That sort of makes sense, but it's a slippery slope. Exactly how much does a doctor need to know beyond his chosen field? Don't you think rotations in other specialties would augment his understanding of his chosen field? Maybe we should all just become specialized nurses.
We ARE specialized, that's my point. We are in a system where physicians, for very sound ethical and legal reasons, basicaly never go beyond their scope of practice. Pediatricians never manage a 'simple' SVD, Internal medicinee doctors never do open abdominal prodcedures, surgeons don't act as attendings in NICUs, etc. A physician should know exactly as much as he needs to know to do his job.
This has become a real issue in medicine. Take, for example, an Orthopaedic surgeon who speciaized in replacing hips. That is all he does. What's the training pipeline for that? 4 years of ccompletely irrelevant undergrad, followed by 4 years of mostly irrelevant medical school, followed by 5 years of mostly irrelevant general orthopaediics (can't replace hips without learning the full spectrum of spine surgery, after all), followed by 3 years of learning the full spectrum of joint replacements. To do a career based entirely around one procedure and a very algorithmic pre-operative work up. We are swallowing up decades of physicians lives, severely impacting their emathy through years of abuse, and driving the cost of their sevices through the roof based on an outdated and romatic notion of what consitutes a total doctor. Really?
BTW since you metioned nurses, this is why the nurses are eating our profession alive. They're able to undersell us by having a faster, cheaper training pipeline with less exposure to superfulous material. If we don't adapt we are eventually goiing to lose a lot of market share.
As a colorectal surgeon, shouldn't I understand the medical treatment of IBD, and the chemo for colon Ca, and be able to interpret radiology?
To what extent do you need to be able to do these things? Do you commonly override the gastroenterologists medical management plan for IBD? Do you ever shake your head and change the oncologists chemotherapy for colon cancer? Do you really disregard the radiologist's read of those KUBs and CTs? And if you do need to know how to do these things, is the most efficient way to learn them to rotate through general rotations in Medcine, Oncology, and Radiology? What's the incidience of cases and films relevant to your profession on those rotations? For example on radiology, how many head MRIs should you reasonably need to sit through to see one film relevant to your own profession?
Also, one of the most important parts of third year is tasting the different specialties and seeing which one is for you. Most students change their mind about specialties, often after experiencing things first hand. If we had a system where students had to choose a specialty up front, we'd have a lot more unhappy doctors.
This is a more intereting argument: third year as a sort of protracted career fair. It might be a good argument for not letting third years decide, right off the bat, what they want to do. However it doesn't explain why so much emphasis is placed on some rotations rather than others. Do students really need 8 weeks of surgery to realize they hate the OR? Or 8 weeks of OB to know they hate L&D? I know I personally needed less than a day for each. If they do need 8 weeks, why do they only need 4 weeks to realize they do or don't like psych? Or neuro? And why can you be a medical school and offer no exposure at ,all to the ER, Anesthesiology, Pathology, Opthomology, Urology, Orthopaedics, Neurosurgery, radiology, neonatology, or any of the Medical, Pediatric, Obstetric, or Surgical subspecialties? If we really just want to expose everyone to everything, should we cut surgery down to a managable 2 weeks to make sure they can fit everything else in?
