Why is the American MD so long?

[hushcom]

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

Just Google "Flexnor" and perhaps you will see the source of my mild amusement.

Carry on.

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[BestDoctorEver]

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).

So why do we still have the 8-year program? Is it because we think we do everything better than the rest of the world a.k.a 'American Exceptionalism'?

 

[oncology2020]

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

didn't even include fellowships (ex. 3 years of cardiology fellowship --> 1 year of interventional cardiology fellowship), that's 4 more extra years of extra education and training...

radiology is 5 years of residency plus 2 fellowships before you can get a job = 7 years after 8 years of pre-med/med (not including gap years) = 15 years of time + sacrifice + high academic achievement + debt + low income

pathology = 5 years of residency plus 2-3 fellowships before you can get a job = 7-8 years after 8 years of pre-med/med (not including gap years) = 15-16 years of time + sacrifice + high academic achievement + debt + low income

clearly residency + fellowship >>> pre-med in terms of preparing you to be a good doctor, focus should be on residency and fellowship not wasting time in pre-med and pre-doctoral gap years

i can't think of any other field that requires as much time, sacrifice, debt, education, training all while maintaining a very high level of academic performance before being able to get a legit job

 

[oncology2020]

Just Google "Flexnor" and perhaps you will see the source of my mild amusement.

Carry on.

haha flexner..good catch

 

[LizzyM]

I am laughing because back in the day, nursing school was 3 years for an RN. Some places cut it back to 2 years for an associate degree and the RN. Somehow, my mom, although she came from a working class family, was herded to a 4 year college for a BSN. Today, the 3 year schools are history, and most of the nurses who do not have bachelors degrees will be put out to pasture soon as "non-professoinal". Now you want to have future physicians trotting off to medical school with essentially an associate degree?? This is not vocational training and it is not technical school.

 

[sourdoughllama]

I am laughing because back in the day, nursing school was 3 years for an RN. Some places cut it back to 2 years for an associate degree and the RN. Somehow, my mom, although she came from a working class family, was herded to a 4 year college for a BSN. Today, the 3 year schools are history, and most of the nurses who do not have bachelors degrees will be put out to pasture soon and "non-professoinal". Now you want to have future physicians trotting off to medical school with essentially an associate degree?? This is not vocational training and it is not technical school.

Well to be fair, that only sounds ridiculous because that's how the system is at the moment and change to the status quo always sounds weird. But that is the way most countries operate, and I don't think people are dropping dead because of that. I'm not sure nurses inherently need a bachelor's to do their jobs - I think it is all but required now because of the job market.

 

[darkjedi]

The majority of medical schools are affiliated with universities.

do you know how ridiculous that sounds

 

[circulus vitios]

I am laughing because back in the day, nursing school was 3 years for an RN. Some places cut it back to 2 years for an associate degree and the RN. Somehow, my mom, although she came from a working class family, was herded to a 4 year college for a BSN. Today, the 3 year schools are history, and most of the nurses who do not have bachelors degrees will be put out to pasture soon and "non-professoinal". Now you want to have future physicians trotting off to medical school with essentially an associate degree?? This is not vocational training and it is not technical school.

The pre-requisite science courses are a year of bio, chem, organic chem, and physics. Substitute organic II with biochemistry for the 2015 MCAT. Non-science courses are a year of english, and a semester each of psychology and sociology. This can all be done in two years.

 

[oncology2020]

I am laughing because back in the day, nursing school was 3 years for an RN. Some places cut it back to 2 years for an associate degree and the RN. Somehow, my mom, although she came from a working class family, was herded to a 4 year college for a BSN. Today, the 3 year schools are history, and most of the nurses who do not have bachelors degrees will be put out to pasture soon and "non-professoinal". Now you want to have future physicians trotting off to medical school with essentially an associate degree?? This is not vocational training and it is not technical school.

