If you had the power of single-handedly changing one thing in medical education

[The Angriest Bird]

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What would you do?

I'd remove all curriculum that teaches people to be nice and professional. People who are already nice don't need them. Jerks won't change a bit even after 1000 hours of lectures.

Maybe another thing is to remove physics and calculus from pre-med curriculum.

 

[Dirt]

I would make it free.

 

[Ashers]

Get rid of Step 2 CS and all other OSCEs.

 

[da me ka don]

Make it $1000 per year!!!

 

[alfonzarel]

free med school to everyone accepted sounds good to me too.

maybe throw in a nice little stipend for rent and groceries, too.

 

[AmoryBlaine]

Get rid of Step 2 CS and all other OSCEs.

👍

Close second would be the removal of all the "communication skills" and "empathy" training.

 

[coffeebythelake]

I would make it free.

Yeah, the tuition for medical education today is quite exorbitant.

 

[Random Anesthesiologist]

I would make it free.

x 2

 

[penguinophile]

Eliminate PBL...just another excuse for med students to get bitchy and show each other up.

 

[koopa_troopa]

I would make it free.

Not just free, they should pay us to go.

But seriously one thing I would like to see all schools do is allow M1 and M2 to create their own electives for their own M4. I've looked through my schools clinical electives and there are certain areas I am interested that aren't offered.

 

[Dedikated2liftn]

I would make it free.

👍👍👍👍

If not free, something a lot more reasonable than what is currently asked (something closer to undergrad tuition rates).

 

[45408]

Since everyone else already suggested "free," I'd go ahead and get rid of useless paperwork. That affects the interns more than me, but I'll be an intern soon enough.

 

[NonTradMed]

Make it cheaper. If they want more primary care physicians, making tuition cheaper is a good way to encourage people to consider it. If people complain about he lack of diversity in medical school, making it cheaper may encourage students from lower economic standings to consider it.

 

[EMH]

I'd make our faculty provide streaming audio/video of our lectures. (something they're already capable of doing but don't by choice).

I'd make med school so that a married parent could actually barrow enough to live. And make it cheaper.

 

[badasshairday]

Definitely make it cheaper. The maximum tuition should be like 15-20k a year at the most expensive privates.

 

[mjl1717]

👍

Close second would be the removal of all the "communication skills" and "empathy" training.

Hmmm-Since Im not asleep at the wheel:

I could partially see getting rid of "empathy" training

But I was under the impression that nearly 80-90% of medicine is "communication skills"..

You often make good post.. 😕

 

[TexasTriathlete]

PE, recess, and nap time would be on the class schedule.

 

[Dirt]

PE, recess, and nap time would be on the class schedule.

OMG dodgeball during recess in med school would be the $hit.

 

[alfonzarel]

make the curriculum only contain pertinent information in regard to usmle boards and being a good doctor.

in other words, keep all of the useful minutae, but ****can all of the totally useless minutae that some of the profs make you memorize for the in-house exams.

 

[J Timberlake]

eliminate psych rounds... can't believe I have to pay to do that ****

 

[SomeDoc]

make the curriculum only contain pertinent information in regard to usmle boards and being a good doctor.

in other words, keep all of the useful minutae, but ****can all of the totally useless minutae that some of the profs make you memorize for the in-house exams.

Hear, hear.

 

[DickyV]

But seriously one thing I would like to see all schools do is allow M1 and M2 to create their own electives for their own M4. I've looked through my schools clinical electives and there are certain areas I am interested that aren't offered.

Most schools with which I'm familiar allow customized electives as long as you're willing to do the work to set them up. Do some research; I wouldn't be surprised if your school had this, too.

 

[indo]

PhDs only teach embryo, biochem, and anatomy. MDs the rest of the way.

 

[alfonzarel]

PhDs only teach embryo, biochem, and anatomy. MDs the rest of the way.

