World Health Education Initiative



First they ignore you,
then they laugh at you,
then they fight you,
then you win. Mahatma Gandhi

Health-Care Reform And Medical Education

The process of becoming a doctor does not start in high school.  In fact, there is very little coursework at the college level that is designed to prepare an individual for medical practice; there is no college "medical" major.

Many students intent upon becoming a physician will major in biology or chemistry, but medical schools do not hesitate to accept applicants who have excelled in any other academic area of study.  Regardless, a majority of things learned at the undergraduate level has no relevance to the practice of medicine.

After college and upon acceptance to a program, the would-be doctor enrolls at a four-year medical school.  Upon graduation, he is awarded the doctor of medicine degree: the M.D.

In the first year of medical school, students cover the basic sciences, including anatomy, biochemistry, and physiology.  For students who have studied science at the undergraduate level, these courses are largely a duplication of material already covered, however, much of what was learned in college is no longer remembered.  There is a huge amount of factual information to be memorized, and as a result, most of it is soon forgotten - much like in college - after the tests.

The second year of medical school - containing a similarly large volume of factual information - is devoted to the study of disease and medication.  Practically the entire focus of the curriculum is dedicated to life threatening diseases, with essentially no emphasis on either nutrition or many of the seriously debilitating 'garden variety' illnesses frequently encountered by doctors.

Like all other medical students, I spent my third year of school at a teaching hospital.  Approximately 65% of the diseases that I saw were severe liver and lung conditions; the result of smoking and alcohol abuse.  Students assisted in surgery, delivered babies, and managed out-of-control cases of diabetes.  The most common conditions that cause people to seek medical attention, however, were neglected.   

The fourth year is a continuation of the hospital clinical experience, and includes work in orthopedics and pediatrics at other specialty hospitals.  After graduation, most doctors complete their residency, which is an additional four years spent in the supervised practice of their medical specialty at a hospital.
By today's standards, the educational process of becoming a physician is extremely arduous and expensive, taking twelve or more years, and costing in the hundreds of thousands of dollars.  Although the student is taught by literally hundreds of physicians, most of whom freely donate their time as a purely charitable gesture, the majority of the student's medical studies take the familiar form: memorize, pass-the-test, and forget.  The process is so inefficient that most of what is learned - even relevant information - is forgotten by the time it is over.

The universe contains an inexhaustible volume of information, and to attempt rote memorization of even a small fraction of that volume is an extremely burdensome task.  Furthermore, it is impossible to predict what one will need to know in the future.  Granted, we need to have a general understanding of how the real world works.

If handled properly, without the dry details, students - seeing the relevance of such information - will be far more likely to retain what they are learning.  Beyond this general understanding, students should be given the freedom to explore their own interests without the constraint of rigid requirements.  Furthermore, the world of academics should be considered in cooperation with the non-academic world, offering bridges to that realm rather than posing roadblocks.

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