I understand what you're saying, I'm not necessarily looking at length of degrees, more at the total length of training and education before being able to get a real job (undergrad + med school + residency + fellowship). Plus, the medical degree historically has been an undergraduate degree. The British system views the medical degree as an undergraduate degree (hence the MBBS = Bachelor of medicine and bachelor of surgery = equivalent to the MD) and residency is viewed as graduate medical education. In majority of other countries, the US system would be equivalent to getting two Bachelor's degrees there. I'm saying we should shorten the length of degrees so that focus can be on actual more relevant training: graduate medical education (Residency + fellowship). You're ignoring residency and fellowship in your comparison. Nurses don't have to go through residency and fellowship, so it's not an apples to apples comparison. Even after cutting our degree training by 2-3 years we still have many many more years of extremely rigorous training than any nurse/dentist/PA/pharmacist/CRNA.

 

[Leoz M Jiliums]

I'll just leave this here.

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

It's posts like these that keep me coming back to SDN. That speech is a gem, thanks for sharing.

 

[BestDoctorEver]

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.

I want to comment on this above point you make... A DO internist that graduated in the late 90s that I shadowed told me why I am wasting my time applying DO with my good MCAT score--my score is a mid 20s. She thought I had a competitive score for MD... I told her my score is not even competitive for the top DO schools and I had to show her the MSAR because she did not believe me. That is when she told me she got in with an 18 MCAT score and she believes at that time her school average MCAT was 20. Now if your MCAT is 25-29, you are not fit to be a physician by adcoms and SDN standards.

 

[mehc012]

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".

I don't think the immaturity comment had to do with the opinion on the length of MD training so much as OP's terrible attitude towards education in general. Cramming the info just for a grade and then binge drinking to purge it quickly, being completely unable to find any merit in a course which is not beinganMD101, etc...that is what struck me as immature about the OP. Perhaps that is not what the previous posters were going for, but it's certainly how I took it.

 

[LizzyM]

I understand what you're saying, I'm not necessarily looking at length of degrees, more at the total length of training and education before being able to get a real job (undergrad + med school + residency + fellowship). Plus, the medical degree historically has been an undergraduate degree. The British system views the medical degree as an undergraduate degree (hence the MBBS = Bachelor of medicine and bachelor surgery = equivalent to the MD) and residency is viewed as graduate medical education. In majority of other countries, the US system would be equivalent to getting two Bachelor's degrees there. I'm saying we should shorten the length of degrees so that focus can be on actual more relevant training: graduate medical education (Residency + fellowship). Nurses don't have to go through residency and fellowship, so it's not an apples to apples comparison. Even after cutting our degree training by 2-3 years we still have many many more years of extremely rigorous training than any nurse/dentist/PA/pharmacist/CRNA.

Keep in mind that the secondary school system is different. And we have 6 year BS/MD programs... what was stopping you from being admitted to one?
http://prestigeobsessed.blogspot.com/p/babsmd-list.html

 

[darklabel]

But is education really 8 years anymore?

It just seems like this would dissuade non-trads or people who need time to think about becoming a physician before it is possible. Then you run into the idea that the general population would not see people straight out of high school as mature enough (which I wholeheartedly agree with). Sure SDN has a lot of mature premeds who know a lot about the process and are willing to do what it takes to be a physician, but I am sure many people in medical school today are different from people they were in high school.

The average age of medical school students is rising and its not uncommon for people who are coming out of a masters degree or another career to apply to medical school these days. I like the current 8+ year program since I took a year off and I know that helped me get into medical school. Those people who are so driven to get into medical school ASAP can just apply to the 7 year programs available around the country.

I want to comment on this above point you make... A DO internist that graduated in the late 90s that I shadowed told me why I am wasting my time applying DO with my good MCAT score--my score is a mid 20s. She thought I had a competitive score for MD... I told her my score is not even competitive for the top DO schools. I had to show her the MSAR because she did not believe me. That is when she told me shot in with an 18 MCAT score and she believes at that time her school average MCAT was 20.

Yeah, it sucks how much competition has grown and will continue to grow as each year passes by. She probably didn't even take the MCAT seriously.

