Why is the American MD so long?

[FutureERDoc16]

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I've always had some pretty strong views against the '8-year plan', but over my time traveling across Australia this semester, my anger towards the American education system has only grown stronger.

Today while having lunch, I introduced myself to a few kids I assumed to be around my age, wearing scrubs. They turned out to be slightly older, at 21, and they were both in their fourth year out of five of medical training. As I was eating, they were talking to me about their clinical rotations and the impending doom of residency applications in the upcoming year. It made me pretty upset. I remember doing some research a few years back, and finding only America and Canada as the two countries that had the generic '8-year plan'. I remember trying to search why, and seeing that the consensus lied around the need to have a "well-rounded, liberal arts education" and the need for "maturation"....because of course, with the shortage of physicians and the introduction of ACA, we really need to be worried about age.

The 'liberal arts education' approach sounds like a bunch of bull to me. Not one class I've approached in college has been with a willingness to learn. I treat every class as an obstacle to earn another A, as does every (or most) other premedical students. After taking a final exam for a course, I kill every single brain cell I created in that class with days of post-exam drinking. One thing I've learned from college is that if you are being forced to learn about something you don't care about, you aren't really learning anything other than how to get an A with the least amount of effort.

The well-rounded education approach is just a well developed plan made by the American education system to take more of our money and put us further in debt. At a $40,000/year tuition rate, I would have invested $160,000 by the end of my four year education, and for what? Maturity? If maturity was what you were going after, why make us pay money for college to get that? I could equally as well work for four years before medical school. I think that would honestly be more beneficial in my personal maturation then staring at a book for 40 hours a week.

Here in Australia, there really is no 'liberal-arts' education, as far as I can tell. You take what you need to know for your degree. If I'm that interested in learning about Greek mythology, however, I can open up a book and read. If you are a chemistry major, you take chemistry classes and other courses that are necessary for the understanding of upper-level chems (such as physics and bio). Because of course, no employer is going to care about your knowledge in the "liberal-arts" when you apply for a job in a laboratory. They care that you can work, not annoy people with your limited knowledge in philosophy.

In terms of maturation, I think some doctors are a little arrogant if they think they are the only ones making such important daily decisions. We are also arrogant if we think that American doctors are better than all of "these MBBS docs". I've gotten sick and had to visit a MBBS here in Australia, and he was just as good if not better than some American doctors. I guess the only good thing is that American schools are finally jumping on the 6-year BS/MD bandwagon....

Sorry for the rant, but I really would like to hear others opinions on this.

 

[leggo_my_ecmo]

Well I think that's pretty debatable considering almost all of the Australian schools have switched to the "American" postgraduate MD system over the past three years.

 

[FutureERDoc16]

The program is still five to six years, depending on the school. It's not a change in curriculum, just a different name for the degree.

"A recent review of the MBBS at UNSW revealed students were already studying at a level equivalent to a postgraduate degree. As such, the MBBS, a double Bachelor degree, did not adequately reflect their achievements.

The new MD program elevates UNSW’s medical training to a postgraduate level qualification with no change to the curriculum."

https://med.unsw.edu.au/mbbs-md-benefits-explained#.U0PfXMc7RiY

 

[leggo_my_ecmo]

Well UNSW is the only one keeping the MBBS 6 year format, while Newcastle and New England are keeping their 5 year program. All others have a 4 year US-typical MD that requires a Bachelor's degree for entry, although some give the option of a combined 7 year BS/MD program akin to those of some schools in the states.

 

[LizzyM]

There are half as many med school slots as there are pre-meds after 3-4 years of college weeds out 80% of those who begin college as pre-meds. Would you really like to take the 200,000 HS seniors who want to be pre-med and put them in a medical school application process that will select 20,000 and leave the other 180,000 empty handed? Given how much you are suffering with basic college courses, would you have wanted to transfer that misery to HS? Do you think you could have risen to the top 10% of the most career focused and ambitious HS students? Furthermore, a direct from HS program really screws the most mature, those who choose medicine as a second career.

 

[Chipster.]

I've always had some pretty strong views against the '8-year plan', but over my time traveling across Australia this semester, my anger towards the American education system has only grown stronger.

