The alarming possibility of virtual medical school

To lighten the mood, when patients ask me where I went to medical school, I sometimes joke that I got my medical degree online. This usually invites laughter because it is preposterous that medicine could be taught virtually. After all, medicine is a noble professional with time-honored traditions of passing down experiential information and hands-on training provided to students who need years of face time with patients before being able to practice independently. So as I currently work to help build a new allopathic medical school and in the process become more familiar with modern medical education, it seems that medical education has significantly changed and is not how I recognized it a decade ago. In fact, the possibility of a nearly online undergraduate medical school seems alarmingly possible.

When imagining medical school, one might think of rites of passage, such as enduring lengthy professor-driven lectures in cavernous lecture halls, spending hours dissecting cadavers, peering into microscopes looking at histology sections or reviewing lecture notes and reading review books in the wee hours of the night in the dark confines of a library.

Today, these elements of medical education have become nearly obsolete, and the mere mention of the word “lecture” is somewhat faux pas. Cadaveric dissection is being done either with virtual reality or well-preserved, previously dissected specimens, microscopes can be replaced with virtual ones that mimic the manipulation of an actual microscope and have the added ability to augment images with teaching points, and lectures are being replaced with group learning and self-teaching tools. Students are no longer being bottlenecked into a one-size-fits-all, take-it-or-leave-it approach to learning.

Lecture halls are now being replaced by small group sessions including problem-based and case-based series to help foster team dynamics that mimic interprofessional approaches in real-world medical practice. If you are currently in medical school, it is very likely that the medical school your professors or even your residents experienced was vastly different in its approach to teaching. Perhaps medical educators, with our varied approaches to teaching and different settings in which we teach, need to adapt to modern learners, however abhorrent it may seem to change seemingly adequate techniques. This is not to say that there aren’t fantastic teachers out there, but rather that students appreciate it when we make an effort to diversify our approaches to instilling in them medical information we feel is critical and often complex for them to understand.

Before I graduated medical school, I began to notice that no one was buying books anymore since they could be viewed (and shared) on a computer, and so the campus medical bookstore was on the verge of closing. Subsequent students were no longer required to rent and lug microscopes to the classrooms to view histology slides as the slides could be easily viewed online. Finally, the process of spending hours on cadaveric dissections was replaced with prosections.

Nowadays similar tools that support social media interactions and exploit online media tools can be used to foster modern learning in medical school. Virtual office hours, message boards to discuss complicated subjects, or videotaped lectures can all be compiled into a single platform to support learning. There are multiple commercial and publicly available resources online that medical students already use to study, and in many instances may be better than the lectures for which they are paying tuition to attend at their home institutions. Producing better physicians requires better teaching and fostering supportive learning approaches that are tailored to highly intelligent students who learn in dynamic ways.

Despite the grueling process of medical school, I do look back at it fondly knowing I accomplished those tasks that many do not have the privilege or stamina to have achieved. And yet I am beginning to realize that I cannot teach current trainees the same way I was trained as a student no matter how much pride I have in my experience. That being said, everyone in medicine will likely have to adapt to the changing tide of medical education, in many instances for the better. One would hope that the future of medical education never takes place entirely in the virtual setting and that schools offering online medical degrees never become a reality.

Marc Braunstein is a hematology-oncology physician and can be reached on Twitter @docbraunstein.

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