 

[mehc012]

Keep in mind that the secondary school system is different. And we have 6 year BS/MD programs... what was stopping you from being admitted to one?
http://prestigeobsessed.blogspot.com/p/babsmd-list.html

Didn't know I was interested in medicine...I would actually have been a far better candidate (on paper, at least) for a BS/MD after HS than I am for an MD now after college.
And yet, 17-yr old me was NOT ready. I grew up so freaking much between HS and college graduation that I honestly don't think that anyone I knew back then would recognize me if it weren't for the whole facial-recognition thing our brains are so damn good at. Everyone says this, I know, but I was probably an outlier both in the amount of growing I had to do and in how little that deficit showed on paper.
I, for one, am grateful that the BS -> MD path still exists, though I wouldn't (and don't) begrudge a 6yr path (since that exists too).

Perhaps the reason the US delays things at the college and graduate stages so much is that we are also far slower on all previous stages of education/maturity. We simply do not expect mature behavior out of 'kids' until they are 18-23! It is expected in America that teens will be incredibly irresponsible and that young adults will be irresponsible only without supervision. Whether that is true in all cases, should be true, or has to be true at all isn't the point...what matters is that we don't consider the average 18-yr old to be a very responsible person. Is it any surprise, then, that we set up a system where people don't go for MD until they're in their early 20s, and don't practice medicine until they're nearly 30?

 

[Womb Raider]

So I'm confused... We've already established that not all medical schools in the US require 4 years of undergrad for acceptance. Why are we still arguing?

@FutureERDoc16 Why did you aim for a 4 year degree before applying to medical school rather than getting the pre-reqs out of the way and applying without a degree?

 

[Euxox]

The majority of medical schools are affiliated with universities.

An absurd and stupid conspiracy theory. The majority of medical schools take the majority of their students from other universities, so they are not the ones earning the undergraduate tuition money.

 

[oncology2020]

Keep in mind that the secondary school system is different. And we have 6 year BS/MD programs... what was stopping you from being admitted to one?
http://prestigeobsessed.blogspot.com/p/babsmd-list.html

how do you know i wasn't admitted to one? either way, im just providing my opinions about the traditional system in hindsight, based on my own personal experiences having gone through the system..my opinion is that programs like the 6 year programs should be the standard..many of the BS/MD programs are not 6 years, most are still 8 years and most schools (especially most of the top schools) don't offer it as an option

 

[Optimus-Prime]

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

I've heard that Brown reports separate step 1 scores between their traditional applicants, and BS/MD applicants; I could see it correlating to poorer scores

 

[Euxox]

So I'm confused... We've already established that not all medical schools in the US require 4 years of undergrad for acceptance. Why are we still arguing?

1. Six year MD programs are a dying breed. They are much rarer than they were ten years ago, and it seems that seven year programs are headed down the same path.
2. Six/seven year programs are much more competitive than regular MD admissions. This good in a way because many 4.0 high school students aren't a great fit for medicine, but there are also many excellent medical students and physicians who were not competitive enough for BS/MD programs as high schoolers. It simply isn't an option for everyone.
3. I know some people who went to six year programs and they felt that they were discriminated against in residency and job interviews because of their age. This will continue to happen unless 24/25 year old medical school graduates become more common.

 

[sourdoughllama]

Perhaps the reason the US delays things at the college and graduate stages so much is that we are also far slower on all previous stages of education/maturity. We simply do not expect mature behavior out of 'kids' until they are 18-23! It is expected in America that teens will be incredibly irresponsible and that young adults will be irresponsible only without supervision. Whether that is true in all cases, should be true, or has to be true at all isn't the point...what matters is that we don't consider the average 18-yr old to be a very responsible person. Is it any surprise, then, that we set up a system where people don't go for MD until they're in their early 20s, and don't practice medicine until they're nearly 30?

Do you have sources for this? I hear this all the time but where are these claims coming from? I have family all over the world and friends from multiple countries and 18 year olds act the same everywhere. I don't think the US is any different. The average sub-3.0 HS student may be under performing in comparison to some of the top countries for compulsory education (ie Finland and the like), but I would argue most AP-loaded high schoolers are on par with other developed countries. These would be the same set of people applying for med school and getting in.

