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Hello, this probably will seem like a crazy question to you all, but I have been wondering and I figured this would be the perfect place to ask.

My question is, why aren't there seperate programs and school for each specialty like the way podiatry school or dental schools are set up for instance? So there would be like a cardiology school or endocrinology school for instance where you would take the first two years of medical/ biological sciences together and then branch off.. would it help to streamline the process and reduce the amount of time needed in school?
 
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Lannister

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Despite the fact that most incoming med students think they know what they want to do, they really have no idea. A lot of people don't pick a specialty until they've completed a few clinical rotations.
 

Goro

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Despite the fact that most incoming med students think they know what they want to do, they really have no idea. A lot of people don't pick a specialty until they've completed a few clinical rotations.
This, plus the fact that everything's interconnected.
 
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CyrilFiggis

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Hello, this probably will seem like a crazy question to you all, but I have been wondering and I figured this would be the perfect place to ask.

My question is, why aren't there seperate programs and school for each specialty like the way podiatry school or dental schools are set up for instance? So there would be like a cardiology school or endocrinology school for instance where you would take the first two years of medical/ biological sciences together and then branch off.. would it help to streamline the process and reduce the amputation of time needed in school?
Your question implies that the 3rd and 4th years are somehow not important to the education of an MD and can be cut to save time.
 

WedgeDawg

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Because in this system it seems like you would go into internship with only theoretical knowledge of the medical sciences and not know how to do an H&P, write a note, present a patient, or come up with an A&P which would be a disaster for in incoming intern.

You learn far more your clinical years than you do in the preclinical years. You also have to have a basic understanding of all areas of medicine to be an effective doctor. Psychiatrists have to know what to do if their schizophrenic patient starts to get tachy. Surgeons will be treating children and patients with many medical complications and comorbidities. Everyone you treat ever will have hypertension or diabetes. OBGYNs have to be able to differentiate abdominal from pelvic pathology. You lay the foundation for this in medical school. You develop your skills more specifically in internship and residency.
 

Dandine

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This doesn't directly answer your question but I looked up why podiatry, optometry, and dental schools are separate from medical schools. Apparently a lot of it is historical separation of those fields from medicine, where each of those fields became so sub-specialized they developed their own organizational branches. It didn't really apply to the other medical fields as much because those other three fields has been slowly separating over time.

There's a discussion here that summarizes a couple reasons. Wikipedia was also my main resource for all this. :D
Why is dental education separate from general medical education in the US? [Archive] - Straight Dope Message Board

As for why we probably wouldn't separate the other fields now, I would argue fields like cardiology and endocrinology are so interconnected systemically that it makes sense to study the basics of both first and then get a deeper understanding of each later (i.e. during residency). No matter what specialized school, you'd probably have to know a bit of everything anyways. Also the way med school is set up, it's to get you to spend prolonged, engaged time on primary medical specializations aka clinical rotations. Not only would you consider a field you may not have before, you also learn a bit of everything to help you even in your desired specialty because you will see it again even there in some form.
 

bobtheweazel

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To add a bit to what Dandine was saying, the vast majority of medical specialties around today were not around early in the 1900s, but things like dentistry and podiatry (chiropody) were. Also at that time medical schools were nothing like they are today. So there were already separate training programs for foot specialists or for general doctors or whatever and they just stayed separate over time.

Also I think what a lot of these posts are missing is that you can still cover the entire body anatomy, physiology, pathology, etc and sill have some time to specialize. For instance if the DOs took cardiology specific courses (since that seems to be a popular specialty in this thread) rather than OMM then they would still have the exact same basic medical education as any other doctor but with an extra string of specialty specific courses and workshops throughout their medical education. Their 3rd year could still include rotations in other specialties in addition to cardiology and their residency could be similar to how residencies residencies are now, including plenty of rotations through other departments. There's no reason to think that if there were a cardiology school that they would be required to only dissect blood vessels in cadaver lab or only learn cardiovascular physiology or only know drugs with cardiovascular effects.

Essentially the same framework as podiatry school, so we know it's very possible. One big advantage is that you could probably cut at least a year off of residency if you know from the beginning what you want to specialize in because of the extra courses in that specialty during school, you can kind of cheat 3rd year rotations towards that specialty and more related specialties, and 4th year could also be cheated towards that specialty. I mean of course still including rotations in other specialties but if you're gonna be a cardiologist for instance you can probably go a little light on the OB/GYN and psych third year in exchange for a little more time in cardio or surgery.

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Healthinfo104

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Your question implies that the 3rd and 4th years are somehow not important to the education of an MD and can be cut to save time.
Not that they are not important, but that the time spent in each rotation could be tailored depending on the specialty (if they were theoretically seperate) just like how they are for podiatry for instance
 

gyngyn

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Not that they are not important, but that the time spent in each rotation could be tailored depending on the specialty (if they were theoretically seperate) just like how they are for podiatry for instance
This would require (at a minimum):
1. That the student knew their specialty at the start.
2. That they were sure to match into that specialty.
3. That there was enough clinical space for all the ones that wanted a particular rotation for the length of time required (a scheduling nightmare).
4. that the student was content to have their privileges limited to the organ system they had chosen (for a lifetime).

I would submit that none of these conditions could be met for even a small proportion of any class.
 
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CyrilFiggis

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Not that they are not important, but that the time spent in each rotation could be tailored depending on the specialty (if they were theoretically seperate) just like how they are for podiatry for instance
So then those 2 years would still be necessary? If that's the case then it renders your whole prerogative for "saving time" irrelevant. The whole point of residency is to build upon the knowledge gained particularly in the 3/4th years as you begin to clinically apply knowledge. While you may never deliver a baby again, you can't foresee that, but you should know how an OB thinks and practices, but you can't get that if you're only ever thinking about the world from a surgical or pulmonary or PCP point of view.
 
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