Med School is Broken

[Perrotfish]

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Oh that's easy... UG gets you to be able to think. Obviously, it's not a perfect process, given the number of anti-vax people and devotees' of herbalism out there.


There's a reason why college grads make ~$1 million more over thier lifetime than those with a degree.

Again, medical students have at least 4 years of real, relevant **** to learn. They can learn 'to think' while they learn physiology and anatomy, rather than 3 years of liberal arts drivel and useless premedical requirements like Ochem. Even if you buy into the idea that undergraduate degrees provide personal growth (an idea that has been disputed) we have enough material for an undergraduate degree.

Before I did this I was an engineer: another licensed, life and death profession. Somehow, even though we studied engineering from the first day of undergrad rather than slogging through a preliminary degree in art history, the world did not fall off of its axis. For that matter every other first world country has students beginning medical school straight out of high school, and they do just fine.

We have about 3 useless years in undergrad, and about 1.5 useless years in medical school. Get rid of those years. Take everything useful in medical school and undergrad and make that the undergrad degree. Take residency and call it medical school. Engineers, computer programs, accountants, and military officers are all capable of learning to think while studying their actual profession, doctors can do the same.

 

[mehc012]

Again, medical students have at least 4 years of real, relevant **** to learn. They can learn 'to think' while they learn physiology and anatomy, rather than 3 years of liberal arts drivel and useless premedical requirements like Ochem. Even if you buy into the idea that undergraduate degrees provide personal growth (an idea that has been disputed) we have enough material for an undergraduate degree.

Before I did this I was an engineer: another licensed, life and death profession. Somehow, even though we studied engineering from the first day of undergrad rather than slogging through a preliminary degree in art history, the world did not fall off of its axis. For that matter every other first world country has students beginning medical school straight out of high school, and they do just fine.

We have about 3 useless years in undergrad, and about 1.5 useless years in medical school. Get rid of those years. Take everything useful in medical school and undergrad and make that the undergrad degree. Take residency and call it medical school. Engineers, computer programs, accountants, and military officers are all capable of learning to think while studying their actual profession, doctors can do the same.

And again, organic chem is hardly useless, as in my opinion truly understanding a dynamic equilibrium and the basics of how molecules like to interact is the underpinning of all of biochem and pharm. More to the point, you really don't have enough material for an undergraduate degree. Seriously, medicine does not cover as much as everyone pretends it does. Med school has yet to show me anything mind-bogglingly new beyond what I learned in a part-time set of undergraduate evening courses, combined with scribing, all over the course of 1.5yrs. Now, if we expanded med school to actually teach a useful amount of material, maybe that would be better done with a 4yr undergrad program in place of 2yrs in med school. It would be difficult to work out how to fit this in with the otherwise-flexible nature of undergraduate education in the US, but sure.

I agree that the clinical years seem to have been dumbed down to the point of uselessness. It really irks me that I had a better learning experience and more access to charts as a premed scribe...hell, I was more useful as a scribe, instead of being dead weight as a med student. But liability is king, I suppose.

 

[Nucleophile1]

And again, organic chem is hardly useless, as in my opinion truly understanding a dynamic equilibrium and the basics of how molecules like to interact is the underpinning of all of biochem and pharm. More to the point, you really don't have enough material for an undergraduate degree. Seriously, medicine does not cover as much as everyone pretends it does. Med school has yet to show me anything mind-bogglingly new beyond what I learned in a part-time set of undergraduate evening courses, combined with scribing, all over the course of 1.5yrs. Now, if we expanded med school to actually teach a useful amount of material, maybe that would be better done with a 4yr undergrad program in place of 2yrs in med school. It would be difficult to work out how to fit this in with the otherwise-flexible nature of undergraduate education in the US, but sure.

I agree that the clinical years seem to have been dumbed down to the point of uselessness. It really irks me that I had a better learning experience and more access to charts as a premed scribe...hell, I was more useful as a scribe, instead of being dead weight as a med student. But liability is king, I suppose.

I'm curious which undergrad you attended and what classes you took. I'm in my first semester of medical school and the majority of the information being presented to me is brand new.

 

[libertyyne]

I'm curious which undergrad you attended and what classes you took. I'm in my first semester of medical school and the majority of the information being presented to me is brand new.

I never took anatomy or histo , immuno or embryo in UG so all of this information is new. I am sure Anatomy and immuno will be necessary building blocks going forward. histo and embryo on the other hand...

 

[libertyyne]

And again, organic chem is hardly useless, as in my opinion truly understanding a dynamic equilibrium and the basics of how molecules like to interact is the underpinning of all of biochem and pharm. More to the point, you really don't have enough material for an undergraduate degree. Seriously, medicine does not cover as much as everyone pretends it does. Med school has yet to show me anything mind-bogglingly new beyond what I learned in a part-time set of undergraduate evening courses, combined with scribing, all over the course of 1.5yrs. Now, if we expanded med school to actually teach a useful amount of material, maybe that would be better done with a 4yr undergrad program in place of 2yrs in med school. It would be difficult to work out how to fit this in with the otherwise-flexible nature of undergraduate education in the US, but sure.

I agree that the clinical years seem to have been dumbed down to the point of uselessness. It really irks me that I had a better learning experience and more access to charts as a premed scribe...hell, I was more useful as a scribe, instead of being dead weight as a med student. But liability is king, I suppose.

why not continue to work or do research if this is all easy. Not everyone takes the same classes you did that overlap with medical education.

 

[Rekt]

And again, organic chem is hardly useless, as in my opinion truly understanding a dynamic equilibrium and the basics of how molecules like to interact is the underpinning of all of biochem and pharm. More to the point, you really don't have enough material for an undergraduate degree. Seriously, medicine does not cover as much as everyone pretends it does. Med school has yet to show me anything mind-bogglingly new beyond what I learned in a part-time set of undergraduate evening courses, combined with scribing, all over the course of 1.5yrs. Now, if we expanded med school to actually teach a useful amount of material, maybe that would be better done with a 4yr undergrad program in place of 2yrs in med school. It would be difficult to work out how to fit this in with the otherwise-flexible nature of undergraduate education in the US, but sure.

I agree that the clinical years seem to have been dumbed down to the point of uselessness. It really irks me that I had a better learning experience and more access to charts as a premed scribe...hell, I was more useful as a scribe, instead of being dead weight as a med student. But liability is king, I suppose.

You're a joke.