 

[Euxox]

I don't think we should hold Flexner report as some kind of unquestionable gospel of medical education. Flexner had some good recommendations like ending for-profit medical education, increasing clinical hours, and emphasizing the role of science. But let's not forget that he was a JHU graduate who (who would believe it) thought that Johns Hopkins was the greatest medical school on earth and that all others should be modeled after it: very heavily research focused and requiring a Bachelor's degree of all matriculants.

Flexner did not value emphasis on things such as primary care, rural care, and African American medical education. His suggestion that every medical school be attached to a university led to the closure of many rural medical schools and historically black medical schools. Fewer physicians also led to increased medical costs.

So I don't think we should discount the high school to medical school track just because Flexner did. Since the UK is clearly able to train high school students into very competent physicians, it doesn't seem reasonable to say that high school students lack the maturity to do well in medical school. There are many students in the UK who opt to do a Bachelor's degree before medical school (either for personal enrichment or because they didn't originally intend to go into medicine), so I also don't think it is accurate to say that dropping the Bachelor's requirement chips away at the ideal of a liberal arts education or that it discriminates against nontrads.

The real issue, IMO, is that it is nearly impossible for high school students to know if medicine is the right career for them. I don't have any hard data to support this, but I'd guess that many med students in the UK have second thoughts about medicine partway through school but feel trapped into the track.

On another note, it's always bothered me that med students only spend two years on the wards. And they only have one year's experience when they apply to residency. It seems like it would be difficult to tell how qualified a medical student is for a residency program just from four or five clerkship grades. Maybe that is why board scores are weighted so heavily? But are board scores really a great indicator either? They test knowledge from the preclinical classroom courses, after all, not clinical knowledge. If you removed the Bachelor's degree from the equation and replaced it with a streamlined basic science curriculum, you could fit in a lot more clinical work into those eight years, or even into six or seven years.

My point is that there are definitely issues with the US/Canadian system as it stands. I'm not sure how they could be resolved, but I also don't think that it is 100% obvious that requiring a Bachelor's for medical school is the right way to go.

 

[ChEMD]

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.

Okay, so then can we agree that it's primarily a monetary argument?

 

[Lucca]

It's posts like these that keep me coming back to SDN. That speech is a gem, thanks for sharing.

I have it bookmarked for those moments when I get neurotic and everything just feels like a hoop to jump through.

 

[sourdoughllama]

Okay, so then can we agree that it's primarily a monetary argument?

Time + effort (for random classes we have to take like physics, o chem). While money is a strong reason, there is just way too much time wasted and wishy-washy reasons as to why the US needs a special path to medicine when it clearly works in a shorter amount of time in most other places.

 

[ChEMD]

Time + effort (for random classes we have to take like physics, o chem). While money is a strong reason, there is just way too much time wasted and wishy-washy reasons as to why the US needs a special path to medicine when it clearly works in a shorter amount of time in most other places.

I guess I just don't see college as wasted time, but I suppose people have different views and goals.

 

[sourdoughllama]

I guess I just don't see college as wasted time, but I suppose people have different views and goals.

Lol I actually like the 4+4 model since it gives me time to think before jumping in, but I can definitely see why proponents of straight-6 yr are against 4+4

 

[ChEMD]

Lol I actually like the 4+4 model since it gives me time to think before jumping in, but I can definitely see why proponents of straight-6 yr are against 4+4

Yeah definitely, I can see both sides. I just want to remind people that there is more to life than a career! But I suppose if fast tracking your career is what makes you happy, who am I to judge.

 

[Euxox]

I guess I just don't see college as wasted time, but I suppose people have different views and goals.

