Length of Training I

In a recent article in the Journal of the American Medical Association, there was a proposal about shortening the time of medical training. The argument for these changes is that excessive training creates waste; it is costly to society, hospitals, as well as the trainees themselves. Furthermore, with an anticipated shortage of providers, changing the length of training could help with skewed supply-demand problems. The paper cites programs in which training is shortened; indeed, there are combined undergraduate-medical school programs (and the British system) which curtails the undergraduate years. University of Pennsylvania medical school and Duke medical school shorten the traditional 2-year basic science curriculum to 1.5 and even 1 year in length. Harvard medical school shortens its required clinical clerkship months. All of these programs produce outstanding residents. Even in residency, the author contends that residents in specialties like internal medicine, family medicine, and pediatrics are ready for independent practice after two years of training rather than three. The author argues that surgical residents should not be required to do research. Overall, they felt that training could be reduced by 30%.

I think that shortening the time to produce physicians is a worthy task so long as it does not compromise newly trained physicians. As residents, we do feel that the bulk of our 20s and early 30s - the time that others dedicate to burgeoning careers, new families, and solidification of identity - is unfairly absorbed by medical training. A lot of what we learn and do does not directly apply to our ultimate practice of medicine. But I'm not sure we can really reduce medical training all that much. I'll try to outline some of my thoughts in the next few posts.