 

[UGA Non Trad]

And again, organic chem is hardly useless, as in my opinion truly understanding a dynamic equilibrium and the basics of how molecules like to interact is the underpinning of all of biochem and pharm. More to the point, you really don't have enough material for an undergraduate degree. Seriously, medicine does not cover as much as everyone pretends it does. Med school has yet to show me anything mind-bogglingly new beyond what I learned in a part-time set of undergraduate evening courses, combined with scribing, all over the course of 1.5yrs. Now, if we expanded med school to actually teach a useful amount of material, maybe that would be better done with a 4yr undergrad program in place of 2yrs in med school. It would be difficult to work out how to fit this in with the otherwise-flexible nature of undergraduate education in the US, but sure.

I agree that the clinical years seem to have been dumbed down to the point of uselessness. It really irks me that I had a better learning experience and more access to charts as a premed scribe...hell, I was more useful as a scribe, instead of being dead weight as a med student. But liability is king, I suppose.

/r/iamverysmart

 

[Iz_FtB]

Some fantastic potential NPs up in here.

 

[libertyyne]

Some fantastic potential NPs up in here.

 

[mehc012]

/r/iamverysmart

How smart I am or am not changes nothing about the fact that it doesn't take an entire degree's worth of undergrad courses to equal what is learned in medical school.

 

[Goro]

Again, medical students have at least 4 years of real, relevant **** to learn. They can learn 'to think' while they learn physiology and anatomy, rather than 3 years of liberal arts drivel and useless premedical requirements like Ochem. Even if you buy into the idea that undergraduate degrees provide personal growth (an idea that has been disputed) we have enough material for an undergraduate degree.

Before I did this I was an engineer: another licensed, life and death profession. Somehow, even though we studied engineering from the first day of undergrad rather than slogging through a preliminary degree in art history, the world did not fall off of its axis. For that matter every other first world country has students beginning medical school straight out of high school, and they do just fine.

We have about 3 useless years in undergrad, and about 1.5 useless years in medical school. Get rid of those years. Take everything useful in medical school and undergrad and make that the undergrad degree. Take residency and call it medical school. Engineers, computer programs, accountants, and military officers are all capable of learning to think while studying their actual profession, doctors can do the same.

One of the things worthy about college that I forgot to mention is that you also learn how to learn.

It sounds like you're advocating the European model of the 6-year medical curriculum. That may work fine for Europeans, but Americans are not Europeans. I dread the idea of some 20,000 18-19 year olds entering med school. We're talking about people who barely know they're alive. much less really understand what they're getting into. They're all at the stage of wanting to be pediatric cardioneurosurgeons!

 

[Lawpy]

One of the things worthy about college that I forgot to mention is that you also learn how to learn.

It sounds like you're advocating the European model of the 6-year medical curriculum. That may work fine for Europeans, but Americans are not Europeans. I dread the idea of some 20,000 18-19 year olds entering med school. We're talking about people who barely know they're alive. much less really understand what they're getting into. They're all at the stage of wanting to be pediatric cardioneurosurgeons!

This is strange because many people don't exactly "learn how to learn" in college or they even develop bad learning habits (like cramming), and yet they somehow do well enough to have a good GPA, nail the MCAT, and get into medical school. If anything, I think learning actually begins in medical school.

 

[Nucleophile1]

One of the things worthy about college that I forgot to mention is that you also learn how to learn.

It sounds like you're advocating the European model of the 6-year medical curriculum. That may work fine for Europeans, but Americans are not Europeans. I dread the idea of some 20,000 18-19 year olds entering med school. We're talking about people who barely know they're alive. much less really understand what they're getting into. They're all at the stage of wanting to be pediatric cardioneurosurgeons!

I agree. Also, there is no way that this model would be feasible in the United States without overhauling public high school education. At my undergrad, we had a lot of foreign exchange students and athletes (many of them from Europe) and they would comment that the things they were currently being taught were things that they learned in high school. The European education system is vastly different than the education system in the United States.

 

[Goro]

This is strange because many people don't exactly "learn how to learn" in college or they even develop bad learning habits (like cramming), and yet they somehow do well enough to have a good GPA, nail the MCAT, and get into medical school. If anything, I think learning actually begins in medical school.

Maintaining good GPAs shows that these successful kids have learned how to learn. They did so in college. Maybe they did so in high school, but I'll bank on college.

The key thing about the switch to med school is something you of all people should know about...the problem isn't the learning per se, it's dealing with the flood of material from the fire hose.

I agree that not everyone learns how to learn in college...and these people don't become doctors. Or have to do an SMP.

 

[Lawpy]

Maintaining good GPAs shows that these successful kids have learned how to learn. They did so in college. Maybe they did so in high school, but I'll bank on college.

The key thing about the switch to med school is something you of all people should know about...the problem isn't the learning per se, it's dealing with the flood of material from the fire hose.

I agree that not everyone learns how to learn in college...and these people don't become doctors. Or have to do an SMP.

Right and that’s where efficient study habits matter to do well in med school. It’s impossible to do well simply by cramming all the material last minute and spitting them out in exams (not to mention it’s setting up for disaster for boards). But it’s possible to get a good GPA by cramming stuff.

Getting a good MCAT score is something different and not achieved by cramming, so I guess the study habits involved in excelling in the MCAT prepare for doing well in med school.

 

[Stagg737]

Honestly that's just losing perspective of how education works. At each level a foundation is laid. At each successive level you use maybe a small amount of what your previously learned to build on a new level of knowledge. You forget the other 95%+ information from the previous step. Hopefully you recall some that possibly may become useful or at least give you a starting place to look stuff up.

I don't see your attitude as cynical. Just fatigued from the grind that is the never-ending process of medical education/adult learning. We all have been there (and may well be again).

If you're forgetting 95%+ of the information from the previous step, then you're in an unnecessarily inefficient system.

How is it different that any other education? By your logic nearly all education is stupid. Why learn about sedimentary rocks or literature? Why not start studying medicine in Kindergarten?

I think some people have wildly unreasonable expectations about medical school. If you think that medical school or anything else in higher education/adult learning is going to be high yield you're way off base.

Even in practice you may spend half an hour reading a journal article that gives you 1-2 useful points to integrate into practice.

I feel ridiculous saying this, because I am a millennial too, but medicine and medical education are not supposed to be fun or easy. There's a lot of drudgery and tedium in it.

The stage of education matters. In elementary school, you should be exposed to as much as possible to explore various areas of interest and this should continue throughout high school. If kids aren't exposed to various knowledge in school, chances are they won't be exposed at all. Imo, college is when those areas of interest are refined to figure out what you want to do in your career and gain the foundational knowledge needed to enter that field. By the time you reach medical school, you should already have all the basic science knowledge you need to succeed as a physician and should be focused on helping you narrow what field you're entering. Yes, this means learning some info you may not need, but the extent and depth to which we learn that info is what's inefficient and frankly unnecessary.

