Why can't medical school be 5 years?

[CaptainJackSparrow83]

Id like to invite opinions on this. I am not trying to bash the medical school system, although some changes may be needed. I'm just curious, what I constantly hear from physicians is there are many more skills required beyond your curriculum in medical school which largely focuses on healthy anatomy/physiology -disease-treatment .

But skills I hear are motor skills, humility (Especially as a Ms3-PGY '''') , compassion, practice management/ insurance billing, ethical decisions, and even more.
The pool of students who get into medical schools are brilliant however Ive met dinguses at my program and others, and people who should never pick up a scalpel or even a butter knife, meanwhile a few stragglers out there who could possibly just make it through the program if they had a little more time (3 years for basic sciences) and outside of that, they are amazing people.

Friendly discourse only please.

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[Doc_Ock]

Id like to invite opinions on this. I am not trying to bash the medical school system, although some changes may be needed. I'm just curious, what I constantly hear from physicians is there are many more skills required beyond your curriculum in medical school which largely focuses on healthy anatomy/physiology -disease-treatment .

But skills I hear are motor skills, humility (Especially as a Ms3-PGY '''') , compassion, practice management/ insurance billing, ethical decisions, and even more.
The pool of students who get into medical schools are brilliant however Ive met dinguses at my program and others, and people who should never pick up a scalpel or even a butter knife, meanwhile a few stragglers out there who could possibly just make it through the program if they had a little more time (3 years for basic sciences) and outside of that, they are amazing people.

Friendly discourse only please.

I completely agree. It will be at some point.


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[LongDucDong]

Hard pass

 

[ProfAnon]

Id like to invite opinions on this. I am not trying to bash the medical school system, although some changes may be needed. I'm just curious, what I constantly hear from physicians is there are many more skills required beyond your curriculum in medical school which largely focuses on healthy anatomy/physiology -disease-treatment .

But skills I hear are motor skills, humility (Especially as a Ms3-PGY '''') , compassion, practice management/ insurance billing, ethical decisions, and even more.
The pool of students who get into medical schools are brilliant however Ive met dinguses at my program and others, and people who should never pick up a scalpel or even a butter knife, meanwhile a few stragglers out there who could possibly just make it through the program if they had a little more time (3 years for basic sciences) and outside of that, they are amazing people.

Friendly discourse only please.

3 years for basic sciences is a bad idea and won't happen. I have seen the results of a "slow track" program and they are not good, very high incidence of board failure. Essentially the students that "need" 3 years to get through the basic science stuff are too weak to accumulate all the knowledge in their head required for Level 1/Step 1 boards. They go into boards 2 - 2 1/2 years away from the first subjects they studied are are not strong enough to just be able to review the material and pick it back up. They have a much better chance of passing by being forced to try and adapt to a 2 year curriculum, and if they can't, they probably don't belong in med school.

I do think a strong student could do a 3 year basic science curriculum and do fine on their boards, but since they can handle a two year curriculum, why would they? I think, if anything, you might see the 2 years condensed a bit more rather than extended.

 

[Drrrrrr. Celty]

As much as I hate to say it the above has a lot of good reasoning. The reality is that the boards are very difficult and to pass requires a certain level of adaptation to being a faster learner or worker.

If you're struggling to get through the average medical school curriculum it means you have a deficit in how you're approaching material or have a major distraction which will be magnified during boards prep.

This will become even more clear as when you're working and you're then required to study during 3rd year too.





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[CaptainJackSparrow83]

3 years for basic sciences is a bad idea and won't happen. I have seen the results of a "slow track" program and they are not good, very high incidence of board failure. Essentially the students that "need" 3 years to get through the basic science stuff are too weak to accumulate all the knowledge in their head required for Level 1/Step 1 boards. They go into boards 2 - 2 1/2 years away from the first subjects they studied are are not strong enough to just be able to review the material and pick it back up. They have a much better chance of passing by being forced to try and adapt to a 2 year curriculum, and if they can't, they probably don't belong in med school.

I do think a strong student could do a 3 year basic science curriculum and do fine on their boards, but since they can handle a two year curriculum, why would they? I think, if anything, you might see the 2 years condensed a bit more rather than extended.

So with this reasoning then the argument could be made that alot of the material will go in the gutter in clinical years yes?

 

[DO2015CA]

If anything reduce all of medical school to 3 years. Cut off the summer of first year and finish by Christmas of second. Start rotations in January. Then chop off 4th years back end because after auditions it’s trash time anyway

 

[DO2015CA]

So with this reasoning then the argument could be made that alot of the material will go in the gutter in clinical years yes?