Today while having lunch, I introduced myself to a few kids I assumed to be around my age, wearing scrubs. They turned out to be slightly older, at 21, and they were both in their fourth year out of five of medical training. As I was eating, they were talking to me about their clinical rotations and the impending doom of residency applications in the upcoming year. It made me pretty upset. I remember doing some research a few years back, and finding only America and Canada as the two countries that had the generic '8-year plan'. I remember trying to search why, and seeing that the consensus lied around the need to have a "well-rounded, liberal arts education" and the need for "maturation"....because of course, with the shortage of physicians and the introduction of ACA, we really need to be worried about age.

The 'liberal arts education' approach sounds like a bunch of bull to me. Not one class I've approached in college has been with a willingness to learn. I treat every class as an obstacle to earn another A, as does every (or most) other premedical students. After taking a final exam for a course, I kill every single brain cell I created in that class with days of post-exam drinking. One thing I've learned from college is that if you are being forced to learn about something you don't care about, you aren't really learning anything other than how to get an A with the least amount of effort.

The well-rounded education approach is just a well developed plan made by the American education system to take more of our money and put us further in debt. At a $40,000/year tuition rate, I would have invested $160,000 by the end of my four year education, and for what? Maturity? If maturity was what you were going after, why make us pay money for college to get that? I could equally as well work for four years before medical school. I think that would honestly be more beneficial in my personal maturation then staring at a book for 40 hours a week.

Here in Australia, there really is no 'liberal-arts' education, as far as I can tell. You take what you need to know for your degree. If I'm that interested in learning about Greek mythology, however, I can open up a book and read. If you are a chemistry major, you take chemistry classes and other courses that are necessary for the understanding of upper-level chems (such as physics and bio). Because of course, no employer is going to care about your knowledge in the "liberal-arts" when you apply for a job in a laboratory. They care that you can work, not annoy people with your limited knowledge in philosophy.

In terms of maturation, I think some doctors are a little arrogant if they think they are the only ones making such important daily decisions. We are also arrogant if we think that American doctors are better than all of "these MBBS docs". I've gotten sick and had to visit a MBBS here in Australia, and he was just as good if not better than some American doctors. I guess the only good thing is that American schools are finally jumping on the 6-year BS/MD bandwagon....

Sorry for the rant, but I really would like to hear others opinions on this.

Post reeks of immaturity. If you don't approach a class with a willingness to learn, then stop spending your parent's money and drop out.

And for the record, if you had gone straight into med school you'd still be binge drinking and forgetting everything you learned.

That's what college is for!

 

[Gut Shot]

Sorry for the rant, but I really would like to hear others opinions on this.

2/10.

In the unlikely event that this is a serious inquiry, you are so immature that you have absolutely no idea how immature you are. It's a bit like being that guy at the post-exam party who is too drunk to know how drunk he is. The liberal arts are the reason why we have Harvard instead of the Cambridge Technical Institute. They foster critical thinking, communication, and creativity, at least in those with a willingness to learn. Those are skills that will enable you to climb whatever ladder you are on long after your college GPA becomes irrelevant. CEO's agree.

If your are truly just upset that you cannot become a glorified healthcare technician as quickly and cheaply as you would like, I have a solution for you: PA school.

 

[Womb Raider]

Hmm.. Yes, I have to agree to some extent with the others that have posted that this sounds slightly immature. I could easily see myself thinking the way you're thinking when I was your age. It's like looking back at your "middle school self" and laughing at how ridiculous and naive you used to be, but not blaming yourself because you didn't know any better.

The thing is... Becoming cultured in areas OTHER than medicine really are important and pertinent to your medical career. This "useless liberal arts education" will come into play for you in ways that are literally unimaginable. You have NO idea how they will help you - but they will, and you'll be glad you took that class you once thought meaningless. Come back to us in a few years, after you have really been exposed to working with physicians, working in a hospital and frequently interacting with patients - I'm sure your opinion on this matter will change.

However, if this is something that you've really put some time into thinking about and it seriously makes you angry, I think you should consider leaving the US and pursuing a medical career outside of the US or Canada. No one wants a whiny, ungrateful kid in medical school.

 

[bc65]

I am not familiar with the Australian system. but I have read about the English system. and although you graduate medical school after 6 post-high-shoool years, the path to become a practicing physician is actually longer than it is in the US. Yes, you graduate medical school after 6 years, but you then have two "Foundation Years", FY1 and FY2. They are two clinical years, with hospital rotations similar to our MS3 and MS4. Then, after 8 years, just like in the US, students begin their residency years. The residency process in the UK seems in general to take longer than in the US for the equivalent specialties, with less predicatable end dates. So in fact, the English system takes longer than ours.

