Medical school is a unique institution. Its student body consists
entirely of adults, most of whom are not financially independent or are in a
mountain of debt and can't hope for a significant improvement for at least a
decade. The students are all very motivated, bright, and capable, and the
schools nurture their abilities and produce, on the whole, fantastic human
beings. Medical schools have much to be proud of; but they are in a bubble with
no concept of time, public need, or priority.
There has been a lot of talk recently about the shortage of
doctors in the United States. The shortage exists in most fields of practice,
and is especially felt in rural regions in the country. With the demand so
high, new medical schools have been opening up all over the place. Medical
schools, as well as many governing bodies, have also been trying hard to come up
with ways to increase the doctor supply. One idea that has been gaining
traction is to reduce the required number of years one must spend in medical
school to graduate, from four years to just three. The country needs more
doctors, and is willing to consider revamping the current system to solve the problem.
With this apparent demand it is hard to understand what most of
the top ranked medical schools in the U.S. view as their ideal student. Many of
them place a lot of value in students who did not plan to begin medical school
immediately after graduating from college, but instead decided to take a year
or two off, if not more, to do research, pursue a higher level degree, or do
"something interesting." According to U.S. News, the average age of a
student entering medical school is 24, indicating that, on average, students
are taking 2 years off after college before starting medical school.
Once the student is finally in medical school there is a stronger emphasis on student
involvement in extra-curricular activities than on mastering the material.
During the first weeks of school the students are inundated with an
overwhelming amount of emails, interest group meetings, impromptu announcements
at the beginning of lectures, and solicitations from the second year students.
Every day there's a different interest group meeting, a different club to run,
and a different program to divert your attention from the reason why you came
to medical school - to learn the intricacies of medicine and be able to care
for patients. These distractions often lead to a student's failing a course or
two, requiring the student to repeat them, and sometimes even repeat the year,
essentially delaying graduation.
Furthermore, in medical school there is an awfully strong emphasis
on medical students doing research. Some residencies are said to not consider
students who haven't done research during their schooling, a phenomenon that
did not exist twenty years ago. And there are others, like plastic surgery and
radiation oncology, about which students and doctors alike say they are not worth
applying to if you haven't taken a "scholarly year," a year in
medical school which the student devotes solely to research, and published
multiple papers, with at least two as first author. The proper time to do
research is obviously once one's medical training has been completed, when a
fully competent clinician can notice a pattern or problem, investigate it
intelligently with a full understanding of the pertinent issues, and propose
comprehensive solutions.
More and more, medical schools are pushing their students to be
"well-rounded" and to be researchers as well as physicians. How can
they honestly talk about the issue of a doctor shortage with seeming concern
while they keep on delaying the graduation of their students by promoting
additional experiences that are not essential, and sometimes completely
extraneous? Most physicians and clinicians are not scientists, so why are
medical schools so proud of the fact that 99% of their student body devoted
their valuable summers between their first and second years of medical school
to do research? Why don't they publicize the statistics analyzing how med
school graduates feel about their summer they spent doing research in medical
school? The vast majority regret the way they spent that summer.
One upperclassman who was advising the incoming first years on how
to cope in medical school and prioritize their time complained that, if she had
known, in her first and second year of school she would have spent less time
studying the material she was being taught and focused more on being involved
in extra-curricular activities and research. Apparently she hadn't made AOA,
the prestigious medical honor society of which membership indicates that a
student ranked in the top 10-15% of his or her class. Without impressive
activities outside of the classroom medical schools will rarely consider a
student to be worthy of AOA, even with stellar grades.
The medical schools have placed so much importance on having
supreme medical students, ones who are apparently capable of doing it all, and
in doing so they have averted the students' focus from the most critical task
at hand - that of becoming a competent physician who can treat patients. On top
of that, they are encouraging students to delay the completion of their
training. How many years must physicians-in-training spend chasing peripheral
endeavors before they can finally get certified? And isn't there a shortage of
doctors? Good job, med school.
