How would you change the med school curriculum so that it actually makes sense?

[Poit]

The current set-up makes even less sense than leasing a sports car as a new attending. The first two years you memorize the urea cycle and HLA subtypes to score high enough on the USMLE so that your selfless aspirations that you recited during your interview cycle of practicing rural primary care don't have to come true. 3rd year you stand around all day trying to pick up a few tid bits so that you don't kill someone in a couple years, and 4th year is sort of joke.

How would you change this so that it makes sense?

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[JamesPotterMS-3]

I think Duke's model is the best. Pre-clinicals shouldn't take more than 12-14 months. Then throw them in clinic/wards for a year. Then give them 6-10 months of open time for research, global health, MPH or MBA, or more clinical time, then give them a traditional 4th year. Boom.

My main point is that much of MSI is such a colossal waste, especially in schools with required dissections in the anatomy curriculum. Cut the crap out. Just go through Robbins, chapter by chapter, while weaving in relevant phys, anatomy, and pharm.

 

[Redpancreas]

The current set-up makes even less sense than leasing a sports car as a new attending. The first two years you memorize the urea cycle and HLA subtypes to score high enough on the USMLE so that your selfless aspirations that you recited during your interview cycle of practicing rural primary care don't have to come true. 3rd year you stand around all day trying to pick up a few tid bits so that you don't kill someone in a couple years, and 4th year is sort of joke.

How would you change this so that it makes sense?

Undergrad Year 1: Give students a year to clear BCPM (bio, chem, etc).

Undergrad Year 2: No more required classes unless you want to take more as a gap. This year, let them take the MCAT and give them a 6 month eligibility period and the next 6 months to do self-directed extra-curricular work, shadowing, etc or anything that they feel will help them.

Undergrad Year 3: Application/Interview year but the 12 months should consist of required USMLE Step 1 material time. PhD/Basic Science educators will have to create courses that have online/classroom components. Students can elect which course they take. All will have to be certified by the LCME and student takes Step 1 (blinded to med admissions)
---
Student submits passing USMLE Step 1 score to medical school to confirm acceptance but acceptance to medical school is based only off of MCAT and self directed ECs.
---

M1: Student comes in and the first year is didactic information on USMLE Step 2 CK material. Meanwhile, students work with standardized patients and any willing bedside inpatients who are willing to teach students their: presentation, diagnostic tests, management, and treatment. Allow 3 months of suturing/cadaver, research, etc. elective time.

M2: Basically what Clerkship director say M3 is like now to the LCME.

M3: Basically M4 and allow SubI before apps just like now following with match.

Residency: Same moving forward. Now only 5 years out of high school, students won't mind PGY8 so much.

 

[whatisthisstuff]

It could be about 2 1/2 years considering all the waste of 1st year and 4th year.

Embrace technology and fantastic teachers across the country to drive the cost of education WAY down.

That said these issues are so systemic across higher education (and getting worse) that I don't see it changing.

 

[Goro]

The current set-up makes even less sense than leasing a sports car as a new attending. The first two years you memorize the urea cycle and HLA subtypes to score high enough on the USMLE so that your selfless aspirations that you recited during your interview cycle of practicing rural primary care don't have to come true. 3rd year you stand around all day trying to pick up a few tid bits so that you don't kill someone in a couple years, and 4th year is sort of joke.

How would you change this so that it makes sense?

It really is the worst system, except for all the others.

All that aside, the switch to mastering required competencies, as opposed to the century-old Flexner model and all its variations (as you described above) should help bring about a better medical education modality. In this day and age, there's really no reason for you to have to learn how the biochemical tests for gram-negative bacteria work, because that's all been outsourced to the lab. I don't think that there's a need for you to learn how to identify tumor A from Tumor B merely by looking at a histo slide...that's pathologist's job, and can be picked up in post-graduate education. You DO need to understand pathology and pathophysiology.

And you sure as hell don't need to know what a northern blot is. And I'm a gene jock! Yet my molecular biology colleague keeps on teaching this!!!

EDIT: I'll vehemently disagree with James...you need to know your way about a body, period. A real body, not a digital one either.

 

[Med student 18]

would mainly change the concept of what professor is apt enough to give lectures. I NEED to change the thought paradigm that just because someone is a superspecialist at something means that they can teach it (OFTEN NOT THE CASE). I think the main prerequisite of a teacher is whether they can teach.... crazy concept.

this drove me strongly to online lectures.