Additionally, there's info that we don't learn or isn't emphasized enough in med school that absolutely should be. 99% of docs are never going to need to know which genetic loci a mutation takes place at to cause X disease, but everyone should know how to read films. As Libertyne said, most of us don't need to know how to differentiate minute details of tissues on stains, but the number of docs I've encountered who know almost nothing about any psych med blows my mind. As Perrotfish said, the core curriculum for medical school needs to be updated to what is relevant to modern day physicians instead of what's easy and brings in money for administrations.

I'm curious which undergrad you attended and what classes you took. I'm in my first semester of medical school and the majority of the information being presented to me is brand new.

I actually feel pretty similarly to Meh about my first year of med school. My curriculum is systems based making 2 passes on each system. First year we cover all systems with a focus on anatomy and physiology, second year was (mostly) the same systems with a focus on pharm, path, and clinical medicine. I learned almost nothing new during my first year of med school outside of embryo (which I think is minimally useful for most physicians). Took all the typical med school pre-reqs plus anatomy, neuroanatomy, and biochem and a bunch of medically irrelevant electives.

That being said I learned a ton second year when we got into path and clinical medicine, but still feel like I could have legitimately jumped straight into second year and completely skipped all but the last section of first year at my school.

 

[Perrotfish]

One of the things worthy about college that I forgot to mention is that you also learn how to learn.

And the reason why I didn't need to 'learn how to learn' before I could learn engineering was...?

That may work fine for Europeans, but Americans are not Europeans. !

How about we let American students decide what works for Americans?

We're talking about people who barely know they're alive. much less really understand what they're getting into.

So they're old enough to decide to take out hundreds of thousands in non dischargeable debt to pay you, and they're old enough to join to military to defend you, but they're not old enough to decide they don't need you?

 

[68PGunner]

I wish that I was told about the magical Anki-pan product from Japan. If I had known about this cheat code back in college, I would have aced all of my college classes w/ minimal effort and scored at least a 34 MCAT.

We can move into a European style med school education with all kids being given the Zanki decks and the Anki app on the first day of orientation.

 

[VA Hopeful Dr]

And the reason why I didn't need to 'learn how to learn' before I could learn engineering was...?


How about we let American students decide what works for Americans?


So they're old enough to decide to take out hundreds of thousands in non dischargeable debt to pay you, and they're old enough to join to military to defend you, but they're not old enough to decide they don't need you?

Letting students decide seems unwise. It would be better to let those who have graduated decide.

 

[hopefulERdoc251]

I've seen a lot of faculty argue that Step 1 prep resources aren't enough to excel, and therefore traditional courses are needed. But really, the current Step 1 resources are so efficient and well organized, that if we wasted less time watching lecture to learn material for our school specific exams, those companies could double or triple the content they cover (since students would actually have time to go through all of it thoroughly) and we would all be learning more material and more easily. I think it's possible for med schools to reach the level of quality or at least approximate the level of quality that these resources achieve, but they don't seem to care to do so since students will just bust their ass to do as well as they can and thus the vast majority are still doing well even if they could be doing better.

This is largely the same contention at my school. The basic sciences find the need to delve into the minutiae of sciences, much like other schools. The problem is that when there's that much information to learn, we need to figure out what's important and what isn't, aka the "high yield". But this also serves as a conundrum. It would be amazing to learn only high yield stuff but if everybody did that and exams were solely based on that, everybody would score >85%. Thereby that's why (or at least that's what we're told), there needs to be some emphasis on detail.

Though, the counterargument that clinical faculty at our school have stated is that well, when's student A going to need to know the molecular appearance of an IgA molecule, or when will a student need to have an appreciation of the crystalline structure of IgE. So to prove a point, what a few clinical faculty at my school decided (aka the pharmacist, the pathologist, and one retired trauma surgeon) decided to do was take STEP1 (granted it was a group test that they took - don't ask me how, I don't know). They collectively scored above national average despite not being in the basic sciences for >15-20 years. They utilized their clinical skills and clinical science application that they've used in everyday life as clinicians.

I would be interested to see a study like this done to examine the efficacy of the rigorous basic sciences curriculum compared to a more clinically oriented curriculum. I do agree that the medical education system needs a large overhaul, especially since many students are transitioning from lectures to resources such as Pathoma, DIT, Boards and Beyond, Kaplan as a PRIMARY SOURCE of learning. Part of this is the emphasis that STEP1/2 is taking in residency applications, and some of it is the real **** instruction at school.

 

[hopefulERdoc251]

This I don't fully agree with...organic chem and biochem directly underly everything in pharm and med school biochem.

But then, I suppose we're arguing opposites anyway. You're arguing they should teach us less, I'm frustrated that they're not giving us enough.

Ok I understand your point. But at the same time, that reductionist approach isn't the way to go IMO. Sure, there are very rudimentary principles one must understand in biochem to understand pharm and path(i.e how a GCPR, voltage gated channel, antagonist/agonism/etc work). But to think that many of those principles are important in understanding the higher up levels like path/pharm I think is a little OD.

 

[neoevolution]

I disagree with the first and last paras as it all of your basics goes into being Legos. You need a foundation if you want to build anything.

But the bolded is so spot on I want to scream! I get annoyed to no end that my students have to learn about bacterial lab tests when none of them will ever set foot in a clinical lab, and all they have to do in the future is take a specimen, submit it, and wait for the lab to make an ID.

A lot of preclinical pathology we learn is weird because I can't even view the images on my rotations even I wanted to. Having us memorize histological appearances of certain cancer types really seems useless, and we don't get beyond the buzzword level of understanding to

Again, medical students have at least 4 years of real, relevant **** to learn. They can learn 'to think' while they learn physiology and anatomy, rather than 3 years of liberal arts drivel and useless premedical requirements like Ochem. Even if you buy into the idea that undergraduate degrees provide personal growth (an idea that has been disputed) we have enough material for an undergraduate degree.

Before I did this I was an engineer: another licensed, life and death profession. Somehow, even though we studied engineering from the first day of undergrad rather than slogging through a preliminary degree in art history, the world did not fall off of its axis. For that matter every other first world country has students beginning medical school straight out of high school, and they do just fine.

We have about 3 useless years in undergrad, and about 1.5 useless years in medical school. Get rid of those years. Take everything useful in medical school and undergrad and make that the undergrad degree. Take residency and call it medical school. Engineers, computer programs, accountants, and military officers are all capable of learning to think while studying their actual profession, doctors can do the same.

The problem is that med schools are convinced there's a maturity crisis, and we need diverse non-trads and an average class age in the mid 20s to fix it, despite most other countries taking doctors straight from high school and doing just fine.