Yes, this is a very personal judgement. For me, the first two years of college were great. I learned an incredible amount. But there is only so much that you can learn from classroom courses, and by junior year, I felt more and more that classes were getting in the way of learning. I could read the tenth textbook about engineering, or I could go out and build something. I could write my thirtieth lab report about some phenomenon discovered in the 70s or I could go work 30 hours a week in an actual lab and learn how to formulate and test a hypothesis under the supervision of a PI. I'd have liked to choose the latter options, but I couldn't because I needed to fulfill degree and premed requirements. I was basically killing time until I got into medical school.

Sitting and having someone lecture at you may be the quickest way to start off when you are at square zero, but it is nowhere near the best way to learn. Eventually you need to move into hands on learning. Ideally undergrad would be two years classes + two years real world experience.

For me, it's not about having a fast-track to a career. It's that the current system encourages you to explore your interests in undergrad before matriculating into medical school, but doesn't really set up the right environment for you to do it completely. Instead you end up with a watered-down undergrad experience that is stretched out to fill out four years. (That's my personal experience. Others may disagree.) If the undergrad degree has to be watered-down anyway, why not cut it to two years?

That said, I'm not sure if I would have been ready for medical school two years ago. I was probably ready at an academic level, but not at a personal/psychological level.

 

[Lucca]

Yeah definitely, I can see both sides. I just want to remind people that there is more to life than a career! But I suppose if fast tracking your career is what makes you happy, who am I to judge.

I agree with you. I think what people find most difficult, whether they realize it or not, is their inability to divorce their career interests from the value of their education.

If you are stuck on this idea that academics must yield some professional value then you're going to be stuck in this sick cycle where the only roles academics plays in your life is as the antagonist to your professional career. An adversary to be conquered rather than an investment in yourself.

What I find tragic is the enormous number of students that gun their whole lives for ivy undergrads and never give a second thought to the fact that all of the ivies are liberal arts institutions and then turn around and laugh at anyone who takes their liberal arts coursework seriously.

 

[altitudinarian]

This topic sounds like a good medical anthropology/public health thesis...

To get to the point though, I can see both sides' arguments, and I wonder, "Is there any ways (s) to make the journey towards becoming a doctor more efficient, yet not losing the high standards, the want of quality?" Because as noted, the world has varying educational systems that have been formed due to the history and progression of the peoples of that country, so it's hard to compare, because like someone noted, there are clearly competent physicians from other countries coming here to practice and teach, and I'm going to assume that they are competent because they excelled at acing the medical educational system their country offers, so what's the big hubbub?

The time commitment, financials, compromises...basically you need to situate your life to accommodate your medical education. It requires much preparation, dedication, and consistent effort over a long period of time to be successful, from your undergrad through the med school process to doing med school and the work that follows. For some people back in college, who wanted to be physicians, the idea of spending those many years, in debt if they didn't get scholarship/financial aid, and not even being assured they were going to get in even if they had a strong application, made them run the other way. Even the first Gen Chem course they took, after the first exam, many said, "Forget this. I'm majoring in ___." Because they realized, "If I can't ace Gen Chem now, how could I possibly do well in Orgo? Med school?" And for some who were on financial aid, the idea of not using the 4 years of undergrad to do something "useful" so to make money if not for their families, but themselves so their parents won't pay for them, made medicine less appealing. And to others, they simply just wanted to finish their prereqs for med school and their major by sophomore year, so either they had to do a science major, or a science major. For it's hard to do a humanities major and pre-reqs for med school in only two years.

Granted, some of them I do believe just need to hone their studying skills and be more confident, but at any rate, I get that the 8 year (and for some doing MD/PhD, MD/MPH, etc. , it's even longer) is a long haul. But it's the US medical system for now, and so far it has produced some great doctors (Atul Gawande, Benjamin Carson, Paul Farmer, Pardis Sabeti, Laurie Glimcher, to name a few), so one either bears with it, becomes powerful enough to change it, or go to another country. But I also understand that the medical school education could be condensed, considering again some of our counterparts overseas have such systems. And time does equate to money being invested, so I can also understand why one would want to shorten the academic journey of a doctor so to accommodate those who are in tough financial situations to the point that they might not be able to go to college, or enter a 4 year university, etc. Also, it could make the medical journey more accessible to underrepresented minorities, particularly Native Americans on reservations and those in rural areas that might not have the mentors, infrastructures, etc. that can get them through the process from start to finish.