 

[Jabbed]

Biggest waste is undergrad. I would do 3 years pre-clinical and 3 years clinical.

More clinical =/= better clinician imo. In virtually all non-surgical fields I feel that you can, for the most part, get away with consulting out every problem so that overall ineptitude doesn't result in horrifically bad outcomes. Take a look at a medicine team in July and you'll be hard pressed to find a patient that doesn't have 1-2 specialists consulting. Essentially, you can skirt by in clinicals by deferring any actual decision-making to your superiors/specialists.

I truly think that pre-clinical education should be central to clinical practice, it's just that most people don't retain much of it. I think implementing longitudinal retention studying and spaced repetition is the key to making it all worthwhile.

 

[Stagg737]

I don't think 4 years of UG are necessary. 3 should be enough to get a solid understanding of the foundations for medicine. It could really be taught in 2 years, but I've met enough 20 year old med students to realize a large percentage aren't mature enough to be in med school at that age, let alone seeing patients a year or 2 later.

The current set-up makes even less sense than leasing a sports car as a new attending. The first two years you memorize the urea cycle and HLA subtypes to score high enough on the USMLE so that your selfless aspirations that you recited during your interview cycle of practicing rural primary care don't have to come true. 3rd year you stand around all day trying to pick up a few tid bits so that you don't kill someone in a couple years, and 4th year is sort of joke.

How would you change this so that it makes sense?

For med school, there's two routes. If we're going to keep Step 1 as a standardized test, first two years could be cut down to 1.5 years. Unless we're going to up the pre-reqs for getting into med school, I don't think 12 months is enough time to learn everything relevant to step 1. If we move from having Step 1 to some other form of evaluation like competencies, shelf exams in pre-clinical years, or just eliminate it until Step 2.

You may not think so, but 3rd year is relevant. If you're just learning a few "tidbits" so you don't kill anyone in the future, you're wasting your education. It also forces you to get exposure to fields you may not have considered otherwise. Given the number of people who change their mind about what field they're entering during 3rd year it's relevant. I also don't know where you're rotating, but the vast majority of my 3rd year I did a lot more than just stand around. 4th year is more of an argument. However, I only think it's a waste if you treat it like one. My first 3 rotations of 4th year I've been putting a lot of work into learning important aspects about the field I'm applying to. Additionally, the first half of 4th year is very relevant if you're doing audition rotations as it can impact residency. After the match is a different story, but can still be worthwhile if you make it so. Though I wouldn't be opposed to just dropping the final semester of medical school altogether.

 

[theonlytycrane]

I have a friend in Canada who says there's no step exams, just a p/f thing at the end. So it's more focused on classes & clinical education without worrying about grinding through UFAP.

 

[W19]

I don't think 4 years of UG are necessary. 3 should be enough to get a solid understanding of the foundations for medicine. It could really be taught in 2 years, but I've met enough 20 year old med students to realize a large percentage aren't mature enough to be in med school at that age, let alone seeing patients a year or 2 later.



For med school, there's two routes. If we're going to keep Step 1 as a standardized test, first two years could be cut down to 1.5 years. Unless we're going to up the pre-reqs for getting into med school, I don't think 12 months is enough time to learn everything relevant to step 1. If we move from having Step 1 to some other form of evaluation like competencies, shelf exams in pre-clinical years, or just eliminate it until Step 2.

You may not think so, but 3rd year is relevant. If you're just learning a few "tidbits" so you don't kill anyone in the future, you're wasting your education. It also forces you to get exposure to fields you may not have considered otherwise. Given the number of people who change their mind about what field they're entering during 3rd year it's relevant. I also don't know where you're rotating, but the vast majority of my 3rd year I did a lot more than just stand around. 4th year is more of an argument. However, I only think it's a waste if you treat it like one. My first 3 rotations of 4th year I've been putting a lot of work into learning important aspects about the field I'm applying to. Additionally, the first half of 4th year is very relevant if you're doing audition rotations as it can impact residency. After the match is a different story, but can still be worthwhile if you make it so. Though I wouldn't be opposed to just dropping the final semester of medical school altogether.

If a few med students are spoiled brats, so everyone gotta waste another 100k+ plus loss of income to make sure that these immature students can behave appropriately... Guess what! I have met many 30s, 40s year old who behave like teenagers...

