Expected benefits of streamlining undergraduate medical education by early commitment to specific medical specialties
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Undergraduate medical education is too long; it does not meet the needs for physicians’ workforce; and its content is inconsistent with the job characteristics of some of its graduates. In this paper we attempt to respond to these problems by streamlining medical education along the following three reforms. First, high school graduates would be eligible for undergraduate medical education programs of 4 years duration. Second, medical school applicants would be required to commit themselves to a medical specialty and choose one of four undergraduate paths: (1) “Interventions/consultations” path that would prepare its graduates for residencies in secondary and tertiary specialties, such as cardiology and surgery, (2) “continuous patient care” path for primary care specialties, such as family medicine and psychiatry, (3) “diagnostic laboratory medicine and biomedical research” path that would prepare for either laboratory-based careers, such as pathology, biochemistry and bacteriology, or research in e.g., immunology and molecular genetics, and (4) “epidemiology and public health” path that would include population-based research, preventive medicine and health care administration. Third, the content of each of these paths would focus on relevant learning outcomes, and medical school graduates would be eligible for residency training only in specialties included in their path. Hopefully, an early commitment to a medical specialty will reduce the duration of medical education, improve the regulation of physicians’ workforce and adapt the curricular content to the future job requirements from medical school graduates.
- Ahn, J., Watt, C. D., Man, L. X., Greeley, S. A., & Shea, J. A. (2007). Educating future leaders of medical research: Analysis of student opinions and goals from the MD-PhD SAGE (students’ attitudes, goals, and education) survey. Academic Medicine, 82, 633–645. CrossRef
- Andriole, D. A., Whelan, A. J., & Jeffe, D. B. (2008). Characteristics and career intentions of the emerging MD/PhD workforce. JAMA, 300, 1165–1173. CrossRef
- Asai, M., Morita, T., Akechi, T., Sugawara, Y., Fujimori, M., Akizuki, N., et al. (2007). Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: A cross-sectional nationwide survey in Japan. Psychooncology, 16, 421–428. CrossRef
- Balis, G. U., Weintraub, W., & Mackie, J. (1974). A four-year behavioral science-psychiatry path in undergraduate medical education. Journal of Medical Education, 49, 1051–1056.
- Barr, D. A., & Schmid, R. (1996). Medical education in the former Soviet Union. Academic Medicine, 71, 141–145. CrossRef
- Benbassat, J., Baumal, R., Borkan, J. M., & Ber, R. (2003). Overcoming barriers to teaching the behavioral and social sciences to medical students. Academic Medicine, 78, 372–380. CrossRef
- Bing-You, R. G., Bates, P. W., Epstein, S. K., Kuhlik, A. B., & Norris, T. E. (2010). Using decentralized medical education to address the workforce needs of a rural state: A partnership between Maine Medical Center and Tufts University School of medicine. Rural and Remote Health, 10, 1494.
- Bland, C. J., Starnaman, S., Harris, D., Henry, R., & Hembroff, L. (2000). “No fear” curricular change: Monitoring curricular change in the W. K. Kellogg Foundation’s National Initiative on Community Partnerships and Health Professions Education. Academic Medicine, 75, 623–633. CrossRef
- Blue, A. V., Barnette, J. J., Ferguson, K. J., & Barr, D. R. (2000). Evaluation methods for prevention education. Academic Medicine, 75(7 Suppl), S28–S34. CrossRef
- Brass, L. F., Akabas, M. H., Burnley, L. D., Engman, D. M., Wiley, C. A., & Andersen, O. S. (2010). Are MD-PhD programs meeting their goals? An analysis of career choices made by graduates of 24 MD-PhD programs. Academic Medicine, 85, 692–701.
