Is reducing medical training to 3 years a good idea?

Dr. Griebling“That’s a great question. As assistant dean for student affairs, I’m heavily involved with student education.

If you go back to the 1970s, that was actually a quite popular trend. The arguments were that people got through their training and into the work force faster. It addressed a need for more practicing clinicians quickly. The benefits for students included a year less of tuition costs.

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The downside is that the curriculum is already so full that trying to achieve the quality of education we can achieve now-in just 3 years-would be incredibly difficult.

Some areas of medical education suffer when schools try to streamline their curriculum. Urology is a great example. Years ago, urology was required at almost all schools. Now, as a required rotation, urology has declined dramatically among undergraduate medical students.

A number of schools matriculate students directly out of high school into a 6-year program. That basically shaves off 2 years of undergraduate education, so they start their medical training earlier. That system has proponents, while others see potential flaws with it.

We’ve had residents from those programs and they’ve done well, but it’s a different model of education.”

Tomas L. Griebling, MD, MPH

Kansas City, KS

Next: "I just can’t envision putting all 4 years of knowledge into 3.”

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Dr. Fuchs“The field of medicine is becoming more and more complex, so I can’t imagine how any student could get enough exposure in 3 years as compared to 4 years to really prepare them for practice, either in general medicine or any specialty.

There is so much more information than when I trained; I can’t imagine how you could cover sufficient information in such a short period of time.

There is a lot of information in medical school you may never use, but being exposed to that information is important because it’s still in your bank of knowledge. You can recall it if situations arise that might require at least some superficial knowledge about a given disease or diagnostic procedure.

I remember things from years ago that I only use occasionally, but it’s served me well.

I don’t think our goal is to sacrifice quality for quantity. Thousands of nurse practitioners and physician’s assistants who have limited clinical experience are graduating. They’re filling the gap for getting people in to see a minimalist and get medical care started.

I just can’t envision putting all 4 years of knowledge into 3.”

Eugene F. Fuchs, MD

Portland, OR

Next: "Why is medical school 4 years? Who determined that?"

“You have to ask yourself, why is medical school 4 years? Who determined that? Urology residencies are also being cut down. When I went, it was 6 years, and many are now 5-year programs. I’m sure I could’ve done it in 5 years, but I don’t know how that will impact the end result for the residents, just as I don’t know if medical students can gather the information they need in 3 years.

On one hand, there’s more and more information for them to digest, and if they decrease the time they have to digest it, that gives me concern. On the other hand, it may force medical schools to become leaner with regards to teaching what really needs to be taught, and not a lot of extraneous stuff.

I think about what I use on a regular basis; it’s probably a tenth of what I learned in medical school. I learned a lot that I never really used after.

I don’t know where I’d really be if I didn’t have that extra information because it’s hard to say how something forms the foundation for other knowledge; things do tend to build off of each other. But what I use day-in and day-out is pretty focused. Maybe there is a valid argument to decrease it, but my question is, ‘Why do it?’

My concern is, when quick becomes the focus, what happens to quality?”

James Roscoe Porter, MD

Seattle

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