Making the course of medical school less lengthy is the issue, and then only as a way of also making it less costly. In the past, medical schools admitted college juniors without degrees and granted them degrees in course as they completed their first two years of medical school. With the exception of the small handful of five and six-year combined degree programs, that era is past. Unless the numbers of quality applicants falls significantly for most medical schools, I don’t see that era returning in any significant way. Now if medical practice reimbursements are really slashed and applications plummet, then I could see some states desperately resurrecting these programs, but that would be not likely to be much of an attractor if medicine became a relatively lower-paid field or a field that became widely known as no longer a profession that offered some degree of independence.

The comparison of medical training to MBAs and JDs is not particularly useful, except that law is more similar to medicine than is business. One cannot practice medicine without a medical degree and a residency; one can work on Wall Street as a trader or analyst with a bachelor’s degree. The MBA is as much a finishing school as it is a pathway to senior management jobs (and a contacts network), but it is not a prerequisite to licensure or bar admission. One can have significant and gainful work experience in business before going for the MBA; it is difficult or impossible to manage the equivalent in medicine before earning the M.D.

In terms of shortening education, it seems to me that first two years of US colleges are often spent on the material people in other countries learn in high school. All the English composition, humanities and social science requirements… Shouldn’t a high school graduate already know how to write in his own language? The main reason the education is shorter in other countries is that people learn so much in high school. So higher education is more specialized, it doesn’t have all the generic subjects, only the requirements of one’s chosen profession.

If you don’t like working around junior people and medical students, then you really aren’t suited to work or seek care in a teaching hospital or other teaching environment. That goes for doctors, nurses and patients. There are private hospital and clinic alternatives to academic environments for those who can’t abide having junior or “immature” people around or who can’t understand or accept the limitations and qualities of the teaching and learning environment.

Making someone interested in medicine a toilet scrubber in a hospital is pointless drudgery. The fact is that most medical students are taking too long as it is to finish their training, having to defer many significant life commitments for utter lack of time and income and incomplete qualifications to work. Adding to that length of time is not the answer.

There seems to be no shortage people who resent doctors but who somehow also think themselves qualified to prescribe what medical training should include. How they should know–beyond thinking that they are older and pay bills and have accumulated personal obligations–is something that begs explanation. And just because you may work in a hospital around doctors does not make you qualified to know what training or experience they should have.

How about a one year hospital internship for the uninitiated, eg like doing all the basic but essential jobs, eg lifting, cleaning and toileting. Let them be led/bullied by nurses, as happens in their first year or two after graduation.

If they can handle that, then s

i don’t think it would help any if you don’t let students into medical school if they have no prior work experience. you’d just end up turning off even more students from going into medical school to begin with.

I’ve also advocated for shortening the training time to get an M.D. Currently, medical students are forced to spend two years and $60,000 languishing away in lecture, while a dinosaur professor reads off PowerPoint slides. I could just as easily see people teaching themselves the entire curriculum from the basic sciences and then taking Step I as the ENTRY to medical school.

Yes, medical training does create a lot of cynics. I look back upon the all the hours that I’ve spent rounding and discussing what ifs, all the time I spent in Physician Training writing about my feelings, and all the times I’ve been pimped by a resident or attending whose sole goal is to embarrass students, rather than teach them, and they realize that a lot of very valuable time it’s been wasted that will serve no good in making me a better physician.

Anyone who spent two years gaining “life experience” would quickly enroll in an MBA program, possibly at employer expense, rather than rolling the dice on a long and expensive medical education.

And while we are at it, let me suggest that “life experience” would be well provided by two mandatory years for males and females alike in the armed services. Be careful what you ask for.

The average age at admission into my medical school class was 24.5 years old (class size, 224 students). While the majority still came straight through from high school to an undergraduate degree to medical school, we have a significant (~25%) number who have graduate degrees or other professional experience (engineers, nurses, lawyers, etc).

Medical school admissions (at least in Canada) already place a very high emphasis on character, maturity, and life experience. Good grades and a high MCAT score are still a prerequisite, but by no means a guarantee of admission.

Would I want more mature doctors? Sure. Do I think there’s a few people in my class who might not belong? Yup. But on the whole, I’m very impressed with the maturity of my classmates, and I know the grueling admissions process was effective at weeding out the crazies at my medical school.

I can’t speak for other medical schools or American medical schools at all, but certainly, NO, there are not too many immature people in my medical school.

As for the last comment (Anon 5:05), perhaps the bitterness is a product of the way our society views and treats physicians, not because of the people in medical school.

If we truly wish to address the shortage of primary care physicians, then perhaps we should be rewarding those who choose to go into that field, and recruit from an earlier age.

My med school anecdote (class of 91) is that of the 8 students who came to medicine after non-medical careers, 2 are already retired, one dead (age 58), and all pursued residencies that were only 3 years long. Experience also means older, with less years to practice, less time to commit to training, and fewer years to provide better care if indeed there is anything better about their care.
Anecdote 2. As a resident I didn’t care for the older residents, because they didn’t have the stamina to pull their weight in the unlimited hours era, and they felt like the single guys should work extra to subsidize their family life.