- Brotherton, S. E., Simon, F. A., & Etzel, S. I. (2001). US graduate medical education, 2000–2001. JAMA, 286, 1056–1060. CrossRef
- Butrov, V. N. (1974). The education of medical personnel in the USSR. American Journal of Public Health, 64, 149–154. CrossRef
- Colwill, J. M., Perkoff, G. T., Blake, R. L., Paden, C., & Beachler, M. (1997). Modifying the culture of medical education: The first three years of the RWJ generalist physician initiative. Academic Medicine, 72, 745–753. CrossRef
- Coulehan, J., & Williams, P. C. (2001). Vanquishing virtue: The impact of medical education. Academic Medicine, 76, 598–605. CrossRef
- Dismuke, S. E., Burns, B. W., Moranetz, C. A., & Ellerbeck, E. (2001). Curriculum assessment for prevention topics and the population perspective. American Journal of Preventive Medicine, 20, 286–290. CrossRef
- Dismuke, S. E., & McClary, A. M. (2000). Putting it all together: Building a four-year curriculum. Academic Medicine, 75(7 Suppl), S90–S92. CrossRef
- Elstein, A. S., Shulman, L. S., & Sprafka, S. A. (1978). Medical problem solving: An analysis of clinical reasoning. Cambridge: Harvard University Press.
- Ganguli, I. (2010). The case for primary care—A medical student’s perspective. New England Journal of Medicine, 363, 207–209. CrossRef
- Glasser, M., Hunsaker, M., Sweet, K., MacDowell, M., & Meurer, M. (2008). A comprehensive medical education program response to rural primary care needs. Academic Medicine, 83, 952–961. CrossRef
- Kaufman, A., Klepper, D., Obenshain, S. S., Voorhees, J. D., Galey, W., Duban, S., et al. (1982). Undergraduate medical education for primary care: A case study in New Mexico. Southern Medical Journal, 75, 1110–1117. CrossRef
- Kissinger, L. (2000). Teaching prevention in internal medicine clerkships. Academic Medicine, 75(7 suppl), S60–S65. CrossRef
- Knowles, M. (1990). The adult learner: A neglected species. Houston: Gulf Publishing.
- Koniaris, L. G., Cheung, M. C., Garrison, G., Awad, W. M., & Zimmers, T. A. (2010). Perspective: PhD scientists completing medical school in two years: Looking at the Miami PhD-to-MD program alumni twenty years later. Academic Medicine, 85, 687–691. CrossRef
- Krebs, E. E., Garrett, J. M., & Konrad, T. R. (2006). The difficult doctor? Characteristics of physicians who report frustration with patients: An analysis of survey data. BMC Health Service Research, 6, 128. CrossRef
- Kuehnle, K., Winkler, D. T., & Meier-Abt, P. J. (2009). Swiss national MD-PhD-program: An outcome analysis. Swiss Medical Weekly, 139, 540–546.
- Laskowitz, D. T., Drucker, R. P., Parsonnet, J., Cross, P. C., & Gesundheit, N. (2010). Engaging students in dedicated research and scholarship during medical school: The long-term experiences at Duke and Stanford. Academic Medicine, 85, 419–428. CrossRef
- Lee, M., Wilkereson, L., Harrity, S., & Hodgson, C. S. (2006). Differences in cancer prevention knowledge and experience among medical students at three institutions over time. Journal of Cancer Education, 21, 223–229. CrossRef
- Lewin, L. O., Papp, K. K., Hodder, S. L., Workings, M. G., Wolfe, L., Glover, P., et al. (1999). Performance of third-year primary-care-path students in an integrated curriculum at Case Western Reserve University. Academic Medicine, 74(1 Suppl), S82–S89.
- Lupu, D. (2010). Estimate of current hospice and palliative medicine physician workforce shortage. Journal of Pain and Symptom Management, 40, 899. CrossRef
- Maley, M., Worley, P., & Dent, J. (2009). Using rural and remote settings in the undergraduate medical curriculum: AMEE guide no. 47. Medical Teacher, 31, 969–983. CrossRef
- Margalit, A. P. A. (2008). Balint group is one part of the whole. Accessed at http://www.annfammed.org/cgi/eletters/6/2/138#8297 on 10 February 2010.