 

[hopefulERdoc251]

A lot of preclinical pathology we learn is weird because I can't even view the images on my rotations even I wanted to. Having us memorize histological appearances of certain cancer types really seems useless, and we don't get beyond the buzzword level of understanding to


The problem is that med schools are convinced there's a maturity crisis, and we need diverse non-trads and an average class age in the mid 20s to fix it, despite most other countries taking doctors straight from high school and doing just fine.

TBH, this isn't wrong lol. I look at my class and the younger people especially and they are all complainers (myself included). The class below me, which is younger, is even worse. To the point where some faculty are afraid to teach them because they're scared of getting backlash due to the spoiled mentality. The older people in my class definitely have a unique perspective on life in general, different than those who went through schooling 4 years and then med school. That type of maturity 1) can't be understood by somebody who doesn't have that life experience (you and I), and 2) is something that is invaluable in a field like this where we all have to deal with some **** everyday.

 

[mehc012]

Ok I understand your point. But at the same time, that reductionist approach isn't the way to go IMO. Sure, there are very rudimentary principles one must understand in biochem to understand pharm and path(i.e how a GCPR, voltage gated channel, antagonist/agonism/etc work). But to think that many of those principles are important in understanding the higher up levels like path/pharm I think is a little OD.

Sure, sure...but if I didn't really, truly understand the main underpinnings of Orgo - dynamic equilibrium as the basis for all molecular interactions, and the basics of what kinds of molecules like to interact with one another - I would have had a much harder time in pharm and biochem. Understanding dynamic equilibrium is how you understand the fuzzy edges of all of these fields, and to me, it's the only thing that even remotely made clearance and half lives and other pharm principles make sense.

Perhaps my med school did a good job of weeding out the stuff you guys are talking about as irrelevant, because I honestly don't think we need to be cutting stuff; if anything, we should be adding to it.

 

[Perrotfish]

TBH, this isn't wrong lol. I look at my class and the younger people especially and they are all complainers (myself included). The class below me, which is younger, is even worse. To the point where some faculty are afraid to teach them because they're scared of getting backlash due to the spoiled mentality. The older people in my class definitely have a unique perspective on life in general, different than those who went through schooling 4 years and then med school.

The issue is that you don't mature with age, but rather with responsibility. MSIII - R3 is very specifically designed to take a spoiled (wo)manchild and mature him/her through exposure to gradually increasing levels of responsibility. You don't need to be mature to start, the entire process is designed to get you there starting from scratch. Similarly no amount of time in a responsibility free enviornment (undergrad) will ever mature anyone. It just makes you older and poorer.

 

[theonlytycrane]

I feel like I am learning minutiae that will be lost in neurons culled in a few years. I dont feel challenged, just annoyed that they are making me memorize stuff that is easily accessible over a phone. The only part of my brain that is being challenged is the regurgitation part, and the ability to sit for x amount of hours part.

I guess this is my personal observation and perhaps very school dependent. I am not being challenged to apply information being thrown at me. My exams are not conceptual in nature, rather they require regurgitation of facts to rule out wrong answers and select the correct ones. I am not being taught to apply the scientific method to problems, or clinical reasoning , or even methodological thinking . I have a graduate degree in an unrelated feild and I can safely say that even though the coursework was not as rigorous, its impact on changing the way I think was substantial. It lead to me trying to solve problems in a more systematic fashion. I do not believe I am getting that currently at my school, maybe I will look back and think differently but currently in the midst of it I just feel like a glorified stick of RAM , where my memory is temporary and it will be completely dumped once I move on to the next subject.

Also a M1 and I resonate with this so much.

 

[mehc012]

I'm curious which undergrad you attended and what classes you took. I'm in my first semester of medical school and the majority of the information being presented to me is brand new.

My undergrad wasn't where I learned most of it...I was an organic chemistry major and bio minor, at a school where none of the exams for science courses were ever multiple choice. I now go to a medical school where none of the exams are multiple choice, so I guess my undergrad was good preparation for that. There, I took biochem, immuno, microbio, etc...the usual suspects, nothing super pertinent.

However, when I decided I was going to go to med school, I needed GPA repair, and since I had just discovered I was interested in medicine, my GPA repair classes included Anatomy, Physiology, Med Micro, Hematology, Cardiac and Respiratory physio, Cancer Biology, Neuroscience, etc. All undergrad level, all evening courses while I was working.

why not continue to work or do research if this is all easy. Not everyone takes the same classes you did that overlap with medical education.

I do plenty outside of med school, most of it far less productive than what you suggest, sadly. And you're right; they have to assume that everyone starts without those courses, or else they'd have to require them. My point was that there's no need to turn med school preclinicals into 4+ years of classroom material. Sure, they throw it at us fast, but you can't just spread it out into undergrad and call that a full degree; it's not 4yrs worth of material.

I dunno, it mostly just sounds like my med school handles things differently. As I said, we don't have multiple choice tests, so they don't really focus on keyword association or brute force memorization. We have essay tests where we are forced to apply the concepts and generate differentials and discuss which empiric therapies we would start given the patient presentation, or what we'd expect the labs to show us. They don't care if we remember which medium TB grows on so much as whether it comes up in our reasoning at the right times in the right patients, and that we rule it in or out appropriately. So just...different. It makes me worried about Step, honestly, since Step is all multiple choice and memorization and keywords, and I haven't spent the past 2yrs doing those things. But in other ways, it's pretty cool.

 

[pstrick]

the problem isn't the learning per se, it's dealing with the flood of material from the fire hose.

I disagree with this.

It's not a flood from a fire hose. That implies a coherent stream. I would describe it as picking up pennies off concrete while somebody is throwing handfuls on the ground.
You're not really sure why they're throwing pennies, you're n0t really sure if there's any point in picking them up, and any questioning of the system gets the same two answers: "You'll understand later" or "This is what I had to go through so suck it up."

Exams are just an accounting of the pennies that you were able to pick up. Even though each penny is just as unremarkable as the next, professors chose 50 pennies and expect that you picked those pennies out of all the other identical coins.

 

[Nucleophile1]

My undergrad wasn't where I learned most of it...I was an organic chemistry major and bio minor, at a school where none of the exams for science courses were ever multiple choice. I now go to a medical school where none of the exams are multiple choice, so I guess my undergrad was good preparation for that. There, I took biochem, immuno, microbio, etc...the usual suspects, nothing super pertinent.

However, when I decided I was going to go to med school, I needed GPA repair, and since I had just discovered I was interested in medicine, my GPA repair classes included Anatomy, Physiology, Med Micro, Hematology, Cardiac and Respiratory physio, Cancer Biology, Neuroscience, etc. All undergrad level, all evening courses while I was working.