PhDs also taught us some physiology, some histo, some cell bio, some neuroscience, some behavioral sci, and probably some other stuff that i'm forgetting.

on the other hand, one of our anatomy profs was an MD and our main embryo guy was a mudphudd.

the only thing pure PhD was biochem.

the only things pure MD was physical diagnosis (rightfully so) and evidence based medicine.

...at our school anyway

 

[indo]

PhDs also taught us some physiology, some histo, some cell bio, some neuroscience, some behavioral sci, and probably some other stuff that i'm forgetting.

on the other hand, one of our anatomy profs was an MD and our main embryo guy was a mudphudd.

the only thing pure PhD was biochem.

the only things pure MD was physical diagnosis (rightfully so) and evidence based medicine.

...at our school anyway

Yeah...i know. I was making a suggestion. Minimize lecturing by researchers and maximizing lectures by physicians would be sweet. 26 hours of writing notes in a huge pool of estrogen has ruined my ability to communicate. ugg.

 

[AZhopeful]

PE, recess, and nap time would be on the class schedule.

During lunch we had a kickball league between the class communities in the early Fall. It was a fantastic way to act like an 8-y.o. while adjusting to the big scary medical school.

 

[Depakote]

During lunch we had a kickball league between the class communities in the early Fall. It was a fantastic way to act like an 8-y.o. while adjusting to the big scary medical school.

Ultimate Frisbee FTW.

 

[AmoryBlaine]

Hmmm-Since Im not asleep at the wheel:

I could partially see getting rid of "empathy" training

But I was under the impression that nearly 80-90% of medicine is "communication skills"..

You often make good post.. 😕

Is this a joke post? Medicine is 90% knowledge.

 

[alfonzarel]

Yeah...i know. I was making a suggestion. Minimize lecturing by researchers and maximizing lectures by physicians would be sweet. 26 hours of writing notes in a huge pool of estrogen has ruined my ability to communicate. ugg.

sorry, friend.

sheesh, i ******edly forgot which thread i was on and figured i'd share who taught what at my school...

 

[la petite mort]

All my classes so far taught by actual doctors and not researchers have been awesome. 👍

 

[mjl1717]

Is this a joke post? Medicine is 90% knowledge.

Well thats what I was going to say .. I thought You were cracking a joke!

Anyway if not 80 or 90% communication skill.. Id say a GREAT part of medicine is communication skills.. {Im sticking with my guns) I thought good communication was one of the differences between so-so physicians or layman and great physicians...

1) Good communication reassures patients, reassures superiors.
2)Good communication is work! (many take good communication for granted)
3)There is an art to communicating concisely, at the right time and not being misconstrued..
4) There could be times in internal medicine where the physician doesnt want to go into a patients room.. A great physician may be able to "click" on a switch and give a patient some encouragement..
5) I found out later that one of the best times to communicate is probably when one doesnt feel like communicating..
6)No offense but a non communicating doctor or inadequate communicating doctor would not be my private doctor.( I think many will agree)..
7) Olser himself was good friends with famous author and writer-Walt Whitman--[One of the reasons was to improve his writing and communications skills..]
8)Lincoln called the Great Communicator because not only would he tell his generals what to do, but he wrote the order down!
8)Communication is a "big deal" in medicine.. I think many will agree!

Geez🙂

 

[DoctorPardi]

Is this a joke post? Medicine is 90% knowledge.

I think there is something to be said for communication.

In my opinion you have to have both the knowledge to do what is needed but also the skills to get it done. In some specialties those skills may involve operating, diagnosing etc, but in almost all it requires the ability to convince your patient to do what you want them to do because it is in their best interest (either by taking their daily prescription or exercising or whatever the case may be).

Ultimately the goal of a good doctor should be improving the patient's quality of life and that will involve more than just the doctor doing something himself or telling the patient to do something. A doctor has to sell his therapy to the patient.