Now for the liberal arts education. The college I'm talking about in the 3rd paragraph prides itself on its liberal arts education b/c it's a liberal arts college. There are plenty of discussions led by faculty on campus of the "disappearing" liberal arts education in this new age of STEM emphasis, and students arguing over if it's worth going into humanities b/c the liberal arts education makes the humanities so much more worthwhile, but "would I get a job with that?" All in all, I believe the liberal arts education is worth it. Now, I don't believe that means colleges should hike up their costs b/c they offer such an education, but at least for this college, the education is engaging, thought-provoking, and the professors (the ones who care about teaching and teach well, which a good portion do), make you think critically and discuss the ideas in class. Not saying it's "the" education or that it's perfect, but it suits well for those who want and are receptive to this education.

 

[mehc012]

Do you have sources for this? I hear this all the time but where are these claims coming from? I have family all over the world and friends from multiple countries and 18 year olds act the same everywhere. I don't think the US is any different. The average sub-3.0 HS student may be under performing in comparison to some of the top countries for compulsory education (ie Finland and the like), but I would argue most AP-loaded high schoolers are on par with other developed countries. These would be the same set of people applying for med school and getting in.

I absolutely do not, feel free to disregard everything I say on the matter.
This is solely my opinion from my travels and conversations with people from various backgrounds.

Honestly, I don't find most AP-loaded high school students to be mature at all. I would be more likely to use the description "uptight perfectionists with no real responsibilities and no idea of how to deal with adversity or the real world". Doing well academically is a goal of a mature person, sure, but that does not by any means make academic prowess a marker of maturity.

The thing is, here the expectation is that they'll go off to college and become more immature. Maybe that's true everywhere - I admit that my opinion on this front is entirely anecdotal - but my impression has been that America is particularly bad on this front.

 

[sourdoughllama]

I absolutely do not, feel free to disregard everything I say on the matter.
This is solely my opinion from my travels and conversations with people from various backgrounds.

Honestly, I don't find most AP-loaded high school students to be mature at all. I would be more likely to use the description "uptight perfectionists with no real responsibilities and no idea of how to deal with adversity or the real world". Doing well academically is a goal of a mature person, sure, but that does not by any means make academic prowess a marker of maturity.

The thing is, here the expectation is that they'll go off to college and become more immature. Maybe that's true everywhere - I admit that my opinion on this front is entirely anecdotal - but my impression has been that America is particularly bad on this front.

My bad, my comment regarding the AP-loading was toward your "America is slower on education" part. I hear American education is crap all the time. I completely agree AP-loading does not equal maturity.

Regarding the US vs. other countries:

1- I suspect people from other countries just like to hate on America. This is coming from someone who is an immigrant and has seen this first hand. Americans like to make fun of America, and in turn, the world thinks America is full of fat, stupid red necks (I'm not sure why this is a fad in the US at all - I quite like the country). We propagate these stereotypes
2- I'm not sure about other countries, but where I came from is a lot less conservative than America (with regards to alcohol, sex, etc), and I've heard this is also true of Europe. Maybe American teens just lash out because we like to make everything taboo?

 

[mehc012]

My bad, my comment regarding the AP-loading was toward your "America is slower on education" part. I hear American education is crap all the time. I completely agree AP-loading does not equal maturity.

Regarding the US vs. other countries:

1- I suspect people from other countries just like to hate on America. This is coming from someone who is an immigrant and has seen this first hand. Americans like to make fun of America, and in turn, the world thinks America is full of fat, stupid red necks (I'm not sure why this is a fad in the US at all - I quite like the country). We propagate these stereotypes
2- I'm not sure about other countries, but where I came from is a lot less conservative than America (with regards to alcohol, sex, etc), and I've heard this is also true of Europe. Maybe American teens just lash out because we like to make everything taboo?