No one will convince me that the whole medical education can not be taught in 6 years (3+3)...

 

[DocWinter]

The system may not make sense, but in the big picture it works.
Disagree that 4 years/bachelors is too much time to prepare for med school. The (hopeful) maturity is a big reason why that is necessary - it's bad enough with some 22/23 year olds coming in fresh out of college, but if you're going to keep the system fair, its necessary to go to that point. While W19 above has a point, I venture that if you're in your 30s/40 and behaving like a teenager you should be vetted out of the application process, so thats on the school.

It's not broken, so don't fix it. What to fix? The crappy residency selection process where the best board scores go on to hammer 65 year old hips or cure psoriasis, and the worst scores care for scores of families and children with great stakes and poor financial repayment.

 

[W19]

The system may not make sense, but in the big picture it works.
Disagree that 4 years/bachelors is too much time to prepare for med school. The (hopeful) maturity is a big reason why that is necessary - it's bad enough with some 22/23 year olds coming in fresh out of college, but if you're going to keep the system fair, its necessary to go to that point. While W19 above has a point, I venture that if you're in your 30s/40 and behaving like a teenager you should be vetted out of the application process, so thats on the school.

It's not broken, so don't fix it. What to fix? The crappy residency selection process where the best board scores go on to hammer 65 year old hips or cure psoriasis, and the worst scores care for scores of families and children with great stakes and poor financial repayment.

If you aren't mature enough after going thru 3-year of undergrad, 3-year of med school and 3+ years of residency, I don't know what else will mature that person

 

[bashwell]

In the UK and other Commonwealth nations, people can go straight from high school to med school. Med school is 5-6 years. Intern/PGY1 around 23 years old. Sure, many are immature, but many are quite mature as well. I don't think age is the primary factor in level of maturity. I think level of maturity is probably more closely associated with how their parents raised them, how they grew up, their personal work ethic, sense of right and wrong, and those kinds of things. Just my opinion.

 

[Redpancreas]

To address the maturity issue, student will adapt to the challenges placed in front of them.

 

[bannie22]

I have to agree that first year was an utter waste of time. Everything had been covered in undergrad. It would have been nice to have more time in 4th year rather than having to squish everything in towards the end.

 

[username456789]

I have to agree that first year was an utter waste of time. Everything had been covered in undergrad.

You must go to a very poor quality medical school.

 

[WingedOx]

Any suggestion that implies that we should be selection for med school admissions out of high school can be ignored outright... thanks.

/and as a rule, students don't really have a great grasp of where their maturity and level of experience actually is....

 

[bannie22]

You must go to a very poor quality medical school.

How did you know?

 

[username456789]

How did you know?

Easy. You told us.

I have to agree that first year was an utter waste of time. Everything had been covered in undergrad.

 

[bannie22]

Easy. You told us.

darn too easy

 

[Lawpy]

Undergrad Year 1: Give students a year to clear BCPM (bio, chem, etc).

Undergrad Year 2: No more required classes unless you want to take more as a gap. This year, let them take the MCAT and give them a 6 month eligibility period and the next 6 months to do self-directed extra-curricular work, shadowing, etc or anything that they feel will help them.

Undergrad Year 3: Application/Interview year but the 12 months should consist of required USMLE Step 1 material time. PhD/Basic Science educators will have to create courses that have online/classroom components. Students can elect which course they take. All will have to be certified by the LCME and student takes Step 1 (blinded to med admissions)
---
Student submits passing USMLE Step 1 score to medical school to confirm acceptance but acceptance to medical school is based only off of MCAT and self directed ECs.
---

M1: Student comes in and the first year is didactic information on USMLE Step 2 CK material. Meanwhile, students work with standardized patients and any willing bedside inpatients who are willing to teach students their: presentation, diagnostic tests, management, and treatment. Allow 3 months of suturing/cadaver, research, etc. elective time.

M2: Basically what Clerkship director say M3 is like now to the LCME.

M3: Basically M4 and allow SubI before apps just like now following with match.

Residency: Same moving forward. Now only 5 years out of high school, students won't mind PGY8 so much.

Biggest waste is undergrad. I would do 3 years pre-clinical and 3 years clinical.

