Just saw this article on an unnamed med school blog I follow. Sounds great, lots of relaxing and fun vacation activities. I'm sure it's nice after three years of working yourself into the ground.
I have a handful of friends that are fourth years, and their life is indeed a glorified vacation. Everytime I go into the lounge to heat up my lunch and go straight back to eat at my desk, I see them hanging out and watching TV. I see them laughing at us while we're going for that second pot of coffee, obsessing over the vertebral level of the superior mesenteric artery. Is it L1? L2? L1/2? Somebody tell me.
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| L1. It has to be L1. |
So here's my half-baked idea: what if we shortened med school by a year?
There are already schools (Duke Emory, Baylor, University of Vermont, UPenn, UVA, Lerner, to mention a few) that shorten the 2 clinical years and the 2 basic science years by just enough to give you a free year to pursue an independent project ranging from bench research to community outreach. This idea if GENIUS. At Stanford they give you every Wednesday off so you can pursue an activity of your choice, which I've covered here. What a great chance to think about what you can do for the world. So I love the idea of having a free year, but what if we just cut out that year entirely?
It would work out logistically. Given how unimportant the pre-clinical years are, there should be no problem with cutting out some M1/M2 time. sidenote - If you don't believe me, look up NRMP residency match statistics. The only things that really matter - step 1 scores and third year clerkship grades.
First - we'd cut out M1-M2 summer (3 months), a resume-padding waste of time. We'd limit biochemistry to only a few fundamental concepts, cut out 75% of it, and you'd learn the rest of the stuff as needed (1 month). We'd get rid of OB-GYN and peds as req'd clinical rotations (2 months). So you'd only be required to do the fundamentals - surgery, internal med, family, and psychiatry. Then you'd remove half of 4th yr (6 months), which we've established is a long vacation.
The money you'd save by spending one less yr in school is huge, but the MD appears much more doable as a 3 yr degree. At that point it's just as long as law school, and they're flooded with applicants.
The only possible downside - you're a year younger, so you'd be slightly less mature and prepared for actual medicine. This is where I'd combine this idea with my half-baked idea of mandatory year off between undergrad and med school would come in, so you'd be the same age when you graduated.
3 yr MD. Sounds great?
See you on the other side,
from ken
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Not a bad idea. The major problem I see is giving people enough time to decide on a specialty and go through the match process. Residency applications go in a couple of months into fourth year, with interviews in December and January and match day in March. It may sound pretty spread out, but that's a lot for residency programs to process in a short amount of time if you really want them to spend quality time considering who to interview and how to do their rankings, beyond just Step 1 scores and a handful of other things that people frequently claim are not actually a good measure of a student's potential as a physician. Like I said before, the other issue would be giving people adequate space to decide what to devote the rest of their lives to. I'm approaching the end of my third year, and many of my classmates still aren't sure what they want to go into. A six week rotation can feel really short when you're trying to decide what you want to do for the rest of your life, and a lot of people need to do an elective in a different environment to figure it out.
ReplyDeleteThe other thing is, after a few years of med school, you're tired. And residency/fellowship is going to be one big long, exhausting process (on the order of 10-11 years for pediatric cardiac surgery, as I'm sure you know). Wouldn't taking a break before diving into that be nice?
Don't get me wrong, being done and moving internship in a couple of months sounds great, especially since I know what direction I'm headed, but we need time to be human too, since most of the rest of our training is so demanding. You mentioned the cost of med school driving people away, and I agree, the cost is absolutely ridiculous, but if you told people that there would be no break, that they wouldn't have time to get married, travel, see their friends and family for 6-12 years, I think that would drive even more away- and probably the ones that you would want to be your doctor.
Hi Kia,
DeleteHope you are doing well. The giving people time to decide their specialty point is debatable, I'd assume that the people who are unsure could be happy/satisfied/not hate their job in several specialties. The tired point would be a challenge. I definitely believe physician burnout is a big problem, and med school is a big part of that. I guess my hope would be having a month or less vacation (b/w 4th yr and residency possibly?) would be enough, rather than a whole yr of a vague pseudo vacation pseudo school situation. Getting married in that gap would be hard.
Good luck and thanks for your thoughts!
from ken