Oh, I wasn't trying to comment on the quality of education. That's a can of worms I don't feel like opening (though there is probably far more data on that).

It's the second part of it I was trying to get at - America is crazy uptight, and I feel like there's this bizarre cycle where
'adults are uptight' --> 'teens are rebellious if they do anything not uptight' --> 'go crazy in secret in HS, which is expected and implicitly if certainly not explicitly encouraged' --> 'go crazy in college which is explicitly expected and celebrated'

And then we're supposed to magically mature. Of course, the stakes grow at every stage in the process, even though expected outward maturity levels decrease.
Honestly, I think people should be immature at some point in their lives, and get exposed to sex and alcohol and whatnot. People who never slip up or let loose are ticking timebombs, imo. I just don't understand the timing here.

 

[circulus vitios]

Okay, so then can we agree that it's primarily a monetary argument?

Yeah, just a mere $700k.

 

[FutureERDoc16]

@FutureERDoc16 Why did you aim for a 4 year degree before applying to medical school rather than getting the pre-reqs out of the way and applying without a degree?[/QUOTE]

?.... Believe me, I looked at every possible solution to skipping the 4-year degree. Last time I checked freshman year, medical schools required 90 credit hours to apply. That's senior status. So no, I didn't apply early.

 

[FutureERDoc16]

Another question I have, which may be off topic, is why do American MD schools only take one class every year? I know several of the Caribbean programs have an entering class every semester. To me that seems like a nice idea.

 

[darkjedi]

Another question I have, which may be off topic, is why do American MD schools only take one class every year? I know several of the Caribbean programs have an entering class every semester. To me that seems like a nice idea.

ok now you're just trolling

 

[hushcom]

Another question I have, which may be off topic, is why do American MD schools only take one class every year? I know several of the Caribbean programs have an entering class every semester. To me that seems like a nice idea.

The Caribbean programs need massive, constant influxes of new students because the attrition rate is so high.

 

[oncology2020]

Another question I have, which may be off topic, is why do American MD schools only take one class every year? I know several of the Caribbean programs have an entering class every semester. To me that seems like a nice idea.

the carribean schools are for-profit..their main goal is not to produce compentent doctors..their goal is to make money

 

[compstomper]

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.

The reason for the long duration of study is that having a well rounded liberal arts education would make anyone, doctor or not, a member of an informed citizenry ideally suited for a democracy such as the US. That doctors are leaders in their fields/community makes this doubly important. This education would also help future physicians learn about people different from themselves, people from background they've never interacted with before, much like the patients they'll see in their medical careers. The flexner report in 1910 was used by the medical profession to set the standard for medical education, as at the turn of the 20th century American medical education was quite slapdash by any standard today here or abroad. Thus requirements for entrance to medical schools were increased substantially...........

.......or

There are many more people who wants to become a doctor than there are slots in medical schools in the US. This is evidenced by the yearly acceptance statistics of MD schools (roughly 42% acceptance was it?). Now a cynical person would say that these requirements to becoming a doctor are simply hoops to jump through, and that the premed curriculum could have been about 18th century French literature and the same candidates who are accepted today would be accepted in that system. That these science/liberal arts courses + the MCAT isn't about learning new knowledge per se, but is simply a seemingly fair yet arbitrarily selected weeding out process that's just as much about testing a student's perseverance and willingness to endure, arguably important characteristics in becoming a physician.


Take your pick.

 

[LuciusVorenus]

Let's put aside the fact that this would result in 14 year old kids looking for clinical volunteering opportunities/spending even more on SAT prep than they already do/basically recreate the entire hell that is the premed experience with the added annoyance that now it's hundreds of thousands of adolescents participating.

Has anyone pointed out that the public k-12 system in the U.S is a complete joke when it comes to leveling the playing field? Sure, college doesn't fix everything, but it definitely helps those premeds who grew up in rural/poverty stricken urban areas. We're not built for a straight to MD system.

 

[Womb Raider]

?.... Believe me, I looked at every possible solution to skipping the 4-year degree. Last time I checked freshman year, medical schools required 90 credit hours to apply. That's senior status. So no, I didn't apply early.