More clinical =/= better clinician imo. In virtually all non-surgical fields I feel that you can, for the most part, get away with consulting out every problem so that overall ineptitude doesn't result in horrifically bad outcomes. Take a look at a medicine team in July and you'll be hard pressed to find a patient that doesn't have 1-2 specialists consulting. Essentially, you can skirt by in clinicals by deferring any actual decision-making to your superiors/specialists.

I truly think that pre-clinical education should be central to clinical practice, it's just that most people don't retain much of it. I think implementing longitudinal retention studying and spaced repetition is the key to making it all worthwhile.

I don't think 4 years of UG are necessary. 3 should be enough to get a solid understanding of the foundations for medicine. It could really be taught in 2 years, but I've met enough 20 year old med students to realize a large percentage aren't mature enough to be in med school at that age, let alone seeing patients a year or 2 later.



For med school, there's two routes. If we're going to keep Step 1 as a standardized test, first two years could be cut down to 1.5 years. Unless we're going to up the pre-reqs for getting into med school, I don't think 12 months is enough time to learn everything relevant to step 1. If we move from having Step 1 to some other form of evaluation like competencies, shelf exams in pre-clinical years, or just eliminate it until Step 2.

You may not think so, but 3rd year is relevant. If you're just learning a few "tidbits" so you don't kill anyone in the future, you're wasting your education. It also forces you to get exposure to fields you may not have considered otherwise. Given the number of people who change their mind about what field they're entering during 3rd year it's relevant. I also don't know where you're rotating, but the vast majority of my 3rd year I did a lot more than just stand around. 4th year is more of an argument. However, I only think it's a waste if you treat it like one. My first 3 rotations of 4th year I've been putting a lot of work into learning important aspects about the field I'm applying to. Additionally, the first half of 4th year is very relevant if you're doing audition rotations as it can impact residency. After the match is a different story, but can still be worthwhile if you make it so. Though I wouldn't be opposed to just dropping the final semester of medical school altogether.

In the UK and other Commonwealth nations, people can go straight from high school to med school. Med school is 5-6 years. Intern/PGY1 around 23 years old. Sure, many are immature, but many are quite mature as well. I don't think age is the primary factor in level of maturity. I think level of maturity is probably more closely associated with how their parents raised them, how they grew up, their personal work ethic, sense of right and wrong, and those kinds of things. Just my opinion.

Sorry I'm lost. Why is the discussion on medical school curriculum factoring in undergrad? I thought the point of undergrad was to explore personal interests, enjoy college, and maybe think about pursuing medicine/doing ECs/taking the MCAT etc. Seeing that nontraditional applicants are applying to medical school, I don't think college has much of a role in it besides traditionally overlapping with the usual journey to medical school. To me, the medical journey starts at orientation day at medical school and starting MS1.

Also eliminating undergrad is a bad idea. College isn't a stepping stone for medical school and some maturity development is needed.

 

[bashwell]

Sorry I'm lost. Why is the discussion on medical school curriculum factoring in undergrad? I thought the point of undergrad was to explore personal interests, enjoy college, and maybe think about pursuing medicine/doing ECs/taking the MCAT etc. Seeing that nontraditional applicants are applying to medical school, I don't think college has much of a role in it besides traditionally overlapping with the usual journey to medical school. To me, the medical journey starts at orientation day at medical school and starting MS1.

Also eliminating undergrad is a bad idea. College isn't a stepping stone for medical school and some maturity development is needed.

All I was saying is that, while there are definitely many immature high school students and med students, that's not true for all high school students and med students. I've seen many high school students who are mature enough to make the decision to become a physician and who do go on to become perfectly fine physicians at a young age. I've seen this in the UK and other Commonwealth nations. They're happy and content, and they don't feel like they've missed out on anything in life as far as anyone can tell.

However, at the end of the day, it all comes down to your philosophy on life. What you think is important in life, what you think is meaningful in life, what you want to pursue, what you think is worth prioritising, and so on. I'm not necessarily here to disagree if someone has a different perspective on life.

 

[Stagg737]

If a few med students are spoiled brats, so everyone gotta waste another 100k+ plus loss of income to make sure that these immature students can behave appropriately... Guess what! I have met many 30s, 40s year old who behave like teenagers...

No one will convince me that the whole medical education can not be taught in 6 years (3+3)...

It's not just a few in my experience, it's nearly all of them who I've interacted with (admittedly not all that many) and I've heard the same from friends at other schools.