You definitely took a lot of classes that I and many others did not take. It makes more sense now why you feel frustrated.

Prior to medical school, I never even took immuno or microbio. I strictly took pre-reqs and that was it.

 

[VincentAdultman]

My undergrad wasn't where I learned most of it...I was an organic chemistry major and bio minor, at a school where none of the exams for science courses were ever multiple choice. I now go to a medical school where none of the exams are multiple choice, so I guess my undergrad was good preparation for that. There, I took biochem, immuno, microbio, etc...the usual suspects, nothing super pertinent.

However, when I decided I was going to go to med school, I needed GPA repair, and since I had just discovered I was interested in medicine, my GPA repair classes included Anatomy, Physiology, Med Micro, Hematology, Cardiac and Respiratory physio, Cancer Biology, Neuroscience, etc. All undergrad level, all evening courses while I was working.


I do plenty outside of med school, most of it far less productive than what you suggest, sadly. And you're right; they have to assume that everyone starts without those courses, or else they'd have to require them. My point was that there's no need to turn med school preclinicals into 4+ years of classroom material. Sure, they throw it at us fast, but you can't just spread it out into undergrad and call that a full degree; it's not 4yrs worth of material.

I dunno, it mostly just sounds like my med school handles things differently. As I said, we don't have multiple choice tests, so they don't really focus on keyword association or brute force memorization. We have essay tests where we are forced to apply the concepts and generate differentials and discuss which empiric therapies we would start given the patient presentation, or what we'd expect the labs to show us. They don't care if we remember which medium TB grows on so much as whether it comes up in our reasoning at the right times in the right patients, and that we rule it in or out appropriately. So just...different. It makes me worried about Step, honestly, since Step is all multiple choice and memorization and keywords, and I haven't spent the past 2yrs doing those things. But in other ways, it's pretty cool.

I can only speak for myself but I didn't take immunology, medical micro, ANY physiology, neuroscience, or hematology until I was in medical school.

I mean what you listed between your UG and postbacc is a pretty decent course load.

 

[Brahnold Bloodaxe]

It's not just medical school that is broken. The very framework underlying the concept of "physician" is broken because the modern world has passed this concept by. The physician as a role hearkens back to an era when healthcare was delivered by a doctor as a self contained entity. It was understood that when someone needed medical attention, there would be a doctor there and that doctor needed to know anything and everything because the buck stopped with him. There was no internet, no multidisciplinary teams, and no algorithms to fall back upon. There was just a finite body of medical knowledge and the "doctor" was expected to know all of it because no backup was coming. It was with this reality in mind that medical training was designed.

Today, when you go to the hospital for a serious condition you're not relying on any particular individual to know their sheet. What you are relying on instead is "institutional knowledge." For 90% of situations there is no thinking at all on anyone's part: just a route execution of protocols designed by anonymous third parties and honed through decades of "evidence based" processes. Presentation such and such results in ordering test so and so, leading to the giving of this or that treatment as "best practice." Probably the last people who are actually relying on a broad yet deep understanding of medical knowledge for the bulk of their work are the radiologists, yet ironically they are the ones who will be the first casualty of weak AI.

This is getting very long winded, but the point is that medical education and the very idea behind the concept of "physician" was created over a hundred years ago and no longer corresponds to what physicians are actually required to do on a day to day basis. It's almost like 100 years ago, pilots had to be able to fix their planes because the infrastructure wasn't there for anyone to do it for them and so the role of "pilot" encompassed not just being able to fly planes but deeply understand them on a component by component level. Now, it's ludicrous that a pilot would have anything to do with trying to fix a Dreamliner and there are entire industries dedicated to aircraft maintenance, so pilots just learn to fly and couldn't care less about knowing the PSI specs on the main fuel injector valve or whatever.

Medical training is still stuck in the past though, which results in dudes who will perform lasik for the rest of their lives spending 4 years in med school learning about the krebs cycle and performing pelvic exams and taking histories from psych patients. It's a noble yet farcical effort to pretend that when we finish training, our job is going to look similar to a late 19th century physician stuck on an island with all the responsibility on his shoulders, whereas in reality we'll be more like narrowly focused technicians with a few PCP triage monkeys to direct traffic.

 

[Suprachiasmatik]

It's not just medical school that is broken. The very framework underlying the concept of "physician" is broken because the modern world has passed this concept by. The physician as a role hearkens back to an era when healthcare was delivered by a doctor as a self contained entity. It was understood that when someone needed medical attention, there would be a doctor there and that doctor needed to know anything and everything because the buck stopped with him. There was no internet, no multidisciplinary teams, and no algorithms to fall back upon. There was just a finite body of medical knowledge and the "doctor" was expected to know all of it because no backup was coming. It was with this reality in mind that medical training was designed.

Today, when you go to the hospital for a serious condition you're not relying on any particular individual to know their sheet. What you are relying on instead is "institutional knowledge." For 90% of situations there is no thinking at all on anyone's part: just a route execution of protocols designed by anonymous third parties and honed through decades of "evidence based" processes. Presentation such and such results in ordering test so and so, leading to the giving of this or that treatment as "best practice." Probably the last people who are actually relying on a broad yet deep understanding of medical knowledge for the bulk of their work are the radiologists, yet ironically they are the ones who will be the first casualty of weak AI.

This is getting very long winded, but the point is that medical education and the very idea behind the concept of "physician" was created over a hundred years ago and no longer corresponds to what physicians are actually required to do on a day to day basis. It's almost like 100 years ago, pilots had to be able to fix their planes because the infrastructure wasn't there for anyone to do it for them and so the role of "pilot" encompassed not just being able to fly planes but deeply understand them on a component by component level. Now, it's ludicrous that a pilot would have anything to do with trying to fix a Dreamliner and there are entire industries dedicated to aircraft maintenance, so pilots just learn to fly and couldn't care less about knowing the PSI specs on the main fuel injector valve or whatever.

Medical training is still stuck in the past though, which results in dudes who will perform lasik for the rest of their lives spending 4 years in med school learning about the krebs cycle and performing pelvic exams and taking histories from psych patients. It's a noble yet farcical effort to pretend that when we finish training, our job is going to look similar to a late 19th century physician stuck on an island with all the responsibility on his shoulders, whereas in reality we'll be more like narrowly focused technicians with a few PCP triage monkeys to direct traffic.

I would argue that some of your higher level arguments transcend medical education and can be applied to higher education in general.