So you're OK with skipping two years of college but not one? Who cares about senior status? That's one year of your life you could be making money instead of going to school. (Heck it could be more if you took more than 15h/s). Am I missing something here?

 

[sourdoughllama]

Let's put aside the fact that this would result in 14 year old kids looking for clinical volunteering opportunities/spending even more on SAT prep than they already do/basically recreate the entire hell that is the premed experience with the added annoyance that now it's hundreds of thousands of adolescents participating.

Has anyone pointed out that the public k-12 system in the U.S is a complete joke when it comes to leveling the playing field? Sure, college doesn't fix everything, but it definitely helps those premeds who grew up in rural/poverty stricken urban areas. We're not built for a straight to MD system.

That's assuming that medical school admissions still keeps the same entrance standards. In many other countries, all it takes is a one-time, national entrance exam (like the MCAT), no ECs, no grades. So it doesn't necessarily mean a rat race - that's just how it is in the US. Also, many countries have education systems way worse than the US (like South America where I'm from). If you guys think the public education in the US is bad, try going to other countries that aren't rich European countries - it's not even remotely close. Every one of these countries has doctors and a medical education system that goes directly from high school to med school and they do just fine.

 

[touchpause13]

Culturally having a BS/MD program exclusively doesn't make any sense. Teens are expected to be immature idiots. We don't let people drink legally until they are 21, or rent a car without jacking up the price until they are 25. People don't want green looking doctors.

Also the idea of reinvention is significant and having exclusively high school to med school would screw over non trads

 

[Womb Raider]

That's assuming that medical school admissions still keeps the same entrance standards. In many other countries, all it takes is a one-time, national entrance exam (like the MCAT), no ECs, no grades. So it doesn't necessarily mean a rat race - that's just how it is in the US. Also, many countries have education systems way worse than the US (like South America where I'm from). If you guys think the public education in the US is bad, try going to other countries that aren't rich European countries - it's not even remotely close. Every one of these countries has doctors and a medical education system that goes directly from high school to med school and they do just fine.

Doesn't mean a rat race? What do you think medical school admissions would be if the MCAT (or any test) and GPA were the only things that mattered? This would be a severe step backward in our huge movement to admit less-than-qualified (or below avg... however you want to look at it) underrepresented minorities to medical school. Also, as someone else mentioned earlier, I would think the education gap between low & high socioeconomic groups are greater in high school than college.

 

[Espadaleader]

An undergrad degree gives students time to mature and it allows for more intellectual and SES diversity. That poor boy from appalachia can go to State U and level the playing field by the time he finishes. Only a very small pool of students would be ready for a MD program at 18

 

[Espadaleader]

Doesn't mean a rat race? What do you think medical school admissions would be if the MCAT (or any test) and GPA were the only things that mattered? This would be a severe step backward in our huge movement to admit less-than-qualified (or below avg... however you want to look at it) underrepresented minorities to medical school. Also, as someone else mentioned earlier, I would think the education gap between low & high socioeconomic groups are greater in high school than college.

Every URM that gets into medical school is qualified. Stop with the BS.

 

[Lucca]

Culturally having a BS/MD program exclusively doesn't make any sense. Teens are expected to be immature idiots. We don't let people drink legally until they are 21, or rent a car without jacking up the price until they are 25. People don't want green looking doctors.

Also the idea of reinvention is significant and having exclusively high school to med school would screw over non trads

There's a lot of conflicting information we send our kids here in the US and it only serves to infantilize them. It doesnt help that undergrad is ridiculously expensive and what should be "adults" are forced to live under their parents until they are 30

 

[touchpause13]

There's a lot of conflicting information we send our kids here in the US and it only serves to infantilize them. It doesnt help that undergrad is ridiculously expensive and what should be "adults" are forced to live under their parents until they are 30

Oh I agree. I don't think it's a good thing that we treat legal adults like they are preschoolers. I think helicopter parenting is also to blame (my parents did this, it sucked)