- McManus, I. C., Livingston, G., & Katona, C. (2006). The attractions of medicine: The generic motivations of medical school applicants in relation to demography, personality and achievement. BMC Medical Education, 6, 11. CrossRef
- Newton, B. W., Savidge, M. A., Barber, L., Cleveland, E., Clardy, J., Beeman, G., et al. (2000). Differences in medical students’ empathy. Academic Medicine, 75, 1215. CrossRef
- Norman, A. W., & Calkins, E. V. (1992). Curricular variations in combined baccalaureate-M.D. programs. Academic Medicine, 67, 785–791. CrossRef
- Patel, M. S., Davis, M. M., & Lypson, M. L. (2011). Advancing medical education by teaching health policy. New England Journal of Medicine, 364, 695–697. CrossRef
- Perkins, D. N., & Salomon, G. (1989). Are cognitive skills context-bound? Educational Researcher, 18, 16–25.
- Pomrehn, P. R., Davis, M. V., Chen, D. W., & Barker, W. (2000). Prevention for the 21st century: Setting the context through undergraduate medical education. Academic Medicine, 75(7 Suppl), S5–S13. CrossRef
- Rego, P. M., & Dick, M. L. (2005). Teaching and learning population and preventive health: Challenges for modern medical curricula. Medical Education, 39, 202–213. CrossRef
- Roland, C. G., Lester, J. W., & Banfield, F. D. (1975). An undergraduate program in family medicine in a setting that lacked a clinical base in that discipline. Mayo Clinic Proceedings, 50, 549–552.
- Sackett, D. L., Haynes, R. B., & Tugwell, P. (1991). Clinical epidemiology: A basic science for clinical medicine (2nd ed.). Boston: Little, Brown.
- Santoro, S. A., Mosse, C. A., & Young, P. P. (2007). The MD/PhD pathway to a career in laboratory medicine. Clinics in Laboratory Medicine, 27, 425–434. CrossRef
- Schauer, R. W., & Schieve, D. (2006). Performance of medical students in a nontraditional rural clinical program, 1998–1999 through 2003–2004. Academic Medicine, 81, 603–607. CrossRef
- Sharma, A., Sharp, D. M., Walker, L. G., & Monson, J. R. (2008). Stress and burnout among colorectal surgeons and colorectal nurse specialists working in the National Health Service. Colorectal Disease, 10, 397–406. CrossRef
- Smith, S. R. (2011). A recipe for medical schools to produce primary care physicians. New England Journal of Medicine, 364, 496–497. CrossRef
- van Niekerk, J. P. (2009). In favor of shorter medical training. South African Medical Journal, 99, 69.
- Watt, C. D., Greeley, S. A., Shea, J. A., & Ahn, J. (2005). Educational views and attitudes, and career goals of MD-PhD students at the University of Pennsylvania School of Medicine. Academic Medicine, 80, 193–198. CrossRef
- Wilkinson, J. E., Hoffman, M., Pierce, E., & Wiecha, J. (2010). FaMeS: An innovative pipeline program to foster student interest in family medicine. Family Medicine, 42, 28–34.
- Woloschuk, W., & Tarrant, M. (2002). Does a rural educational experience influence students’ likelihood of rural practice? Impact of student background and gender. Medical Education, 36, 241–247. CrossRef
- Zeldow, P. B., Preston, R. C., & Daugherty, S. R. (1992). The decision to enter a medical specialty: Timing and stability. Medical Education, 26, 327–332. CrossRef
- Expected benefits of streamlining undergraduate medical education by early commitment to specific medical specialties
Advances in Health Sciences Education
Volume 17, Issue 1 , pp 145-155
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- Medical education, undergraduate
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- Residency training
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