 

[Frostbite22]

I feel the way our education systems are set up right now most people would not be mature enough or have the mental capacity to pursue an MD so young.

What I'm saying is out of the top 10 people in my high school only 3 actually graduated college. They ditched their medical aspirations/engineering aspirations when they couldn't pass organic chem or calc. I don't think we are as mature as other countries are at that age either. I mean in some countries you have to test into each level of schooling, in America as long as you come to class you are passed along.

I know that I was not mature at age 16-18. I didn't know I wanted to be a doctor, all I wanted to know is if this cute boy was going to be calling me back. It would've been a disaster to put me in an MD program at that age. Plus we are still discovering ourselves. As a country we strive for freedom and sometimes you don't know what you really want to be until you are a bit older. One of my best friends brothers was extremely pushed into an MD and entered into one of those 6 year programs after graduating high school early and realized after becoming a surgeon he had no interest in medicine. If he would've been allowed to live a little maybe he could've seen that sooner.

tl;dr. We're not mature enough to be MD's at 22, school systems aren't structured that way, etc etc.

 

[kreme]

I've had two friends in BS/MD programs drop out. One became an ibanker and is now in VC and throws money in my face when we go out. The other went to law school. I wasn't pre-med per se, but rather a biochemistry major because I wanted to one day run my own company that researched protein delivery systems. I think the point of spending an extra time before you commit yourself to something for the rest of your life is that you don't really know what that something is. Cheers to the people that already knew what they wanted to do when they were 16 or 17 years old, but I just wanted a job that could support my hobbies.

 

[DokterMom]

I could see a 6-year BSMD path as viable if we were to completely overhaul our high schools, say, splitting them into tiers the way the Germans do. But as long as 4-year 'high school for all' continues, and the focus remains on football, cheerleaders and socializing instead of serious learning, then IMO, we need that 4 years of college to get the education many students didn't get in high school.

 

[BestDoctorEver]

I vote for 2-year just to take the prereqs and 4 -year of med school... Most pharm schools are that way and I think these pharmacists end up doing fine in the workforce.

 

[Frostbite22]

I vote for 2-year just to take the prereqs and 4 -year of med school... Most pharm schools are that way and I think these pharmacists end up doing fine in the workforce.

I think it is pretty common now for pharmacy students to have a bachelors as well. Its competitive in every professional program. The people I knew in college all obtained a bachelors first and some were never accepted.

 

[lmn]

If you really think that all you are getting out of your undergraduate "liberal arts" courses is learning about a book, or some random history, your time at undergrad has clearly been a failure and for nothing...

 

[type12]

I would argue that it is tradition rather than any actual snippet of fact or scientific research. You can see lots of traditions that just won't die, and the length of a medical education is one of them.

It's really hard to change things when they just have been for so long. There's no discussion here because there's little research to be had. In general, though, what research there is has been showing that most of the educational systems (not specific to medicine) are inefficient, especially with the economy of time. I recall seeing work in engineering and computer sciences, but nothing specific to medicine.

That being said, there are three year programs here and there, which lend credence to the idea that medical education is long for the sake of tradition rather than necessity.

 

[yuiness]

I vote for 2-year just to take the prereqs and 4 -year of med school... Most pharm schools are that way and I think these pharmacists end up doing fine in the workforce.

I actually had a classmate in who decided to apply to medical school after doing 2 years of college (most schools will actually let you do this if you've completed all the prerequisites-- read their admission requirements closely). She ended up realizing sometime in 3rd year that she didn't actually like working with patients and is now in the middle of her 2nd research year with plans to finally finish her 4th year next year and apply into Radiology.

I personally knew that I wanted to be a doctor since I was in high school and potentially would even have been competitive for a BS/MD program out of high school if I had applied. But I'm glad that I went the traditional route because I think my undergraduate experience was valuable.

 

[EMME25]

There are half as many med school slots as there are pre-meds after 3-4 years of college weeds out 80% of those who begin college as pre-meds. Would you really like to take the 200,000 HS seniors who want to be pre-med and put them in a medical school application process that will select 20,000 and leave the other 180,000 empty handed? Given how much you are suffering with basic college courses, would you have wanted to transfer that misery to HS? Do you think you could have risen to the top 10% of the most career focused and ambitious HS students? Furthermore, a direct from HS program really screws the most mature, those who choose medicine as a second career.