 

[neoevolution]

TBH, this isn't wrong lol. I look at my class and the younger people especially and they are all complainers (myself included). The class below me, which is younger, is even worse. To the point where some faculty are afraid to teach them because they're scared of getting backlash due to the spoiled mentality. The older people in my class definitely have a unique perspective on life in general, different than those who went through schooling 4 years and then med school. That type of maturity 1) can't be understood by somebody who doesn't have that life experience (you and I), and 2) is something that is invaluable in a field like this where we all have to deal with some **** everyday.

I'm not denying that there's less life experience, but that you'll gain enough of it through the 7+ year training process that it won't matter that you're 29 vs 31 at the end of it.

I know complainers of all ages in my class (it's a guilty pleasure of mine too), but it's not really about the workload as we all knew coming in to expect it. The most legitimate criticisms are about things like faculty chewing students out for asking which days are mandatory so people can book travel home for the holidays or refusing to have an honest discussion about major grading policy changes or making blatant racist comments in class. They harp about professionalism but it really means respecting those above you in the hierarchy rather than expecting to be treated with respect as an "adult learner." I'm glad our generation is whining, because that's our best shot at actually changing these attitudes a few decades from now.

 

[Giovanotto]

It's not just medical school that is broken. The very framework underlying the concept of "physician" is broken because the modern world has passed this concept by. The physician as a role hearkens back to an era when healthcare was delivered by a doctor as a self contained entity. It was understood that when someone needed medical attention, there would be a doctor there and that doctor needed to know anything and everything because the buck stopped with him. There was no internet, no multidisciplinary teams, and no algorithms to fall back upon. There was just a finite body of medical knowledge and the "doctor" was expected to know all of it because no backup was coming. It was with this reality in mind that medical training was designed.

Today, when you go to the hospital for a serious condition you're not relying on any particular individual to know their sheet. What you are relying on instead is "institutional knowledge." For 90% of situations there is no thinking at all on anyone's part: just a route execution of protocols designed by anonymous third parties and honed through decades of "evidence based" processes. Presentation such and such results in ordering test so and so, leading to the giving of this or that treatment as "best practice." Probably the last people who are actually relying on a broad yet deep understanding of medical knowledge for the bulk of their work are the radiologists, yet ironically they are the ones who will be the first casualty of weak AI.

This is getting very long winded, but the point is that medical education and the very idea behind the concept of "physician" was created over a hundred years ago and no longer corresponds to what physicians are actually required to do on a day to day basis. It's almost like 100 years ago, pilots had to be able to fix their planes because the infrastructure wasn't there for anyone to do it for them and so the role of "pilot" encompassed not just being able to fly planes but deeply understand them on a component by component level. Now, it's ludicrous that a pilot would have anything to do with trying to fix a Dreamliner and there are entire industries dedicated to aircraft maintenance, so pilots just learn to fly and couldn't care less about knowing the PSI specs on the main fuel injector valve or whatever.

Medical training is still stuck in the past though, which results in dudes who will perform lasik for the rest of their lives spending 4 years in med school learning about the krebs cycle and performing pelvic exams and taking histories from psych patients. It's a noble yet farcical effort to pretend that when we finish training, our job is going to look similar to a late 19th century physician stuck on an island with all the responsibility on his shoulders, whereas in reality we'll be more like narrowly focused technicians with a few PCP triage monkeys to direct traffic.

This is why, even if I had the option to do Optho, Gas, or Path, I wouldn't, because you're essentially a technician at that point (especially with all of the "optional" fellowships). I'm hoping being a PCP (FM) is less like that and less "triage-monkey"-y.

Edit: this was a very ignorant comment to make.

 

[theonlytycrane]

FM and gainz >>>

 

[kb1900]

This is why, even if I had the option to do Optho, Gas, or Path, I wouldn't, because you're essentially a technician at that point (especially with all of the "optional" fellowships). I'm hoping being a PCP (FM) is less like that and less "triage-monkey"-y.

What? How much exposure have you actually had to those fields aside from what you read online?

 

[VincentAdultman]

This is why, even if I had the option to do Optho, Gas, or Path, I wouldn't, because you're essentially a technician at that point (especially with all of the "optional" fellowships)....

I would advise against saying this out loud.

 

[Giovanotto]

What? How much exposure have you actually had to those fields aside from what you read online?

I've had extensive experience in two/three fields that I mentioned. I'm not putting them down in any way, but the work seems highly repetitive and technical. Incidentally, I've spoken to a PCP at Kaiser who told me that he believed, after finding out what I did for a living, that he felt like he too was a technician (as I was at the time).

 

[Stagg737]

The issue is that you don't mature with age, but rather with responsibility. MSIII - R3 is very specifically designed to take a spoiled (wo)manchild and mature him/her through exposure to gradually increasing levels of responsibility. You don't need to be mature to start, the entire process is designed to get you there starting from scratch. Similarly no amount of time in a responsibility free enviornment (undergrad) will ever mature anyone. It just makes you older and poorer.

The problem isn't necessarily the M3 and beyond, it's those pre-clinical years which currently require high levels of discipline in order to study consistently and pass Step 1. Plenty of people get into med schools with minimal study skills in UG and wouldn't stand a chance in med school. Just look at the different in attrition rates at any 6 year school in the U.S. that take kids straight out of high school (>20% at all of them) vs. the national rate in the U.S. (<4%) and most of that attrition occurs at the earlier stages in the curriculum.

So while I agree that people mature with responsibility, there is no growth (or not enough) if they're not mature enough to handle the initial responsibility.

I'm not denying that there's less life experience, but that you'll gain enough of it through the 7+ year training process that it won't matter that you're 29 vs 31 at the end of it.

It's not the difference at the end of it that matters, it's the difference at the beginning. The difference in life experience between a 29 vs 31 year old or even a 27 vs 31 year old isn't the issue. It's the difference between a 18 vs 20 vs 22 that matters and that maturity/experience gap closes the older one gets.

 

[msk2016]

As a recently minted attending radiologist, here is my take. I have to say that I haven't read every post on this thread and don't intend to.

When I think of med school and training in general, there is a ton of minutiae that went on one ear and was regurgitated on an exam of some sort, whether it be individual pre clinical tests, step examinations, in service exams, and and even board exams. So all that knowledge is gone but can be retrieved (thank God for the internet and a foggy memory).