There's also evidence to back that up when you compare attrition rates of 6 year combined programs in the US (greater than 20%) to the national average of schools with traditional 4 year curriculums (~6%) (**edit: current 8 year graduation rate due to MD/PHD programs is 96.6%, so a 3.4% attrition rate**). With those stats we might as well be comparing the model you're talking about to the Caribbean diploma mills.

I'm not saying there aren't kids mature enough to handle med school at 18, but the percent who aren't ready at that age is significantly higher than the percent of those not ready after finishing college. In my experience, it's significant enough that I think programs like what you're suggesting are a bad idea to implement on a large scale.

 

[W19]

@Stagg737 I am not sure if you read my post, but I will reiterate that I am not advocating for a 6-year med school directly from HS... I am saying that the baccalaureate degree requirement is a waste (I know of a few schools that do not require it, but you will have a hard time getting into med school without it). People can just take the prereqs in 3 years and decide whether they want to go to med school or not... And med school itself can be converted into a 3-year program easily...

 

[kablemach2o]

UMKC 6 year BA/MD is a great way to go. Every other country except the United States does 6 year MBBS. Are all other countries graduating immature doctors? Or are American students immature?

 

[IslandStyle808]

Maturity is relative, I've seen maturity and immaturity in all spectrums of ages. The main thing is having a flexible system that can cater to those who want medical school from 18 and beyond. The problem occurs when you streamline stuff (deciding on life at 18 and are stuck in said occupation for life) not because of those BS/MD programs that allows students to choose medicine at 18. The former is the fault of the system the latter is the fault of the student...

 

[bananafish94]

I think a lot of it works very well. I actually do enjoy learning all of the "low-yield" details and I'm glad they're taught. I think it's an appropriate length. I disagree with some of the sentiments expressed here...I do think that medical school should come after college and offering it to high school graduates would be a bad idea. I also very strongly believe that real dissection is vastly superior to anything offered by technology. If I were to make my own medical school I would want pre-clinical courses to be taught be people trained in education, as opposed to researchers or physicians. So, more of a change in delivery rather than curriculum.

 

[Stagg737]

UMKC 6 year BA/MD is a great way to go. Every other country except the United States does 6 year MBBS. Are all other countries graduating immature doctors? Or are American students immature?

I know several of the students who are in the 4 year portion of UMKC's curriculum (my SO worked with their spouses). They've said a large portion of that class is unbearably immature and that they mostly keep to themselves. The school you've mentioned also had a 21% attrition rate 2 years ago, and if you take out the first two years (the undergrad years), the attrition rate is still 15%, which says either there's a problem with the curriculum or the students they're accepting (data is in the first two hits when googling "UMKC med school attrition rate). I'm not trying crap on UMKC, as I know a few physicians who went there and are great, but if their attrition rate is that much worse than the current national average of 3.4% (made a mistake in previous post) there's something wrong with their 6 year program.

@Stagg737 I am not sure if you read my post, but I will reiterate that I am not advocating for a 6-year med school directly from HS... I am saying that the baccalaureate degree requirement is a waste (I know of a few schools that do not require it, but you will have a hard time getting into med school without it). People can just take the prereqs in 3 years and decide whether they want to go to med school or not... And med school itself can be converted into a 3-year program easily...

Fair enough. I can certainly see UG being shortened by a year. I have mixed feelings about shortening med school though. As I said, spring of 4th year could be dumped, but unless we change the way we evaluate pre-clinical education, I don't think significantly shortening the first 2 years would be beneficial for students as a whole.

 

[WingedOx]

know several of the students who are in the 4 year portion of UMKC's curriculum (my SO worked with their spouses). They've said a large portion of that class is unbearably immature and that they mostly keep to themselves. The school you've mentioned also had a 21% attrition rate 2 years ago, and if you take out the first two years (the undergrad years), the attrition rate is still 15%, which says either there's a problem with the curriculum or the students they're accepting (data is in the first two hits when googling "UMKC med school attrition rate). I'm not trying crap on UMKC, as I know a few physicians who went there and are great, but if their attrition rate is that much worse than the current national average of 3.4% (made a mistake in previous post) there's something wrong with their 6 year program.

Interview day for the 6-7 year accelerated program at my school was always surreal to see. You had ~17 year old kids taking the campus tour wearing varsity jackets with their parents alongside them. It just screamed "lack of adulthood".