A lot of the material does go in the gutter 3rd year

 

[ProfAnon]

So with this reasoning then the argument could be made that alot of the material will go in the gutter in clinical years yes?

To a certain extent, this is probably true. It depends on whether the clinical experiences reinforce the basic science knowledge or not. It may also depend on whether a particular preceptor demands that their students know the scientific underpinnings of what they are doing or not -- there is a wide variety of expectations in that regard.

So with this reasoning then the argument could be made that alot of the material will go in the gutter in clinical years yes?

To a certain extent, this is probably true. It depends on whether the clinical experiences reinforce the basic science knowledge or not. It may also depend on whether a particular preceptor demands that their students know the scientific underpinnings of what they are doing or not -- there is a wide variety of expectations in that regard.

 

[SurgDoc95]

How bout no? We spend enough time in undergrad and medical school not to mention residency already.


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[CaptainJackSparrow83]

How bout no? We spend enough time in undergrad and medical school not to mention residency already.


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I agree with you.
The point was more over why isnt there an Option- to have 5 year medical programs.
There are definitely talented individuals who graduate year upon year from dozens of medical schools around the country.

 

[BorntobeDO?]

I agree with you.
The point was more over why isnt there an Option- to have 5 year medical programs.
There are definitely talented individuals who graduate year upon year from dozens of medical schools around the country.

There are schools that have slow tracks, I have heard AT Still in Arizona I believe has one that they offer if you don't do so hot. I know some MD schools do the same. But as stated above, most of the time slow track students are at risk for failing. That said, every curriculum is a bit different and some are obviously more successful than others (see TCOMs/KCU whatever they call it vs the traditional 'Integrated' curriculum of some of the newer schools with much higher attrition rates).

 

[AnatomyGrey12]

I agree with you.
The point was more over why isnt there an Option- to have 5 year medical programs.
There are definitely talented individuals who graduate year upon year from dozens of medical schools around the country.

Many schools actually have a decelerated track for certain individuals. I would propose that we get rid of the basic science crap and get people involved with clinical medicine a year earlier. Start the curriculum with anatomy and Phys and then go right into systems.

 

[BorntobeDO?]

Many schools actually have a decelerated track for certain individuals. I would propose that we get rid of the basic science crap and get people involved with clinical medicine a year earlier. Start the curriculum with anatomy and Phys and then go right into systems.

Oh you mean like a PA or NP? Seems like I already passed on that idea

 

[AnatomyGrey12]

Oh you mean like a PA or NP? Seems like I already passed on that idea

No I meant more like Duke or Vandy that have a condensed preclinical curriculum. Not to mention that residency is what separates us the most from mid levels, I just don’t see how knowing tons more of molecular biology compared to a PA is in any way relevant to a clinical practice.

 

[CaptainJackSparrow83]

No I meant more like Duke or Vandy that have a condensed preclinical curriculum. Not to mention that residency is what separates us the most from mid levels, I just don’t see how knowing tons more of molecular biology compared to a PA is in any way relevant to a clinical practice.

Thank you, thank you, thank you for saying this.

 

[MADD!!!]

I'm actually pro a shorter track. Cut out the fluff and just tailor curriculum to board prep from day 1. Clear us out as fast as possible (If it can be done in a year I'm down) then let us learn more through more clinical experience. I just keep hearing a lot of pre-clinical curriculum is fluff that will never be used.... and it's like WHY are we learning this then?!!!

 

[Jinxapotato]

I'm actually pro a shorter track. Cut out the fluff and just tailor curriculum to board prep from day 1. Clear us out as fast as possible (If it can be done in a year I'm down) then let us learn more through more clinical experience. I just keep hearing a lot of pre-clinical curriculum is fluff that will never be used.... and it's like WHY are we learning this then?!!!

so true, the doc I'm working with often pimps us on biochem/molecular bio stuff - when I try to guess, he'd be like:" welp look it up and let me know if you're right, cuz I have no idea *trololo*"

 

[QueenJames]

Simple solution.

Why not just go to PA or RN route ---> NP then...? They don't go as in depth and get out faster.

 

[MADD!!!]

Simple solution.

Why not just go to PA or RN route ---> NP then...? They don't go as in depth and get out faster.

That's not the point... the point is why do we learn information that's not relevant to our work? In undergrad OK, but this is professional school and training us to be Physicians.

 

[AnatomyGrey12]

Simple solution.

Why not just go to PA or RN route ---> NP then...? They don't go as in depth and get out faster.