First, I had not even thought of the numbers- an excellent point. I'm grateful not to compete with all the people that thought they wanted to be pre-med at the end of high school.

I lived and worked in a country with a 5 year MD program right out of high school (my roommates for the first half of the year were 4th years doing rotations and my roommates for the second half of the year were aspiring physicians on a gap year working in a clinic). I can't comment on the level of education and preparedness received in the different programs, I only met excellent doctors where I was, but the experience did leave me with some thoughts.

Mostly, I felt old, and way behind in my career. People younger than I was were almost done with their medical education, and I had even entered the application process yet. By the time I'm done, they will have been practicing for four years. There were moments when I wished there was an option like this in the United States, but honestly, I was not ready to commit to medicine when I was done with high school. I loved my liberal arts education and exposure to other fields, I wouldn't give it up. I know many people do not feel that way however, and I have no way of knowing if they benefitted from being 'forced' to take English and History classes (not just by learning how to get an A with minimal effort).

Were the medical students I met as mature as I would like my physician to be? Not really, but I knew them on a personal level, when they were goofing off and being silly. I know they were always professional at the hospital, and they showed a lot of motivation and determination. They were hard workers. To a large extent, I think maturity is gained in leaps and bounds through working with patients. The ones going to medical school (18 year olds), now they seemed WAY TOO YOUNG to be in medical school- but then, I think the 5 years of medical education they were about to receive would mature them much more quickly than getting a BA would.

Anyways, there are merits for both systems. The US system is probably a lot better at whittling down candidates that are less motivated and sure of their goals, at least in part because of how long and difficult the process is (and certainly in part because of how expensive it is-don't get me started), but on the other hand, do we really want to make the path to becoming a doctor so difficult that so many individuals who might have made excellent physicians entirely give up? I think more options and different paths to becoming an MD is a good thing, and people will choose the path that works for them.

 

[Lucca]

I'll just leave this here.

I recommend you read or watch the full 22 min address because it's brilliant.

 

[Sassafrass23]

I actually had a classmate in who decided to apply to medical school after doing 2 years of college (most schools will actually let you do this if you've completed all the prerequisites-- read their admission requirements closely). She ended up realizing sometime in 3rd year that she didn't actually like working with patients and is now in the middle of her 2nd research year with plans to finally finish her 4th year next year and apply into Radiology.

I personally knew that I wanted to be a doctor since I was in high school and potentially would even have been competitive for a BS/MD program out of high school if I had applied. But I'm glad that I went the traditional route because I think my undergraduate experience was valuable.

Yep. An undergraduate degree isn't required before starting most US medical schools. If you don't want to do 4 years of undergrad, don't. But you'd better be competitive in other ways because I'm sure a degree or degree plan is a plus.

 

[bambi]

I am not familiar with the Australian system. but I have read about the English system. and although you graduate medical school after 6 post-high-shoool years, the path to become a practicing physician is actually longer than it is in the US. Yes, you graduate medical school after 6 years, but you then have two "Foundation Years", FY1 and FY2. They are two clinical years, with hospital rotations similar to our MS3 and MS4. Then, after 8 years, just like in the US, students begin their residency years. The residency process in the UK seems in general to take longer than in the US for the equivalent specialties, with less predicatable end dates. So in fact, the English system takes longer than ours.

You clearly haven't read much about the UK system if you think FY1 and 2 are like MS3 and 4. We have 3 clinical years in medical school, they are like your MS3+4 except that clinical skills are a greater focus in the UK and much more heavily tested than they seem to be in the US. Your post is actually incredibly insulting. I am sure it wasn't meant that way but it is. FY1 is essentially our intern year. We rotate as junior doctors to get a broader education, a better feel for each specialty and so we don't have to refer out for every tiny problem outside of our own specialty.

 

[BestDoctorEver]

Would the quality of physicians in the workforce be different (worse) if med school education were only 6-years (2-year prereqs at university + 4-year med school)? Many from countries that have 5-6 year program come here and pass the boards, and they practice medicine with no issues... If a 6-year program would compromise the quality of physicians in the workforce, then I am all for the 8-year program.