 

[W19]

Fair enough. I can certainly see UG being shortened by a year. I have mixed feelings about shortening med school though. As I said, spring of 4th year could be dumped, but unless we change the way we evaluate pre-clinical education, I don't think significantly shortening the first 2 years would be beneficial for students as a whole.

I obviously don't know how your school curriculum is structured... At my school, Histology and Cell biology is a 14-week course. We have community medicine, ethics and professionalism that take up a lot space... Not to count a few useless workshops we have to attend with nursing students so the school can show us how to work in a team... In addition, a lot of stuff in the curriculum are repetitive. Don't get me started about PBS and other group work!

Also, our 3rd year IM rotation is 12 freaking weeks . Seriously!


Why can't it be 18 months preclinical and 18 months clinical? Why do you have to use an extreme case (1-year preclinical) to argue your point?

I agree that 1-year preclinical would not work for many (or most) students...

 

[Stagg737]

I obviously don't know how your school curriculum is structured... At my school, Histology and Cell biology is a 14-week course. We have community medicine, ethics and professionalism that take up a lot space... Not to count a few useless workshops we have to attend with nursing students so the school can show us how to work in a team... In addition, a lot of stuff in the curriculum are repetitive. Don't get me started about PBS and other group work!

Also, our 3rd year IM rotation is 12 freaking weeks . Seriously!


Why can't it be 18 months preclinical and 18 months clinical? Why do you have to use an extreme case (1-year preclinical) to argue your point?

I agree that 1-year preclinical would not work for many (or most) students...

I used the 1 year pre-clinical because other posters were suggesting that's all that was necessary, which I think it ridiculous. I think 18 months each is more reasonable.

We did not have histology or cell bio at my school. Cell bio was a pre-req (I think we had a 1 hour lecture on it first day of class) and histo was somewhat worked into path, though we didn't actually get tested on any pictures and were expected to learn that on our own for Step (I'm at a DO school). We had a course called Principles of Clinical Medicine which was basically a lecture and lab every other week. Bioethics was a lecture or two a month with no actual tests and online quizzes that we were allowed unlimited guesses at, so no real commitment there. We also didn't have classes with any other professionals and it was expected that professionalism was already understood. I think the idea of having to teach professionalism is ridiculous and goes along with not accepting immature brats into med school.

We did have some stuff that was annoying and time consuming, but almost all of our actual classes were relevant to either our actual careers or boards.

 

[username456789]

Sounds like a lot of you would enjoy being PAs instead of physicians.

 

[kablemach2o]

I know several of the students who are in the 4 year portion of UMKC's curriculum (my SO worked with their spouses). They've said a large portion of that class is unbearably immature and that they mostly keep to themselves.

I just graduated from this program. If you ask any school's students, they will tell you that it's cliquey. It is cliquey, like every medical school, every workplace, etc. Of course they will say that most of their class is unbearably immature, because people are always more critical of their peers. You see posts on sdn and r/medicalschool about how people don't like the rest of your class, so I think this is a relatively common feeling. I'm sure there are some maturity differences, but what is the difference in maturity between 24 and 26?

The school you've mentioned also had a 21% attrition rate 2 years ago, and if you take out the first two years (the undergrad years), the attrition rate is still 15%, which says either there's a problem with the curriculum or the students they're accepting (data is in the first two hits when googling "UMKC med school attrition rate).

The high attrition rate of the 6 year program is a function of some mediocre students, and not a function of the school or curriculum. Because UMKC is a public school funded by the state government, it is required to take 60% of its students who are Missouri residents, which severely degrades the quality of its recruitment pool, simply because there are not 69 (0.6*115 incoming freshman) highly qualified Missouri high school students who did not get into better schools and choose to go to UMKC. The minimum ACT was 23 up until last year; now it is 26. UMKC accepts several students a year with the minimum ACT. Can you imagine someone with a 23 ACT going through medical school? The vast majority of the attrition is in in-state students, because the admissions standards are significantly lower than regional or out-of-state pools. Because of geographical restriction, the school is forced to matriculate students who would not make it through traditional premed weed out classes.

I felt the curriculum had its faults, but the difficulty and stress was not unreasonable.

 

[allantois]

If you were immature at 22, that's on you. Stop making assumptions about every 22 year old. The worst thing is when people think that there's only one right way of doing things.