I never said to cut the length of medical school, I said to shorten pre-clinical and cut out the fluff. There is a lot of fluff that is simply in there because it’s what has always been taught. Our systems courses already go way more in depth than the education at PA school.

 

[QueenJames]

People just be complaining. Study it and move on like the thousands before us have.

 

[Save a life]

I’m an M1 and I haven’t honestly seen that much “fluff.” All of the anatomy is very relevant to all specialties and the biochem has a lot of relevant stuff. For example, you need biochem to understand all the genetic diseases and how diabetes works with insulin and diabetic ketoacidosis. We’re also learning all the cells and histology. I mean if I’m a surgeon and I order a frozen section and want to look at the margins with the pathologist I want to be able to know what I’m looking at.

 

[CaptainJackSparrow83]

I'm actually pro a shorter track. Cut out the fluff and just tailor curriculum to board prep from day 1. Clear us out as fast as possible (If it can be done in a year I'm down) then let us learn more through more clinical experience. I just keep hearing a lot of pre-clinical curriculum is fluff that will never be used.... and it's like WHY are we learning this then?!!!

My primary concern isnt to make the medical curriculum longer for the students already in med school, it was to offer the opportunity to people who just need a little (and I mean little) more time to study for the entire curriculum.
I wasnt aware some schools offered this as anatomy grey and born2be pointed out

 

[MADD!!!]

My primary concern isnt to make the medical curriculum longer for the students already in med school, it was to offer the opportunity to people who just need a little (and I mean little) more time to study for the entire curriculum.
I wasnt aware some schools offered this as anatomy grey and born2be pointed out

I know, and I can relate to your post. Med school is far from what I thought it would be. It seems more like a test to see how much you can cram in a short amount of time and move forward. They don't want to lengthen it b/c like others said you need to pass boards, which again requires cramming lots of info in a short time period. How conducive is this to actually practicing medicine in the real world? I don't know, but I don't think it's the best way. But then again I'm just a first year who doesn't know much.

 

[MADD!!!]

People just be complaining. Study it and move on like the thousands before us have.

This is dumb. If you don't question things, how do you expect to improve. Med schools are changing their curriculums to current environments and everything should be re-evaluated and stay efficient. Technology isn't the same today as it was 30 years ago, the amount of info we need to learn now is much more than 30+ years ago (One of my professors told us when he was a med student, their entire first year was just dedicated to learning what we learn as our pre-reqs now). We shouldn't just follow a Dogma just because "that's the way it's always been."

 

[68PGunner]

There's already an option for the Fifth Year option track. It's called failing classes and repeating a year. If anything, the entire preclinical years should be cut into 1.5 years and not to expand this stupid crap.

As for people that you're considering dinguses, in what ways are they considered a-holes? If they're truly a-holes to everyone in general, then chances are that they're total d-bags. However, if they're being dicks to you bc you're one of those kids asking ignorant quests and wasting people time, you deserve to get that kind of treatment. Unlike what you have been told, there's such a thing as a stupid quest.

 

[W19]

No I meant more like Duke or Vandy that have a condensed preclinical curriculum. Not to mention that residency is what separates us the most from mid levels, I just don’t see how knowing tons more of molecular biology compared to a PA is in any way relevant to a clinical practice.

You are the voice of reason, sir...

 

[Mad Jack]

Id like to invite opinions on this. I am not trying to bash the medical school system, although some changes may be needed. I'm just curious, what I constantly hear from physicians is there are many more skills required beyond your curriculum in medical school which largely focuses on healthy anatomy/physiology -disease-treatment .

But skills I hear are motor skills, humility (Especially as a Ms3-PGY '''') , compassion, practice management/ insurance billing, ethical decisions, and even more.
The pool of students who get into medical schools are brilliant however Ive met dinguses at my program and others, and people who should never pick up a scalpel or even a butter knife, meanwhile a few stragglers out there who could possibly just make it through the program if they had a little more time (3 years for basic sciences) and outside of that, they are amazing people.

Friendly discourse only please.

Because it should be 3 years

 

[Danbo1957]

Medical school is going towards 3 years.

 

[shadowlightfox]

How bout no? We spend enough time in undergrad and medical school not to mention residency already.


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Not to mention the tuition money, ESPECIALLY if you're out of state. I'd rather be one step closer to making that six fig salary over another year racking up an extra six fig debt...

 

[Dr.Jekyll75]

maybe its just me but i feel the complete opposite. i think 1.5 years is sufficient for BMS then 2 years of rotations. Might not be the best idea for those who have families though

 

[TeddyBoomBoom]

The farther along I get my education, the more I realize that much of the fluff was important for basic understanding.