 

[FutureERDoc16]

I think it's a little inappropriate to say my post "reeks of immaturity". If you think the liberal arts education is so crucial, then please tell my Australian uni and many other international colleges that they are also extremely immature for not holding the same beliefs as you.

Also, condemning me for approaching a class only thinking about the grade is immature in itself. I'm not the only one, darling. Every other premedical student in the US approaches their coursework with the same manner, and I have even had professors vocalize their dislike for teaching certain classes because of this exact situation. And can you accuse us premeds? It's kind of hard to enjoy that philosophy class if you know you need to get an A at all cost. Especially if you attend a top 15 university, like myself. Might be different at easier schools.

As for the drinking...if the American drinking age wasn't so high, I wouldn't have felt the need to drink so heavily right when I was given the opportunity.
You are also probably correct in stating that I would have also drank heavily in medical school right out of high school, but you are wrong in stating that I would have not taken my medical education seriously. If I'm constantly using knowledge everyday, it's different than having to know it for that final exam freshman year and never having to see it again. My parents, who both work in business, can't recall anything from their 'required' botany courses (or any course not related to business) in undergrad. Have you ever seen "Five Minute University" on YouTube? I think that makes my argument without saying anymore.




As stated before, I'm interested in the 6-year BS/MD as the standard (2 years science and four years med). If you decide later on that medicine is for you, you can still apply for the 6-year program. Students who aren't capable will be weeded out in the first two years. Liberal arts courses should be taken pass/fail, if schools feel as if they are that necessary.

 

[circulus vitios]

The 8 year pathway is a waste of time, but you'll never change the minds of college and medical school administrators because education is money.

 

[mrh125]

Because it is. Just accept it. If you're in the system bashing and criticizing it isn't going to change anything. There are a lot of unnecessary things in every system. And there a lot of people who base their ego off of having the system be a certain way and you wouldn't want to shatter their precious egos 😛.

 

[BlueCircle]

Post reeks of immaturity. If you don't approach a class with a willingness to learn, then stop spending your parent's money and drop out.

And for the record, if you had gone straight into med school you'd still be binge drinking and forgetting everything you learned.

That's what college is for!

Wow thats pretentious. Who are you to give someone reasons to do anything?

Its this pretentious attitude that many premeds carry with them that makes me not want to be associated under the premed label.

 

[ChEMD]

Up to this point, college was probably the most fun 4 years of my life. I wouldn't give up two of those years just because I'm ambitious and want to be a doctor. Slow down and have some fun for once, college is the perfect time for that. Although I love being in medical school and enjoy this path, I often find myself reminiscing about less stressful times in college. Stop trying to go through life so quickly and enjoy the ride.

 

[mrh125]

Wow thats pretentious. Who are you to give someone reasons to do anything?

Its this pretentious attitude that many premeds carry with them that makes me not want to be associated under the premed label.

This. No one attitude fits all especially when a large portion of people don't have that attitude to begin with. People are unique and acting like they have the same capabilities, interests or ways of doing something is a gross oversimplification at best.

 

[Chipster.]

Wow thats pretentious. Who are you to give someone reasons to do anything?

Its this pretentious attitude that many premeds carry with them that makes me not want to be associated under the premed label.

This literally has nothing to do with being a premed. Why would you spend thousands of dollars going to class for something you have no interest in?

I am also not so sure you know what the word pretentious means.

And @mrh125 my post had nothing to do with anyone's capabilities. But it serves to reason that if you think your education is a waste of time then you probably shouldn't waste your time on it.

 

[Anthrax]

OP I totally get where you are coming from and I agree with you.

Many of us disagree with the North American system of earning an MD. However, I don't think it's quite right to label us all as "immature".

My family immigrated to North America when I was 3 years old. I have family members who are physicians in my home country. So I have the perspective and knowledge of the education system in both places. And I have to agree with the OP that I feel a lot of the time spent in my undergrad could have been contributed toward learning what I actually want to pursue after undergrad (MD). I am not saying I didn't have any interest at all in my undergrad education. I did. I do.

I have direct family members (uncle, cousin, mother, aunt) who are excellent physicians abroad, both in terms of medical knowledge and patient care, who had their training under the 5-year system out of high school . I like how medical education in other countries spends more time on the field you're actually going to be working in (medicine) rather than spending it in undergraduate. I am not saying there are no benefits of doing an undergraduate education. Definitely there are. However, there are many aspects of undergrad education that are simply put a waste of time and not useful whatsoever in a medical education.