 

[DocWinter]

If you were immature at 22, that's on you. Stop making assumptions about every 22 year old. The worst thing is when people think that there's only one right way of doing things.

If you graphed maturity and age, you'd get a pretty strong correlation. The vast majority of 22 YOs are immature, and medical school admissions, just like pretty much every other professional field guides itself on standards. This isn't a campaign against youth, but letting 18 YOs into a BS/MD program is a disaster

 

[Stagg737]

I just graduated from this program. If you ask any school's students, they will tell you that it's cliquey. It is cliquey, like every medical school, every workplace, etc. Of course they will say that most of their class is unbearably immature, because people are always more critical of their peers. You see posts on sdn and r/medicalschool about how people don't like the rest of your class, so I think this is a relatively common feeling. I'm sure there are some maturity differences, but what is the difference in maturity between 24 and 26?



The high attrition rate of the 6 year program is a function of some mediocre students, and not a function of the school or curriculum. Because UMKC is a public school funded by the state government, it is required to take 60% of its students who are Missouri residents, which severely degrades the quality of its recruitment pool, simply because there are not 69 (0.6*115 incoming freshman) highly qualified Missouri high school students who did not get into better schools and choose to go to UMKC. The minimum ACT was 23 up until last year; now it is 26. UMKC accepts several students a year with the minimum ACT. Can you imagine someone with a 23 ACT going through medical school? The vast majority of the attrition is in in-state students, because the admissions standards are significantly lower than regional or out-of-state pools. Because of geographical restriction, the school is forced to matriculate students who would not make it through traditional premed weed out classes.

I felt the curriculum had its faults, but the difficulty and stress was not unreasonable.

Those are fair points. However, you're just creating a better argument against letting 18 year olds enter combined programs for medical school. Look at pretty much every public medical school across the country that isn't a six year program and I guarantee you'll struggle to find even 1 that has an attrition rate of 20% or higher (if one even exists). The fact that they're choosing from a significantly smaller, and by your own admission lower quality, applicant pool which is leading to worse results only gives MORE evidence that letting younger students into medical school is a bad idea.

I cannot imagine someone with a 23 ACT going from high school straight into a curriculum with the difficulty of medical school. Frankly, I think that's just plain stupid and it blows my mind that any medical school would even consider those applicants. However, I do know plenty of people who scored mid-20's on their ACTs (or the equivalent for SATs) who went to med school in their mid-20's after they went to college and matured, then did very well. I know a few people at my school who fall into this category and are near the top of our class. I didn't know them in high school, but I would be willing to bet that letting them into med school 6-8 years earlier when they were coming straight out of high school would have probably been a complete disaster for them.

Like I said before, I don't think UMKC is a terrible med school by any means. However, there's clearly a problem with who they are accepting into the program if the curriculum is good and they're still having 1/5th of their students not make it to graduation day.

 

[iqe2010]

I guess the biggest issue I have with medicine is that a bachelors is required. I wish it were like pharmacy where all you need are the prerequisites + PCAT.

It should be a specific path that doesn't require regular core classes (history, government, etc), only math & science.

I'd even be in favor of some kind of entry exam that you have to take in order to get into a "pre-medicine" track.

 

[VA Hopeful Dr]

It should be a specific path that doesn't require regular core classes (history, government, etc), only math & science.

I'd even be in favor of some kind of entry exam that you have to take in order to get into a "pre-medicine" track.

That is a supremely bad idea, unless you want to have students that don't know anything outside of math and science.

 

[Jabbed]

That is a supremely bad idea, unless you want to have students that don't know anything outside of math and science.

I don't often go to the doctor, but when I do I prefer being seen by an English Lit major.

 

[VA Hopeful Dr]

I don't often go to the doctor, but when I do I prefer being seen by an English Lit major.

There is value in having a more broad-based education.

 

[WingedOx]

That is a supremely bad idea, unless you want to have students that don't know anything outside of math and science.

Seriously. People are seriously ok with physicians who don't even understand basic functions of government?

I don't often go to the doctor, but when I do I prefer being seen by an English Lit major.

And is it any more ridiculous that you'd think your dermatologist is more qualified because he took p-chem?

 

[cellsaver]

Teach to step 1 so students get high scores. Then teach to step 2 so that students do well on shelf and step 2. Nothing else matters.

in medical school they are done with you after Step 1 and you run through their skinner boxes for clinical rotations. IOW, there is no teaching to Step 2...