As physicians, we are required to communicate with one another for the good of our patients. When I'm speaking with another physician or even a medical student (and this is somehwhat of a broad generalization), we can communicate at a certain level and convey information efficiently and even feed off of one another when speaking about anatomy and pathology (my areas of focus) and treatment leading to good patient outcomes. I imagine this is the way it works when you operate in a multidisciplinary environments as a lot of us do in the practice of medicine. So it pain say that when I'm speaking with non-physicians (and sorry for the broad generalization), it is a different interaction. I remember one time in residency, I told a nurse practitioner that an ER patient that a patient had hydrocephalus. She asked me if the fluid was inside or outside the brain. It would have been otherworldly for a first year med student to ask me that question. So, as frustrated as I was taking time out from a busy ass call, I had to take the time to go over simple anatomy at 3am when I should have been doing more important things. You would be surprised at how limited the knowledge of some health care providers really is( some doctors are included in this category). I actually enjoy my interactions with other clinicians. It's stimulating. So going to med school really helps in this instance.

I think that our training is what separates us from other providers. It's why we get payed the "big bucks". As an attending radiologist, all of my training goes into the clinical decisions I make every day for my patients. No, biochem and physiology hardly ever apply, nor does a lot of the stuff I've learned before, but every now and then, you'd be surprised. Some of us do see zebras and sometimes you could make a difference when some one else couldn't.

Also in general, your family, friends, and others will consult you about random stuff. As a doc, it's great to be able to use that wide breath of knowledge to help them out.

 

[Brahnold Bloodaxe]

As a recently minted attending radiologist, here is my take. I have to say that I haven't read every post on this thread and don't intend to.

When I think of med school and training in general, there is a ton of minutiae that went on one ear and was regurgitated on an exam of some sort, whether it be individual pre clinical tests, step examinations, in service exams, and and even board exams. So all that knowledge is gone but can be retrieved (thank God for the internet and a foggy memory).

As physicians, we are required to communicate with one another for the good of our patients. When I'm speaking with another physician or even a medical student (and this is somehwhat of a broad generalization), we can communicate at a certain level and convey information efficiently and even feed off of one another when speaking about anatomy and pathology (my areas of focus) and treatment leading to good patient outcomes. I imagine this is the way it works when you operate in a multidisciplinary environments as a lot of us do in the practice of medicine. So it pain say that when I'm speaking with non-physicians (and sorry for the broad generalization), it is a different interaction. I remember one time in residency, I told a nurse practitioner that an ER patient that a patient had hydrocephalus. She asked me if the fluid was inside or outside the brain. It would have been otherworldly for a first year med student to ask me that question. So, as frustrated as I was taking time out from a busy ass call, I had to take the time to go over simple anatomy at 3am when I should have been doing more important things. You would be surprised at how limited the knowledge of some health care providers really is( some doctors are included in this category). I actually enjoy my interactions with other clinicians. It's stimulating. So going to med school really helps in this instance.

I think that our training is what separates us from other providers. It's why we get payed the "big bucks". As an attending radiologist, all of my training goes into the clinical decisions I make every day for my patients. No, biochem and physiology hardly ever apply, nor does a lot of the stuff I've learned before, but every now and then, you'd be surprised. Some of us do see zebras and sometimes you could make a difference when some one else couldn't.

Also in general, your family, friends, and others will consult you about random stuff. As a doc, it's great to be able to use that wide breath of knowledge to help them out.

Sure, but nobody is complaining about having to learn what hydrocephalus is. In fact, if I didn't have to spend 70% of my time memorizing and refreshing minutiae like which vasculitis is associated with P-ANCA vs C-ANCA or whether it's COPI or COPII in anterograde transport I'd have much more bandwidth to master and internalize clinically relevant topics like hydrocephalus. I mean seriously, has COPII ever been mentioned in even the most tangential of fashions in a clinical setting? Must I not only know that sheit can move both ways between the ER and the golgi and that proteins are involved in this process, but also that the freakin' names of those proteins are COPI and COPII? There is no value added to this trivia, just value subtracted because there is an almost infinite amount of clinically relevant material to master and instead we're wasting time memorizing the names of random intracellular proteins.

 

[VincentAdultman]

I'm not putting them down in any way

Saying this doesn't make it so.

 

[QueenJames]

Honestly....

I enjoy the sheer amount of learning. I'm not mad at the system because it is what it is.

But I'm not a huge fan of my fellow classmates. Obviously this is subjective and everybody has a different experience. I go out of my way to help others if they need it... but GODDDD...

EVERYTIME we meet as a class or do those small groups discussions... it's literally SO draining.

All of this pent up enthusiasm seems so FAKE.

You know damn well you are NOT that excited about learning hawkin's impingement and UE nerve impingement as you fake it out to be.

Also, can I PLEASEEEE type notes on my laptop and do so privately without you breathing down my neck or staring onto my screen as you proceed to ask me some obscure fact about pathology or micro that only you know so that you can feel smart for a good few minutes? Or the dreaded, "What are you studying?"

NONE OF YOUR DAMN BUSINESS JESUS CHRISSTTTT. lol

Put me in a room with some tea and wi-fi for 5 days straight... let me hit these 25-30 lectures, FA, pathoma, and Sketchy hard... and I'm all smiles.

But as SOON as we get into a room together... arrghhh... energy levels are down immediately.

 

[neoevolution]

The problem isn't necessarily the M3 and beyond, it's those pre-clinical years which currently require high levels of discipline in order to study consistently and pass Step 1. Plenty of people get into med schools with minimal study skills in UG and wouldn't stand a chance in med school. Just look at the different in attrition rates at any 6 year school in the U.S. that take kids straight out of high school (>20% at all of them) vs. the national rate in the U.S. (<4%) and most of that attrition occurs at the earlier stages in the curriculum.

So while I agree that people mature with responsibility, there is no growth (or not enough) if they're not mature enough to handle the initial responsibility.

It's not the difference at the end of it that matters, it's the difference at the beginning. The difference in life experience between a 29 vs 31 year old or even a 27 vs 31 year old isn't the issue. It's the difference between a 18 vs 20 vs 22 that matters and that maturity/experience gap closes the older one gets.

Are you referring to attrition at 6 year BS/MD programs? Anecdotally, I think the retention rates can vary a lot with those, but I'm familiar with a BS/MD program that averages like 95+% graduation over the few years I know of (for full completion). Med schools wouldn't run them if students were failing out at crazy high rates (some are closing down now, but I think that's because the applicant pool is strong enough that they don't feel it's worth it; plenty of them have been around for decades).

I also don't see why it would be expected that someone coming through a program would be any less disciplined or weaker academically than a traditional 4 year undergrad student. If anything, the program students have evidence of high levels of discipline dating back to high school if they were able to get into a program.

As long as they're making it through med school at similar rates, I don't really see the difference that maturity gap coming in makes. You'll still be 26 before you're an intern, and you'll still have a lot of years of supervision beyond that, so the gap will essentially be closed by the time it really starts to matter. The immature M3 isn't going to get a patient harmed.

