10 Fixable Problems In US Medical Education

For the record, this list is not only based on my direct personal experiences at my current and former institutions, but also based on countless conversations with students and faculty at other institutions, discussions at meetings/conferences, and chatter on social media (thanks for the insights /r/medicalschool!). None of these criticisms should be inferred to be directed at any specific individual, school, or program.

“Dishonorable” mentions to poor implementation of problem-based learning, poor use of PowerPoint, poorly written tests, excessive focus on basic science at the expense of clinical science, having content experts each teach individual lectures within a course instead of a single expert teacher teaching the whole course, inadequate attention given to evidence-based medicine (i.e. how to look-up, appraise, and apply clinical evidence), uselessness of Step 2 CS, and inadequate consideration given to student input in their own education.

A problem which unfortunately doesn’t look to me to be fixable is our current time-based training, rather than competency-based training. In other words, medical school and residency are a fixed number of years in duration, after which all but the absolute lowest performers are graduated. Since the primary goal of medical training is to ensure that doctors are competent clinicians, it would be more logical for trainees to graduate at the point when they meet a prespecified list of milestones, irrespective of how long or short it takes to achieve that. But the logistical challenges to implementing this seem insurmountable.

Additional info on problems related to physicians seeking help for mental health and/or substance abuse: https://www.medscape.com/viewarticle/849772

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