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 Health-Care Reform And Medical Education
The process of becoming a doctor does
not start in high school. In fact, there is very little coursework
at the college level that is designed to prepare an individual for
medical practice; there is no college "medical" major.
Many students intent upon becoming a physician will major
in biology or chemistry, but medical schools do not hesitate to accept
applicants who have excelled in any other academic area of study.
Regardless, a majority of things learned at the undergraduate level has
no relevance to the practice of medicine.
After
college and upon acceptance to a program, the would-be
doctor enrolls at a four-year medical school. Upon
graduation, he is awarded the doctor of medicine degree: the M.D.
In the first year of medical school, students cover the basic sciences,
including anatomy, biochemistry, and physiology. For students who
have studied science at the undergraduate level, these courses are
largely a duplication of material already covered, however, much of
what was learned in college is no longer remembered. There is a
huge amount of factual information to be memorized, and as a result,
most of it is soon forgotten - much like in college - after the tests.
The second year of medical school - containing a
similarly large volume of
factual information - is devoted to the study of disease and
medication. Practically the entire focus of the curriculum is
dedicated to life threatening diseases, with essentially no emphasis on
either nutrition or many of the seriously debilitating 'garden variety'
illnesses frequently encountered by doctors.
Like all other medical students, I spent my third
year of school at a teaching
hospital. Approximately 65% of the diseases that I saw were
severe liver and lung conditions; the result of smoking and alcohol
abuse. Students assisted in surgery, delivered babies, and
managed out-of-control cases of diabetes. The most common
conditions that cause people to seek medical attention, however, were
neglected.
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The fourth year is a
continuation of the hospital clinical experience, and
includes work in orthopedics and pediatrics at other specialty
hospitals. After graduation, most doctors complete their
residency, which is an additional four years spent in the supervised
practice of their medical specialty at a hospital.
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educational process of becoming a physician
is extremely arduous and
expensive, taking twelve or more years, and costing in the hundreds of
thousands of dollars. Although the student is taught by literally
hundreds of physicians, most of whom freely donate their time as a
purely charitable gesture, the majority of the student's medical studies
take the familiar form: memorize, pass-the-test, and forget. The
process is so inefficient that most of what is learned - even relevant
information - is forgotten by the time it is over.
The universe contains an inexhaustible volume of information, and to attempt rote memorization of even a small fraction of that volume
is an extremely burdensome task. Furthermore, it is impossible to
predict what one will need to know in the future. Granted, we
need to have a general understanding of how the real world works.
If
handled properly, without the dry details, students - seeing the
relevance of such
information - will be far more likely to retain what they are learning.
Beyond this general understanding, students should be given the freedom
to explore their own interests without the constraint of rigid
requirements. Furthermore, the world of academics should be
considered in cooperation with the non-academic world, offering bridges
to that realm rather than posing roadblocks.
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