 

[pookatooth]

The issue is that you don't mature with age, but rather with responsibility. MSIII - R3 is very specifically designed to take a spoiled (wo)manchild and mature him/her through exposure to gradually increasing levels of responsibility. You don't need to be mature to start, the entire process is designed to get you there starting from scratch. Similarly no amount of time in a responsibility free enviornment (undergrad) will ever mature anyone. It just makes you older and poorer.

How do you suppose admissions to medical schools sans undergraduate would work? It seems that pre-medical undergraduate coursework does self-select candidates to a certain degree of intelligence (or diligence.) How do you sift through the massive influx of applicants directly out of high school when the metrics are not as discerning? As for curriculum do you propose just a major cut of any subjects not deemed useful or cramming all of undergraduate + didactic medical school into a shorter period?

 

[Stagg737]

Are you referring to attrition at 6 year BS/MD programs? Anecdotally, I think the retention rates can vary a lot with those, but I'm familiar with a BS/MD program that averages like 95+% graduation over the few years I know of (for full completion). Med schools wouldn't run them if students were failing out at crazy high rates (some are closing down now, but I think that's because the applicant pool is strong enough that they don't feel it's worth it; plenty of them have been around for decades).

I also don't see why it would be expected that someone coming through a program would be any less disciplined or weaker academically than a traditional 4 year undergrad student. If anything, the program students have evidence of high levels of discipline dating back to high school if they were able to get into a program.

As long as they're making it through med school at similar rates, I don't really see the difference that maturity gap coming in makes. You'll still be 26 before you're an intern, and you'll still have a lot of years of supervision beyond that, so the gap will essentially be closed by the time it really starts to matter. The immature M3 isn't going to get a patient harmed.

I am talking about those degrees, and the one I am very familiar with had over a 20% attrition rate last time the data was released (Probably over 5 years old now). Do you really think an 18 year old, even one who did very well in high school, has the academic or overall maturity of a 22 year old that has proven they can excel at the college level? Plus let's be real, high school is a total joke compared to medical school. I crushed high school and don't think I ever studied for a single test. If I did that in med school I probably would have failed out in the first couple months. Even if someone gets near perfect ACT/SAT scores, that doesn't mean they'll be able to succeed in med school level classes straight out of hs or even after a year of college (as the attrition rate shows).

My concern isn't about those programs putting out competent physicians, as I'm sure the ones who graduate are fine (and the ones I've interacted with were). My concern is accepting kids into the program who have a 1 in 5 risk of failing out and racking up debt towards a degree they can't use.

 

[Perrotfish]

How do you suppose admissions to medical schools sans undergraduate would work? It seems that pre-medical undergraduate coursework does self-select candidates to a certain degree of intelligence (or diligence.) How do you sift through the massive influx of applicants directly out of high school when the metrics are not as discerning? As for curriculum do you propose just a major cut of any subjects not deemed useful or cramming all of undergraduate + didactic medical school into a shorter period?

1) I would propose doing allof medical school as a 5 year undergraduate degree. Cut all undergrad subjects not deemed useful, which means year 1 would be bio 1 &2, chem 1 &2, stats, physics 1&2, and some humanities (3 semesters, no summer). Year 2 and 3 would be med school years 1 and 2. Years 4 and 5 would be med school years 3 and 4. You would then apply to residency, which becomes a doctoral program, and you don't get the title of doctor until you finish residency.

2) If you did it this way you are right that the admissions process just wouldn't be as selective, and people would fail out. Which would be fine, people fail out of undergrad majors all the time. They wouldn't even have to call it failing, they would just say 'I'm switching out of the med program and changing my major to communications'. It happened all the time in engineering, when people couldn't pass the classes, and it would work jut as well for medicine.

 

[neoevolution]

I am talking about those degrees, and the one I am very familiar with had over a 20% attrition rate last time the data was released (Probably over 5 years old now). Do you really think an 18 year old, even one who did very well in high school, has the academic or overall maturity of a 22 year old that has proven they can excel at the college level? Plus let's be real, high school is a total joke compared to medical school. I crushed high school and don't think I ever studied for a single test. If I did that in med school I probably would have failed out in the first couple months. Even if someone gets near perfect ACT/SAT scores, that doesn't mean they'll be able to succeed in med school level classes straight out of hs or even after a year of college (as the attrition rate shows).

My concern isn't about those programs putting out competent physicians, as I'm sure the ones who graduate are fine (and the ones I've interacted with were). My concern is accepting kids into the program who have a 1 in 5 risk of failing out and racking up debt towards a degree they can't use.

The programs usually had a 3.6 GPA and 30 MCAT minimum for that reason. Some were higher and some were lower, but they overall required stats pretty similar to the average matriculant. And is the 20% attrition you're referring to at the undergrad level or medical school? Because 20% attrition in med school means the program is doing a terrible job and should probably get shut down. At the college level, it could just be people slacking or realizing their interest lie elsewhere, but they'll still be able to finish a regular college degree.

 

[Catman21]

1) I would propose doing allof medical school as a 5 year undergraduate degree. Cut all undergrad subjects not deemed useful, which means year 1 would be bio 1 &2, chem 1 &2, stats, physics 1&2, and some humanities (3 semesters, no summer). Year 2 and 3 would be med school years 1 and 2. Years 4 and 5 would be med school years 3 and 4. You would then apply to residency, which becomes a doctoral program, and you don't get the title of doctor until you finish residency.

2) If you did it this way you are right that the admissions process just wouldn't be as selective, and people would fail out. Which would be fine, people fail out of undergrad majors all the time. They wouldn't even have to call it failing, they would just say 'I'm switching out of the med program and changing my major to communications'. It happened all the time in engineering, when people couldn't pass the classes, and it would work jut as well for medicine.

legit love everything you said in this thread, exactly how you said it.

 

[Stagg737]

The programs usually had a 3.6 GPA and 30 MCAT minimum for that reason. Some were higher and some were lower, but they overall required stats pretty similar to the average matriculant. And is the 20% attrition you're referring to at the undergrad level or medical school? Because 20% attrition in med school means the program is doing a terrible job and should probably get shut down. At the college level, it could just be people slacking or realizing their interest lie elsewhere, but they'll still be able to finish a regular college degree.

I'm not sure what schools you're talking about, but neither of the 6 year programs I know of require the MCAT at all, and have "recommended" ACT/SAT scores and GPAs. I'm talking overall attrition rate. The one I'm more familiar with has a 15% attrition rate in the first 2 years and an 8-9% attrition rate in years 3-6 (more than double the national average). True about the college level thing, but if they decide not to go into health sciences they've essentially wasted 2 years one a hyper-focused UG curriculum that is useless to them.