To me, the point of the scientific curricula is to be able to branch out in whatever field you choose, from a base where you can actually learn and understand the material.

You need the scientific basis to be able to critically interpret literature put out by leaders of various fields.

I think that the scientific background is really what separates the physicians from the mid levels. It allows us to branch off from cookie cutter algorithms and to be able to make critical choices based on what we’ve learned. Anybody can read a scientific paper, but it takes a reasonable amount of expertise to be able to criticize it intelligently.

 

[W19]

4th year of med school is a joke... Almost all students are in vacation mode except for a few who are doing EM and surgical subspecialties, and even these few students are somewhat free by October.

 

[CaptainJackSparrow83]

4th year of med school is a joke... Almost all students are in vacation mode except for a few who are doing EM and surgical subspecialties, and even these few students are somewhat free by October.

That seems to be pretty consistent with all steps of school. High school senior year was a joke, college senior year was a joke. etc

 

[CaptainJackSparrow83]

There's already an option for the Fifth Year option track. It's called failing classes and repeating a year. If anything, the entire preclinical years should be cut into 1.5 years and not to expand this stupid crap.

As for people that you're considering dinguses, in what ways are they considered a-holes? If they're truly a-holes to everyone in general, then chances are that they're total d-bags. However, if they're being dicks to you bc you're one of those kids asking ignorant quests and wasting people time, you deserve to get that kind of treatment. Unlike what you have been told, there's such a thing as a stupid quest.

You should not be failing classes in medical school if there is an admissions process unless there is an external issue. Ive said I agree with cutting down on the fluff in medical school but looks like that isnt happening soon, so in order to expand the pool beyond just people who can study lots of fluff , a 5th year could be added.

People who are dinguses at my school were overall dinguses to everyone and one who Ive known since elementary school has always been an dingus

 

[Beargryllz]

As long as we scrap the 4 years of undergrad bull****, I'd be willing to consider a 5 year medical school program

 

[QueenJames]

This is dumb. If you don't question things, how do you expect to improve. Med schools are changing their curriculums to current environments and everything should be re-evaluated and stay efficient. Technology isn't the same today as it was 30 years ago, the amount of info we need to learn now is much more than 30+ years ago (One of my professors told us when he was a med student, their entire first year was just dedicated to learning what we learn as our pre-reqs now). We shouldn't just follow a Dogma just because "that's the way it's always been."

But you aren't "questioning" things. You are declaring that there is a bunch of useless info that you don't wanna even see.

It's called laziness.

Do what you gotta do and move on.

Didn't wanna say it... since I am one... but... here it goes.

"Damn Millenials".

lolz

 

[MADD!!!]

But you aren't "questioning" things. You are declaring that there is a bunch of useless info that you don't wanna even see.

It's called laziness.

Do what you gotta do and move on.

Didn't wanna say it... since I am one... but... here it goes.

"Damn Millenials".

lolz

I am questioning though... if it's useful and has a purpose im all for learning it (I am learning it). But I've had various attendings, residents, and students tell me there's fluff so I ask why.

 

[AnatomyGrey12]

But you aren't "questioning" things. You are declaring that there is a bunch of useless info that you don't wanna even see.

It's called laziness.

Do what you gotta do and move on.

Didn't wanna say it... since I am one... but... here it goes.

"Damn Millenials".

lolz

Lol what a stupid comment, when I talk to residents or attendings that went to my medical school and they ask what I’m currently doing and I say molecular, or some overly detailed embryo stuff and they laugh and say, “just get through it because you’ll never need it again” then it is time to rethink the curriculum. There is a reason that schools can condense their curriculums and it ain’t because they just smash even more info into the same amount of time. They cut the fluff.

There is absolutely useless fluff that is taught in medical school and should be cut out. What separates us from the mid levels is residency and our clinical reasoning and decision making. Yes you absolutely have to have a foundation for clinical practice, but there are things we learn just for the sake of learning that contribute nothing to practicing medicine.

At the very least get rid of the PhD created exams that test the minutia of their research and mandate everyone gives the NBME exams as their tests. Make pre-clinical somewhat standardized.

 

[68PGunner]

Lol what a stupid comment, when I talk to residents or attendings that went to my medical school and they ask what I’m currently doing and I say molecular, or some overly detailed embryo stuff and they laugh and say, “just get through it because you’ll never need it again” then it is time to rethink the curriculum. There is a reason that schools can condense their curriculums and it ain’t because they just smash even more info into the same amount of time. They cut the fluff.