I also agree with you OP that the requirement for undergrad education is strongly driven by $$$$.

However, I am here now. And the system is what it is. I am still going to pursue my ambition of studying medicine here. But it doesn't mean I can't criticize the system. And my criticism doesn't mean that I am complaining. I am just saying that I think this system is not ideal.

If there was a change I could make, then I would take the best of both worlds. Require students to complete 1-2 years of undergraduate education after they can apply to medicine.

 

[nabilesmail]

There are half as many med school slots as there are pre-meds after 3-4 years of college weeds out 80% of those who begin college as pre-meds. Would you really like to take the 200,000 HS seniors who want to be pre-med and put them in a medical school application process that will select 20,000 and leave the other 180,000 empty handed? Given how much you are suffering with basic college courses, would you have wanted to transfer that misery to HS? Do you think you could have risen to the top 10% of the most career focused and ambitious HS students? Furthermore, a direct from HS program really screws the most mature, those who choose medicine as a second career.

Today I learned something! Never thought about any of those points!

 

[XmedBarney]

There are half as many med school slots as there are pre-meds after 3-4 years of college weeds out 80% of those who begin college as pre-meds. Would you really like to take the 200,000 HS seniors who want to be pre-med and put them in a medical school application process that will select 20,000 and leave the other 180,000 empty handed? Given how much you are suffering with basic college courses, would you have wanted to transfer that misery to HS? Do you think you could have risen to the top 10% of the most career focused and ambitious HS students? Furthermore, a direct from HS program really screws the most mature, those who choose medicine as a second career.

How about a dual entry system like the UK? A 6 year course for direct entry and a 4 year course for college grads?

 

[Anthrax]

Would the quality of physicians in the workforce be different (worse) if med school education were only 6-years (2-year prereqs at university + 4-year med school)? Many from countries that have 5-6 year program come here and pass the boards, and they practice medicine with no issues... If a 6-year program would compromise the quality of physicians in the workforce, then I am all for the 8-year program.

Yes, absolutely that is an important factor to analyze.

However, I think in a way, you answered your own question. You mentioned that physicians from other countries are practicing medicine here without issues so it wouldn't compromise the quality of physicians in the workforce (my opinion).

 

[darkjedi]

I also agree with you OP that the requirement for undergrad education is strongly driven by $$$$.

how?? that makes no sense

 

[LizzyM]

How about a dual entry system like the UK? A 6 year course for direct entry and a 4 year course for college grads?

There is a 6 year (some 7 or 8) year program for direct entry. Most require "perfect" SAT or ACT scores.

 

[oncology2020]

It's true that the current medical education system is one of the most inefficient, most expensive educational systems in the world. It is true that it serves to weed out applicants but it's also a huge money maker. 4 years of pre-med is a complete waste of time in the long run besides for the "experience" and having fun, the free AP Bio/Chem/Physics classes in high school were more than enough for the background needed in medical school (despite what they tell you, you do not need organic chemistry/calculus/or even undergrad biochem for medical school). It's a $$$-making scheme for universities and private loaners..why do you think they hand out loan money like candy because by the time comes where you have to pay just multiply that debt by about 2x due to that interest being built up on it. And its a debt that can never be discharged, not even in personal bankruptcy.

The system is now also "encouraging" applicants to waste even more time by taking a couple of years off to strengthen their application as competition increases every year (biggest waste of time that is encouraged by adcoms, people don't take a year off unless you really need to! you're giving up lost income potential while adding more debt for very minimal gain, wish I got this advice when I was applying).

The MCAT and AAMCAS are a money making scheme. The MCAT does not predict the quality of doctor you'll be. In fact the people who are judging you as an applicant likely scored much lower than you back in their day.

pre-med: upto $200,000 in loans for some
medical school: upto $250,000 in loans for some
residency: get paid $50,000 before taxes for several years while running the entire hospital (they say residency is for education but the reality is you're cheap subsidized labor which is why residency is unnecessarily brutal for many)