Take the case of a patient receiving oral antibiotics. Compare the doctor with poor communication skills to the one with good communication skills. Which doctor's patients comply with their prescriptions more often?

 

[Ashers]

I think there is something to be said for communication.

In my opinion you have to have both the knowledge to do what is needed but also the skills to get it done. In some specialties those skills may involve operating, diagnosing etc, but in almost all it requires the ability to convince your patient to do what you want them to do because it is in their best interest (either by taking their daily prescription or exercising or whatever the case may be).

Ultimately the goal of a good doctor should be improving the patient's quality of life and that will involve more than just the doctor doing something himself or telling the patient to do something. A doctor has to sell his therapy to the patient.

Take the case of a patient receiving oral antibiotics. Compare the doctor with poor communication skills to the one with good communication skills. Which doctor's patients comply with their prescriptions more often?

Those classes that try to teach communication skills are such a waste of time though. I think that seems to be the point. It's a little easier than teaching empathy. If a person is in their 20s to whatever, it's going to be difficult to teach them communication skills if they don't already have them set.

Teaching what goes in a basic interview is fine -- I sure didn't know that starting med school even though I had been to the doctor numerous times. My school did it in a waste of time way.

 

[MonkeyNuts!]

only allow chicks who are hot to be admitted

sadly this probably means the entire physician force of the US will end up male...

 

[rachmoninov3]

In a perfect world...
Have the whole damn thing, premed and med school be fashioned after one of those old time nursing programs my grandmother graduated from (but without daily mass and nuns):

Undergrand
Lectures in the AM, then inpatient or clinic in the afternoon as a lowly tech, candy striper, etc. (believe me, the actually patient work will weed out more people than ochem or physics)
Two choices for BS: BSN, or BS in science depending on the student's interests.
Med school
Lectures in the AM, work as RN or in a lab in the afternoon for the first two years.
By clerkships, a lot of the SCUT will be cut down, or at least not "new" and more time can be spent on medicine.

This way you get rid of all the touchy feely lecture classes, and have actual experience instead. Lectures won't change the @ssh*les, and if anything has a chance of actually doing that, it's experience.

 

[DoctorPardi]

Those classes that try to teach communication skills are such a waste of time though. I think that seems to be the point. It's a little easier than teaching empathy. If a person is in their 20s to whatever, it's going to be difficult to teach them communication skills if they don't already have them set.

Teaching what goes in a basic interview is fine -- I sure didn't know that starting med school even though I had been to the doctor numerous times. My school did it in a waste of time way.

Ok well I understand that. Yeah maybe the current system by which schools are trying to push empathy and communication on us isn't effective. However I don't think you can discredit communication even if it isn't being taught well now.

 

[OncoCaP]

I can't think of anything I would change. I even like the PBL, communication, and empathy classes (and other classes as well). Oh well, I guess that's a good thing. Our medical school is very reasonable in cost as well thanks to a bunch of state money.

 

[Dedikated2liftn]

only allow chicks who are hot to be admitted

sadly this probably means the entire physician force of the US will end up male...

 

[leechy]

Eliminate first and fourth year, do second year, then third year, then more of second year, so that you can see diseases and get a sense of what the big problems in medicine are, then go back and study them again.

Change grading to be less subjective, and decrease amount of time spent in the hospital (though obviously a lot of time should still be spent in the hospital - I just don't see the utility of doing TONS of call nights that mess with your circadian rhythm and make it difficult to actually study and learn anything).

 

[leechy]

Ok well I understand that. Yeah maybe the current system by which schools are trying to push empathy and communication on us isn't effective. However I don't think you can discredit communication even if it isn't being taught well now.

Yeah I think some communication skill training is important. For example, not all of us have had to deliver bad news to people in our previous non-medical lives, and it's good to have a few stock phrases in mind to spout when the situation arises.