There is absolutely useless fluff that is taught in medical school and should be cut out. What separates us from the mid levels is residency and our clinical reasoning and decision making. Yes you absolutely have to have a foundation for clinical practice, but there are things we learn just for the sake of learning that contribute nothing to practicing medicine.

At the very least get rid of the PhD created exams that test the minutia of their research and mandate everyone gives the NBME exams as their tests. Make pre-clinical somewhat standardized.

This... It's not a surprising fact that the top tier MD schools have 1.5 years for preclinical science and all of the basic science tests are from NBME.

 

[CaptainJackSparrow83]

.

At the very least get rid of the PhD created exams that test the minutia of their research and mandate everyone gives the NBME exams as their tests. Make pre-clinical somewhat standardized.

AMEN

 

[pstrick]

Med school is still being run based on a report written over two decades before the great depression.

Flexner Report - Wikipedia

That's the problem.

 

[68PGunner]

Here's a recent exam of the discrepancy of in class exams vs NBME exams:

For a recent in class exam, there were 5 Micro questions. I got 2/5 when the class average was 4/5.

For a NBME exam testing everything that we've learned from 1st year, there were also about 5 Micro questions. Average me got 5/5 when the class average was about 3/5. LOL

 

[CaptainJackSparrow83]

Med school is still being run based on a report written over two decades before the great depression.

Flexner Report - Wikipedia

That's the problem.

I have a strong feeling within a decade with the release of watson , the medical school curriculum will change. It will sort of represent the change of many open surgeons to lap and robotic with the invention of the davinci system.

 

[IslandStyle808]

At the very least get rid of the PhD created exams that test the minutia of their research and mandate everyone gives the NBME exams as their tests. Make pre-clinical somewhat standardized.

Our school will hopefully follow suit and get NBME questions soon. I'm having the opposite problem where our school is giving 3rd year stuff during 2nd year. And our pathophysiology knowledge is suffering because of it...

 

[deleted407021]

My feelings are divided. On one hand, it’s not like y’all are crusaders for change, complaining about med school on the Internet. But I also am growing to really hate PhD exam nonsense that isn’t relevant to my future work or the COMLEX/USMLE. I feel like, outside of lectures on clinical material by physicians, I can better learn the basic sciences my teaching myself with good board resources.

But it’s not like saying that is going to change anything. Realistically, med students love to complain, so here we are.

 

[AnatomyGrey12]

But I also am growing to really hate PhD exam nonsense that isn’t relevant to my future work or the COMLEX/USMLE. I feel like, outside of lectures on clinical material by physicians, I can better learn the basic sciences my teaching myself with good board resources.

Pretty much this is my biggest complaint. You can know the material inside and out but still miss questions simply because “while correct, it wasn’t the answer I was looking for.” It becomes a guessing game as to what they want you to say, instead of what the material leads you to say

 

[deleted407021]

Pretty much this is my biggest complaint. You can know the material inside and out but still miss questions simply because “while correct, it wasn’t the answer I was looking for.” It becomes a guessing game as to what they want you to say, instead of what the material leads you to say

I'm sat here right now going over my pharm professor's weird obsessive pet interests and it's not in sketchy pharm. So it's frustrating knowing I have to hit my head against low yield material that's not representative of what I need to know for 3rd and 4th year. But what can I do? Just gotta deal with it.

And for the "if u don't wanna learn about gut microbiome biochemistry, then u should just be an np lololol" folks, you know what I'm talking about. Don't act like fluff projects from PhDs is somehow prepping us for our actual jobs more than focused, board directed instruction would. NPs still can't pass a dumbed down version of the boards, so idk what the gripe is.

 

[BorntobeDO?]

No I meant more like Duke or Vandy that have a condensed preclinical curriculum. Not to mention that residency is what separates us the most from mid levels, I just don’t see how knowing tons more of molecular biology compared to a PA is in any way relevant to a clinical practice.

Agreed partially. But our basic science knowledge is a big difference as well. How we learn to think and operate is totally different. PA's and NP's are protocol driven, a physician *should* be more than that based on higher order understanding of the disease process.

I see you are really advocating less PhD time, that is something I am in favor of as well as long as the physicians teaching are able to integrate the science in with their experience. I don't want to be regaled with unrelated clinical stories all day either about so and so agenda. Even tho its more tolerable than PhD's pet qualms and I get that 'the patient doesn't read the book,' but classic presentations are called that for a reason.

I think the 3 year crowd will eventually win out, but because of pressure from lower trained competitors more than anything else. They are 'proving' you don't really need that extra knowledge (or rather that insurance is more than happy to pay less for less). Maybe when the insurance marketplace collapses and people actually pay for what they get, I imagine a physicians worth will shine through again.