It takes 12-15 years to become a full fledged doctor here in the US while you have dentists, nurse practitioners, CRNAs, and PAs making almost as much as some doctors in less than half the time, education, money, and less stringent academic performances. As you'll see once you enter the field of medicine, these other fields are making rapid advances in controlling the field with much less training than us. PA's doing surgeries, CRNAs administering anesthesia alone, nurse practitioners seeing patients and prescribing medicine by themselves. Included are IMGs (foreign medical students applying for residency in the US), many of who go straight out of high school without any of the ridiculous pre-med requirements or taking the MCAT. Many of these IMGs score extremely high on USMLE Step 1. Clearly, they did not do "pre-med" or take the MCAT and turn out just fine (you'll see many IMG staff physicians even at the top institutions like Mass General, Mayo or Cleveland Clinic)

The educational system for medicine in the US needs to be changed. Make it 5 years (2 years of "pre-med" + 3 years medical school). The 4th year of medical school is also a waste and just there for students to go on interviews for residency. Basic sciences can be taught in a year also which is why some medical schools have transitioned to 1 year or 1.5 years but have still kept medical school as a 4-year medical curriculum. I love what I do but the system they created for students is terrible. You guys will see once you've been through it.

 

[LizzyM]

[ Y]ou have dentists, nurse practitioners, CRNAs, and PAs making almost as much as some doctors in less than half the time, education, money, and less stringent academic performances. As you'll see once you enter the field of medicine, these other fields are making rapid advances in controlling the field with much less training than us. PA's doing surgeries, CRNAs administering anesthesia alone, nurse practitioners seeing patients and prescribing medicine by themselves. Included are IMGs (foreign medical students applying for residency in the US), many of who go straight out of high school without any of the ridiculous pre-med requirements or taking the MCAT. Many of these IMGs score extremely high on USMLE Step 1. Clearly, they did not do "pre-med" or take the MCAT and turn out just fine.

The educational system for medicine in the US needs to be changed. Make it 5 years (2 years of "pre-med" + 3 years medical school).

Make all of med education 5 years and the PAs and NP's you deride would have more years of education than MDs.

 

[oncology2020]

Make all of med education 5 years and the PAs and NP's you deride would have more years of education than MDs.

We also have several years of residency which none of those fields have as a requirement. Residency is considered graduate medical education right?

 

[LizzyM]

We also have several years of residency which none of those fields have as a requirement. Residency is considered graduate medical education right?

You said that residency was "cheap subsidized labor" and not really education.
Go back to Flexner and you'll see why med ed is what it is today.

 

[circulus vitios]

how?? that makes no sense

The majority of medical schools are affiliated with universities.

 

[circulus vitios]

Make all of med education 5 years and the PAs and NP's you deride would have more years of education than MDs.

All premedical prerequisite coursework can be completed in two years. The 8 year program could easily be compressed to 6 years without changing the med school curriculum.

 

[ChEMD]

Did no one in this thread enjoy college?? I'm still trying to understand why you all want to cut out 2 years of it...are you really that career driven, so much so that you'll only be happy once you reach the end? I understand it from a monetary perspective (fewer years paying tuition) but that doesn't seem like the primary argument here. Also, why would you want to get rid of 4th year? You just went through 3 years of difficult school, why wouldn't you want a little time you relax a little and have some fun before you go through another 3-7 years of stressful training?

I dunno, maybe it's just me, but I prefer to enjoy my time and not just rush to get to the end.

 

[sourdoughllama]

Did no one in this thread enjoy college?? I'm still trying to understand why you all want to cut out 2 years of it...are you really that career driven, so much so that you'll only be happy once you reach the end? I understand it from a monetary perspective (fewer years paying tuition) but that doesn't seem like the primary argument here. Also, why would you want to get rid of 4th year? You just went through 3 years of difficult school, why wouldn't you want a little time you relax a little and have some fun before you go through another 3-7 years of stressful training?

I dunno, maybe it's just me, but I prefer to enjoy my time and not just rush to get to the end.

Liking undergrad and saying it's necessary to be a good doc are two different things. I really liked my undergrad experience and would do it again, but I do not need 4 yrs of undergrad to tell me I want to go to med school. That is complete BS. Maybe you prioritize enjoying the ride, but to some of us, we don't have time to enjoy the scenery while our families are struggling financially. I can definitely see how a well rounded education makes people better people overall, but I do not see the benefit of taking these fluff classes for medicine. And like others have said, countless countries do not require undergrad+4 years and their docs do just fine

 

[ChEMD]

Liking undergrad and saying it's necessary to be a good doc are two different things. I really liked my undergrad experience and would do it again, but I do not need 4 yrs of undergrad to tell me I want to go to med school. That is complete BS. Maybe you prioritize enjoying the ride, but to some of us, we don't have time to enjoy the scenery while our families are struggling financially. I can definitely see how a well rounded education makes people better people overall, but I do not see the benefit of taking these fluff classes for medicine. And like others have said, countless countries do not require undergrad+4 years and their docs do just fine

See I get that argument, which is another monetary one. But many of the people in this thread are advocating for an MD program straight out of high school. For those people, they most likely wouldn't have a family dependent on them financially. They just seem much more career driven.