Medical school is a business just like everything else in America. Get em in, get em out. You teach yourself medicine by reading and studying while having the Faculty serve as guides, and Admins who run a money driven program for you to enter, push on the metal bar and take your pellet. churn and burn

People dont understand today that medicine is chiefly auto-didactic. The more you strive to circumvent that, the more Third Party Payers and Hospital Admins own you as their slaves.

Let's End The Enslavement Of Healthcare Providers

Unless if you end up being a physician with great medical skills, impressive medical knowledge and savvy business skills....then you run the show

Its really your call...

 

[cellsaver]

I obviously don't know how your school curriculum is structured... At my school, Histology and Cell biology is a 14-week course. We have community medicine, ethics and professionalism that take up a lot space...

Medical schools that wish to be accredited have little say about their curriculums. Additionally any entity that accepts Federal monies must comply with Fed Govt regulations for the industry to which that entity belongs.

e.g. dropping Professionalism from MD SOM curriculum isnt even an option

Thank the AAMC for that

We can throw as many stones as we like at our medical schools but the Admins have regulations and guidelines to follow that people way above their food chain set for them. If they want to see their medical school exist, they must follow the money. Sad but true

 

[Jabbed]

And is it any more ridiculous that you'd think your dermatologist is more qualified because he took p-chem?

You're 100% right, which is again why I think undergrad in general is just a waste of time and why I'm in favor of the 6 year model out of high school.

 

[Redpancreas]

Sorry I'm lost. Why is the discussion on medical school curriculum factoring in undergrad? I thought the point of undergrad was to explore personal interests, enjoy college, and maybe think about pursuing medicine/doing ECs/taking the MCAT etc. Seeing that nontraditional applicants are applying to medical school, I don't think college has much of a role in it besides traditionally overlapping with the usual journey to medical school. To me, the medical journey starts at orientation day at medical school and starting MS1.

Also eliminating undergrad is a bad idea. College isn't a stepping stone for medical school and some maturity development is needed.

It's absolutely a factor because medical school requires xyz credits to apply and a degree that usually takes 4 years before matriculation so there's no point hiding that fact that it is a pre-requisite. You could even say the mcat is now demanding more courses out of students limiting their flexibility.

I came into medical school as soon as possible and was debating graduating earlier and coming in a year earlier if possible. I agree that I would have been less-mature than the average student but that is because of the current norm. If you decreased the age, I firmly believe in our capacity to adjust to take on the challenge.

 

[Redpancreas]

in medical school they are done with you after Step 1 and you run through their skinner boxes for clinical rotations. IOW, there is no teaching to Step 2...

Medical school is a business just like everything else in America. Get em in, get em out. You teach yourself medicine by reading and studying while having the Faculty serve as guides, and Admins who run a money driven program for you to enter, push on the metal bar and take your pellet. churn and burn

People dont understand today that medicine is chiefly auto-didactic. The more you strive to circumvent that, the more Third Party Payers and Hospital Admins own you as their slaves.

Let's End The Enslavement Of Healthcare Providers

Unless if you end up being a physician with great medical skills, impressive medical knowledge and savvy business skills....then you run the show

Its really your call...

One of the best posts in a while

 

[VA Hopeful Dr]

One of the best posts in a while

Not really

 

[WingedOx]

One of the best posts in a while

actually, it was kind of idiotic...

 

[Redpancreas]

actually, it was kind of idiotic...

I mean, it's true that after second year, we're at the mercy of the hospital system we rotate at with minimal support and that most true learning is self directed. I skimmed over the slave stuff/etc. and suppose I didn't read the link.

 

[WingedOx]

You're 100% right, which is again why I think undergrad in general is just a waste of time and why I'm in favor of the 6 year model out of high school.

I mean, no offense, but when you post stuff like this...

More clinical =/= better clinician imo. In virtually all non-surgical fields I feel that you can, for the most part, get away with consulting out every problem so that overall ineptitude doesn't result in horrifically bad outcomes. Take a look at a medicine team in July and you'll be hard pressed to find a patient that doesn't have 1-2 specialists consulting. Essentially, you can skirt by in clinicals by deferring any actual decision-making to your superiors/specialists.

...which revolves around a fundamental misunderstanding of how the medical team functions, I can't really take seriously any suggestions about what is or isn't a "waste of time" with regard to medical education.