Medical Education - Essential Information In Need of a Delivery Overhaul

I read a recent opinion piece in the Wall Street Journal, whimsically entitled "Medical Education Needs Major Surgery."

I come across these types of "who needs basic sciences anyway?" articles and am ever-amazed at the authors' opinions, especially when the author happens to be a physician.

 The author of this article states:

"The uncomfortable truth is that medical schools today provide a preclinical education that their students neither want nor need. Students hate live classroom lectures, especially for basic content, and they know they learn better on their own time at their own pace. Yet schools still rely on these educational relics."

While it may be true that live classroom lectures are more time-consuming and rigorous than independent home study, the camaraderie and discipline that comes with students working towards a common goal, together, at the same time, and pressured by the time of not only the course but the upcoming examination, cannot be underestimated. Daily, as a practicing interventional radiologist, I use information gleaned from those years. Where would I be without basic knowledge? I hesitate to ask.

I will continue to rail against commentary that attempts to discount the many hours (and many all-nighters!) that I spent learning those "unnecessary" and "unneeded" subjects in order that I might become a competent, nay an excellent, physician.

Making the argument that school tuition costs have risen unfairly does not equate to suggesting that there is no value in the education being offered. 

But there is also no doubt that technological advances should enhance information delivery and improve communication between teachers and students. There is no doubt that the age-old lecture format, that is used in many/most medical schools, could be improved upon.

As a colleague (Lee Bennett aka @dleerad) stated: 

"Newer methods (& better) of teaching need to be implemented in the first 2 years.  Many topics would be better taught via teaching modules by intranet (or internet).  But these teaching modules CAN’T just be a talking head (otherwise they should just continue to have live lectures). 
In my view, we still need small classes/small groups to develop those skills (& camaraderie) that cannot be learned through isolated, introverted teaching modules.  This could include teaching groups analogous to what is done at Cambridge, Oxford, for example.  (A good example is seen in the movie “Shadowlands” where Anthony Hopkins plays CS Lewis – a professor). The students prep before the group meets; the pre-read content is then discussed, debated, and questions are answered.   My view is that the giant classroom with a droning, talking head is obsolete in professional education.  A great example of post-grad medical education is the ACR’s own Education facility in Reston, VA; Excellent blend of modules, hands-on small group, interactive education.  

In summary, doctors need to understand the basic foundation of their clinical experiences in order to fully excel as physicians. Without such appreciation, perspectives that early medical courses are unnecessary will prevail. We will find ourselves condemning future patients and doctors to a limited existence filled with uncertainty and missed opportuniites.

Just because the teaching methods have become tired does not mean that the information is no longer essential. We must remember that fact as we try to improve our methods of information delivery. Without such clarity, future patients will suffer as a result.