 

[Trismegistus4]

I agree with those who would get rid of the touchy-feely/communication/empathy/liberalism curricula. I'd keep some discussion of traditional medical ethics, but throw out all the liberal BS about "cultural sensitivity," offering minors contraceptives without their parents' permission, changing terminology (e.g., "adherence" vs. "compliance") to appear more "patient-centered," wearing white coats and asking people to call us "doctor" allegedly being intimidating, etc.

Of course, it could very well be that the simple change of ceasing to admit women into the profession would take care of all of that as a downstream effect.

 

[AmoryBlaine]

I think there is something to be said for communication.

In my opinion you have to have both the knowledge to do what is needed but also the skills to get it done. In some specialties those skills may involve operating, diagnosing etc, but in almost all it requires the ability to convince your patient to do what you want them to do because it is in their best interest (either by taking their daily prescription or exercising or whatever the case may be).

Ultimately the goal of a good doctor should be improving the patient's quality of life and that will involve more than just the doctor doing something himself or telling the patient to do something. A doctor has to sell his therapy to the patient.

Take the case of a patient receiving oral antibiotics. Compare the doctor with poor communication skills to the one with good communication skills. Which doctor's patients comply with their prescriptions more often?

1. I don't know the answer to that last question, have you any data?

2. I'm not saying that doctors with poor communication skills are the ideal.

3. If you have excellent knowledge and subpar communication skills you can be a great doctor. If you have subpar knowledge you can have communication skills that are off the chart but all you are is a nice person.

4. We need to give patients more credit in these discussions of empathetic physicians. If I as a rational adult go see a doctor and am told that I have high blood pressure and should take HCTZ then I should take it. If I decide in my own mind that Dr. X seemed mean or that he didn't connect with me and then use THAT as an excuse not to take medication to control my BP what have I accomplished?

4.1. The other side of this is the argument that nice doctors "get more" out of patients when doing H&Ps - once again give patients some credit! If I go into the ED with abdominal pain and decide to withold from the doctor my history of Crohn's because I don't feel like he established rapport I have hurt only myself. I am responsible for conveying to the physician my medical information, s/he is not responsible for dragging it out of me. Doctor patient relationships cut both ways!

 

[Lokhtar]

Of course, it could very well be that the simple change of ceasing to admit women into the profession would take care of all of that as a downstream effect.

Haha, what?

 

[PeepshowJohnny]

Of course, it could very well be that the simple change of ceasing to admit women into the profession would take care of all of that as a downstream effect.

Don't feed the trolls.

 

[Blesbok]

Well thats what I was going to say .. I thought You were cracking a joke!

Anyway if not 80 or 90% communication skill.. Id say a GREAT part of medicine is communication skills.. {Im sticking with my guns) I thought good communication was one of the differences between so-so physicians or layman and great physicians...

1) Good communication reassures patients, reassures superiors.
2)Good communication is work! (many take good communication for granted)
3)There is an art to communicating concisely, at the right time and not being misconstrued..
4) There could be times in internal medicine where the physician doesnt want to go into a patients room.. A great physician may be able to "click" on a switch and give a patient some encouragement..
5) I found out later that one of the best times to communicate is probably when one doesnt feel like communicating..
6)No offense but a non communicating doctor or inadequate communicating doctor would not be my private doctor.( I think many will agree)..
7) Olser himself was good friends with famous author and writer-Walt Whitman--[One of the reasons was to improve his writing and communications skills..]
8)Lincoln called the Great Communicator because not only would he tell his generals what to do, but he wrote the order down!
8)Communication is a "big deal" in medicine.. I think many will agree!

Geez🙂

Good communication doesn't cure patients. It helps get info for the diagnosis, but it doesn't make the diagnosis. I would rather have someone slap me everytime they walk in the room and save my life than make me feel like they are the greatest person on earth and then let me die.

They are not mutually exclusive, but you get my point.

 

[Blesbok]

I would make me king of medicine. Whatever I say goes. If I say candycorn cures cancer, it suddenly works.