Length of Training II

The premedical curriculum ought to be changed. The courses required are so extensive and onerous that it locks in biology majors and dissuades humanities majors, a composition of applicants which might not be ideal. Although medical students need to have some grounding in basic science principles, it always seemed excessive to me that the premed curriculum requires two years of chemistry, a year of biology, and a year of physics. Although there are pockets of medicine in which we do use a microscope or consider chemical structures or apply fluid dynamics, these are not requirements of being a good physician. Indeed, the basic sciences taught to undergrads are designed to train those who will go into academic, research, or industry careers, not those who will end up as doctors. I would advocate minimizing undergraduate requirements because I found that I learned and enjoyed my non-science courses the most. This would also allow premeds to graduate sooner if desired and reduce overall debt burden.

Similar ideas translate to the basic science years of medical school; there's a lot to learn, but the key is to train students to think critically and study independently, not to teach them everything in the textbook. Medical knowledge is changing so rapidly that it only makes sense to teach young physicians to teach themselves. However, I would not curtail the clinical years; unlike everything else so far, stepping into the hospital, learning a new environment, and seeing the practice of medicine - that's crucial for training. Even with two clinical years in medical school, there are facets of medicine I have not seen. As for the length of residency, I don't know the optimal timing, but I don't think research should be required. Residency should be designed to teach clinical competence but not force everyone down a track of academic leadership. Those who want it should have the opportunity to pursue it. It would be ideal to eliminate wasted time for trainees, but we don't want to streamline the process so much that trainees don't get to pursue their own interests and develop their own expertises.