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 A Specific Plan For Medical Education Reform
We must remove unnecessary obstacles in the system that increase cost, intensify stress, and consume valuable time.
We must emphasize preventive medicine, outpatient treatment, and functional medicine. We must expand our focus to include nutrition. Furthermore, we can eliminate the cost to the student and his family.
At present, a free, privately funded internet university, which will be open to all, is being formed. This university will inevitably include medical education, with teaching methods essentially the same as those that I have proposed. There should be telephone and email support available, but we need not wait for that. We can start now.
At what age should the medical education start? If conducted via the internet, there would be no minimum age. Rather than begin with the medical student memorizing and then forgetting volumes of inconsequential information, he or she would begin with basic sciences that contain only relevant information. By reducing the sheer volume of information, the overall rates of retention would be much higher.
Without the institutions (and their inherent rigidity or expense), this education would be essentially free of cost. For a mere $29, students could begin their studies with a paperback book entitled by Patricia S. Hurlbut. This book would
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familiarize the student with the basic routine of a doctor’s office.
Once he or she has started his or her apprenticeship, I would suggest that he read . This book will serve as an excellent reference tool. |
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Although some of the information in Current Diagnosis is incorrect, most doctors still rely upon it. The student should be cautious of accepting any information at face value, and should always augment his information base by scouring the resources available on the internet, and carefully considering the information presented to him by motivated patients. It is much easier to learn about diseases and medications when dealing with a patient who is actually suffering from that particular ailment.
Once the student has completed this independent study, entirely on his own initiative, he can approach his first prospective doctor-mentor. The student's hands-on medical education would begin with the student taking patient histories. This 'apprenticeship' was discussed earlier. Next he would learn the fundamental elements of disease and medication.
The student will essentially offer to act as the doctor's medical assistant in exchange for the doctor's willingness to associate with him. Based on an interview to determine the applicant’s maturity and other personal attributes, and a standardized test administered to measure the student's understanding of basic medical concepts, the doctor may agree to such a partnership. Both doctor and student would agree to such an arrangement. The apprenticeship would be entirely voluntary on both sides.
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Although the student would not give medical advice or treatment, he would provide the valuable - and often time consuming service - of taking patient histories. This would provide the student with a wealth of knowledge.
The doctor would confirm the accuracy of the key points in the patient histories and provide reports monitoring
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the progress of the students. In contrast to current medical education, the student would begin in an outpatient setting, as it is less stressful. Also, the monitoring of his progress would be more easily controlled. In addition to apprenticeships with many doctors practicing in different specialties, the student's education would be augmented with conferences and discussion groups.
At the end of the second and fourth years of the student's apprenticeship, he would be required to pass written examinations, prepared by a committee of various doctors. Additionally, such doctors could, for example, create a finite set of medical multiple choice questions (between 5,000 - 10,000), from which a random sample would be drawn for the student's testing. The student could also be required to make a contribution to the medical community in the form of preparing a web site on the diagnosis and treatment of a specific disease. At the end of the four years, there would be a five-day oral exam, conducted by a committee of physicians who practice in the field of the student's specialty. Upon successful completion of this process, the student would become certified in the practice of his specialty, but may elect to test for certification in other areas if he meets the specialty-specific requirements.
At the core of our "university without walls", is the mentor/apprentice relationship. See the enlightening film, The Cider House Rules, and observe the relationship that exists between the doctor and his apprentice. They relate to each other much like a father and a son.
I would expect that after reading this particular section, a number of questions would be raised with regard to the details of executing our plan of reform. For this purpose, there is a discussion board where you can post comments and inquiries. Please do not feel as though you need any specific qualifications to post to this forum. We welcome the input of people from all walks of life.
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