Questioning medical school

Medical schools date back to the 9th Century in Europe. After over a millennia, the structure and content of the training provided in these schools have undergone constant revision and improvement. The dissection of stolen corpses and content driven solely on a sit-down-and-listen lecture format are now shadowed by current trends of online interactive anatomy programs and collaborative learning environments in Problem Based Learning (PBLs) Tutorials. We have certainly come a long way in how we train our medical students. So, after all of this time, have we finally perfected the art of training our future doctors? I would argue not.

Length of medical school

The length of medical school ranges from four years and eight months for undergraduate medicine, and up to seven years for post-graduate medicine. It is a common cause of shock for the public when they hear how many years it takes to become a trained doctor. However, despite an exponential increase in the amount of medical knowledge and discovery that has occurred over recent decades, the length it takes to work through medical school has largely gone unchanged.

Thus, is five years too little time to expect one person to master all the knowledge of medicine? Should we stretch the curriculum over a greater time period to reduce the stress of medical students? A recent policy on Mental Health and Wellbeing passed by the NSWMSC advocated for the evidence-based decrease in contact hours and increase in schedule flexibility to combat such stressors.

However, on the flip-side, do we then risk designing degrees in which one would be in their 30s before they finish their university qualification?

Is med school too general?

As the medical field becomes increasingly more specialised, is there a need to cram every medical concern known to man into the brain of every medical student in a five-year time frame?

Ask any neurosurgeon about the surgical and anatomical concerns of a ruptured ACL that they had to memorise during medical school, and I can assure you that those facts had long passed from their mind. Why then do we invest so many resources, tax-payers’ dollars and, most importantly, time, teaching content to medical students on the very likely chance that they will never use that information in their professional life? Could they not refer them to someone who has had that training instead? Should we skip the high school to BMedSc to MD to multiple training pathway options, into a far more efficient high-school to neurosurgery degree?Similarly, as medical science undergraduates transition into pre-clinical medicine, and clinical year medical

students transition into junior medical officers, there is an astronomical amount of overlap in content. How many times must one learn the Krebs cycle in their educational life? How many months of the medical program are spent repeating content that was taught earlier, or will be covered again later?

Paid learning

In clinical years, medical students wander wards, learn and perform simple procedures for patients and, when used correctly, can be a very valuable addition to a medical team. Students can see and treat patients under close guidance and provide a real service to the community. Why then do medical students pay, in some cases, in excess of $100,000 to do work that overlaps with that of a junior doctor? It is obvious that as students, they are still provisional providers and are currently learning. But when a service is provided, is it not fair that their work be financially rewarded? This could help alleviate the strain many medical students face trying to balance full-time studies with additional paid work.

Why ask why?

As I dissect each component of my medical school training, the parts that have remained unchanged over the years continue to bring the question to my mind – “but why?”

It is difficult to challenge something that has changed so much, yet remained so fundamentally similar over the centuries. I encourage you to not agree with me. Indeed, I encourage you not to agree with the system itself. That is the whole point of this article in the first place.

Let us continue to question, to change and to grow medical education for centuries to come.