I’m honored to be involved in the formation of the new medical school in Austin. Taking part in this exciting effort has lead me to reflect on the strengths and weaknesses of my own medical school, residency, and fellowship training experiences. A new article in the Wall Street Journal by Dr. Jonathan David provides some interesting ideas about how medical education in the U.S. could be improved.
The U.S. medical education system is the finest in the world, yet it is very expensive and inefficient. Although each medical school prides itself on the quality and delivery of its curriculum, all medical schools teach basically the same material.
For the first two “preclinical” years, students immerse themselves in the study of normal and then abnormal human bodily structure and function: anatomy, histology, physiology, pathophysiology and related disciplines. The curriculum is largely standardized by national accrediting bodies, and also by common sense (no school could eliminate the study of anatomy), although many schools will add such “extras” as “creative writing in medicine” or “medical drawing.”
Historically, each school has operated in isolation from others nearby, viewing their “brands” as valuable intellectual property to be guarded. For this reason, each of the 170 or so U.S. medical schools invests a huge amount of time and money to develop and implement its course of study. But students generally skip the live lectures to watch videos of those lectures and read the books on their own.
The uncomfortable truth is that medical schools today provide a preclinical education that their students neither want nor need. Students hate live classroom lectures, especially for basic content, and they know they learn better on their own time at their own pace. Yet schools still rely on these educational relics.
A more individualized system of self-study using the latest in digital technology, along with small study groups to integrate knowledge, would provide more effective learning. It seems wasteful to pay 170 anatomy professors to design 170 separate courses and then bill students for this privilege.
I recommend reading the entire piece. It strikes me that a challenge common to nearly all reform efforts is preserving the wisdom of tradition, while being open to new, unfamiliar ways of doing things.