 

[oncology2020]

You said that residency was "cheap subsidized labor" and not really education.
Go back to Flexner and you'll see why med ed is what it is today.

Yes, residency is cheap government-subsidized labor for the hospital but because residency is technically suppose to be graduate medical education, it should ideally educate and train residents, not have them run the entire hospital. Granted running the service helps with education and training to some degree but in a lot of institutions this is abused at the expense of didactics and actual teaching.

I am familiar with Flexnor report and understand the need to have accredited medical education that meets certain high standards. I'm not saying we should decrease standards, I'm saying we need to adapt the education system to be more efficient which can be done while meeting the principles proposed by Flexnor. With the increasingly high standards required now a days, I'm sure US pre-med students with their 3.8+ GPAs, 34+ MCATs, research or publications, holding a leadership position in every club, having to take a year off to travel the world to Africa, etc. will be just as good doctors in 5-6 years of medical education as opposed to 8. I bet not many of the current adcoms even came close to the current stats required, but they clearly have made very fine doctors. Students now a days are cream of the crop when compared to 20-30 years ago.

However, with the increasingly hostile climate in the field of medicine and increasing scrutiny, there will be a point of diminishing returns--where being a doctor will not be worth all the time, debt, sacrifice, all while maintaining a constant level of very high academic achievement while other fields are making significant advances without all those sacrifices or requirements.

Duke medical students do all their medical school in 3 years plus 1 year of research, NYU has just started a 3 year medical school program (http://school.med.nyu.edu/student-resources/medical-education/md-curriculum/three-year-md-degree) ---these are prestigious institutions, it clearly can be done without sacrificing standards or quality. Pre-med needs to be shortened as well.

 

[sourdoughllama]

See I get that argument, which is another monetary one. But many of the people in this thread are advocating for an MD program straight out of high school. For those people, they most likely wouldn't have a family dependent on them financially. They just seem much more career driven.

There are many people who come from poor families who would be supporting their parents/siblings (without being the main source of income). But yes, I agree, those who are proponents of the direct MD path are more career driven

 

[hushcom]

I am familiar with Flexnor report

Are you sure?

 

[oncology2020]

Did no one in this thread enjoy college?? I'm still trying to understand why you all want to cut out 2 years of it...are you really that career driven, so much so that you'll only be happy once you reach the end? I understand it from a monetary perspective (fewer years paying tuition) but that doesn't seem like the primary argument here. Also, why would you want to get rid of 4th year? You just went through 3 years of difficult school, why wouldn't you want a little time you relax a little and have some fun before you go through another 3-7 years of stressful training?

I dunno, maybe it's just me, but I prefer to enjoy my time and not just rush to get to the end.

I loved my undergrad experience, but we're talking about whether undergrad is truly required to prepare you to be a good doctor..and the answer is: no it isn't. I didn't appreciate it either as a pre-med, but as you get older and mature, you realize and appreciate time, money, the need to spend time with family a bit more. And time isn't on your side.

 

[oncology2020]

Are you sure?

feel free to contribute to the discussion, we're debating opinions, but go ahead and correct anything that was factually incorrect

 

[circulus vitios]

Did no one in this thread enjoy college?? I'm still trying to understand why you all want to cut out 2 years of it...are you really that career driven, so much so that you'll only be happy once you reach the end? I understand it from a monetary perspective (fewer years paying tuition) but that doesn't seem like the primary argument here. Also, why would you want to get rid of 4th year? You just went through 3 years of difficult school, why wouldn't you want a little time you relax a little and have some fun before you go through another 3-7 years of stressful training?

I dunno, maybe it's just me, but I prefer to enjoy my time and not just rush to get to the end.

It's not just tuition, it's also lost income. Sure, I like relaxing and having fun. I'd rather not pay $10k/year for two years of college; $70k/year COA for a potentially useless 4th year; and forfeit $200k/year x3 years.