program similar to what the OP is describing [Tulane</a> University - School of Medicine - Office of Admissions - taptp](<a href=“http://tulane.edu/som/admissions/tulane-accelerated-physician-program.cfm]Tulane”>http://tulane.edu/som/admissions/tulane-accelerated-physician-program.cfm) Two years of undergrad, a year of volunteer community service and then right into med school, with the first yr of med school qualifying as the last year of undergrad</p>
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<p>I will gladly correct you. Yes, there are plenty of people who apply without a competitive application. However, there are still PLENTY of highly qualified applicants who are rejected multiple times. Trust me, until you’ve been through the application process, and seen either yourself or your friends struggle with rejections you won’tl know just how painful the truth is. I’ve seen it over and over that HS students believe that “if I just do these things, I’ll totally get accepted” - it just doesn’t work that. I promise you, the doctor “shortage” is not due to a lack of interest, so trying to recruit more pre-meds is not an effective strategy in solving that problem.</p>
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<p>Based on your statements, you obviously have some deficiencies in your knowledge of post graduate medical education. To be brief, 3rd year medical students get to “play” doctor, but they don’t have any real responsibility, the decisions are still made for them. Yes, there’s stress, but it’s the stress of learning in an entirely different way. Most people feel the clinical years are less stressful because it’s not the constant grind of time in the library and exams. My medical school, during the first 2 years averaged an exam every 2.5 weeks. While 4th year med students are more likely to spend time in the ICU setting they are usually given the less complicated, less ill patients. But most of 4th year is focused on residency interviews and the Match process. Clinical knowledge takes a back seat to this process during the year.</p>
<p>Being an intern in the medical field only means that you are first year physician. It is not used in the same way “intern” is used anywhere else in the world. In most fields, it is the most time consuming, high stress year of training. As a pediatric resident, I typically only had 4 days off a month during my intern year. It is the first time that patients are your responsibility and you have to make all the decisions.</p>
<p>The attainment of knowledge during both the third year of medical school and the intern year are in hyper drive. If you can’t learn quickly, you’ll largely get behind. This is one of those latent lessons of the pre-clinical curriculum. It is a skill to rapidly interpret and incorporate new knowledge, as well as selecting out what’s the most important to remember and that skill must be developed. I’ll be honest, it’s possible that I’ve forgotten more info than some people have learned in their lifetime, and I’m still learning lots of new things every day I go to work. If I hadn’t had the pre-clinical curriculum at a rapid pace, I would be handicapped now.</p>
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<p>The USMLE does not publish the passing score %. However, it is generally believed that for Step 1, the % required is about 70%, and with each subsequent step, the required percentage drops. </p>
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<p>Again, I’ve probably forgotten more than some people have ever learned. However, the distinction between clinical practice and remembering something like specific aspects of cell processes is LOW YIELD. That’s one of the main reasons why I think your idea of slowing down the preclinical years is suspect at best - the outcomes for actual patient care are not straight forward. I say this as a future pediatric intensivist (sorry, but the ER sees too many people who are way too healthy for me), someone who really enjoys the application of physiology to medical care. But it’s a focused application and one that if the physiology doesn’t change what I do (for example the minute details of digestion is largely irrelevant to my practice - I don’t need to know all the exact actions of cholecystikinin). </p>
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<p>See, this is where your lack of knowledge causes your argument to break down. Medical school is where you learn how to be a doctor. Residency is where you learn how to take care of patients. It’s not just some sort of hazing ritual or some sort of way to make sure that teaching hospitals have a cheap labor supply. I didn’t graduate medical school ready to be a general pediatrician. Again, students do not get RESPONSIBILITY. They are not physicians, the M3 or M4 behind their name doesn’t mean much. Students are learning the basics, learning how to do a good physical exam, take an adequate history and write a proper note. Interns and residents are actually learning what to do so that they can be independent decision makers when they leave the highly supervised environment of residency. For your surgeons, that means learning how to do surgery. For your pediatric residents that means learning how to take care of kids of all ages - from the 24 week premature 700 gram neonates, to the 19 year old with a host of STD’s. One of the reasons why people are worried they may have to extend residencies is because there is so much attainment of knowledge that must happen within that 3-7 years, lengths of time that were set when there were no rules and residents worked 120 hours a week. Now we can’t work more than 80, and the possibility of being further limited means that we get to see even fewer patients - and every resident will tell you that it’s the volume and the need for experience that they want.</p>
<p>In sum, your suggestions, at least in my mind won’t result in producing better physicians. And I haven’t even touched on the implications that would occur to undergraduate education…</p>
<p>Yeah, I guess your right. I don’t know much about the medical school and post-med school side of it, but I still do believe that the last two years of undergrad is pointless (maybe even the entire undergrad). I made my decision to go to Emory University for pre-med, and still looking at my degree plan, I don’t see how any of these courses can help me prepare to be a better physician. I feel like it will be a waste. I heard some countries have doctors who graduate with bachelors degrees…again I know that we are the best in the world, but I’m sure they do just fine. I know for a fact that doctors don’t remember information from general bio, chemistry, calculus, or organic chemistry. There was a medical school student the other day during my clinical rotations and I asked her for help with my General Chemistry final review. She told me she forgot literally everything. Also one day there was a doctor who told me that he forgot calculus…and as for general bio, my favorite doctor forgot cellular respiration. It’s all pointless. Also, I don’t think that our doctors are twenty times better than all the doctors around the world, I just think that we have the most available resources in America to be able to achieve what we do in medicine.</p>
<p>Also, if you don’t mind me asking. Was it worth it to become a doctor? I’m also considering becoming a PA…just to avoid the stress of a doctor. My interpretation of it is this:</p>
<p>Undergrad: Fun (but some hard classes)
Med School: Hell
Residency: Hell * 10
Post-Residency: Normal Life…can actually have a wife and kids</p>
<p><strong>I just took my General Bio and General Chem finals last week, scored A’s in both courses, and the information is already leaking. Hopefully I don’t bomb my MCAT’s :D</strong></p>
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When you take your science classes from some professor of high caliber, like a winner of Nobel prize in a science subject, or a fellow in National Science Academy, make sure to tell him what you just said here.</p>
<p>No wonder so many professors dislike premeds!</p>
<p>When I was a college student decades ago (not on the premed track though), one of my classmates expressed a similar view, implying that what the professor taught was useless/impractical for his future career. You could imagine how angry the professor became. The student was wise enough to drop the course.</p>