Becoming a doctor in 2021 no longer looks the way it did back in 2000. In recent years, U.S. allopathic medical schools have been introducing new changes that impact the content of their curricula, the way they impart knowledge to their students, and the way students are assessed over the course of their medical school journeys. In this blog post, we’ll review four changes that many medical schools are making so that you can be better prepared once you start your medical school career.
In recent years, many medical schools throughout the United States have been focusing more of their preclinical curriculum on population health and health care delivery. What does this mean for you? Well, it means that these schools are emphasizing the acquisition of knowledge and skills for future clinicians to recognize and address adverse social determinants of health.
For instance, the Social Justice Vertical Integration Group (SJVIG) at the Geisel School of Medicine at Dartmouth is responsible for developing a social justice curriculum for medical students while also identifying appropriate institutionally-affiliated venues by which students can implement what they have learned in the classroom . More specifically, the curriculum aims to integrate concepts in health disparities into the basic science curriculum. Dozens of other medical schools are following suit; Harvard Medical School offers a course in social medicine and global health , the Warren Alpert Medical School of Brown University offers clinical electives on patient advocacy, activism, and caring for underserved communities , and the University of Michigan Medical School offers an elective “path of excellence” in Global Health and Disparities .
Some physicians have voiced criticism of these curricular changes, citing the risk of overt politicization of medical education. Dr. Stanley Goldfarb, former Associate Dean of Curriculum of the Perelman School of Medicine at the University of Pennsylvania, stated in the Wall Street Journal that teaching topics related to racism and poverty at medical schools comes at the expense of scientific and technical proficiency . In a limited amount of time, says Dr. Goldfarb, something will have to give; rigorous classroom instruction on the scientific method and pathophysiology of various disease processes will be lessened in the wake of didactics and lectures on racism.
Along with these curricular content changes, many medical schools are shifting the medium by which they teach their students. Schools like the Icahn School of Medicine at Mount Sinai no longer require students to attend lectures in person (aside from the occasional mandatory lectures). Lecture content and even exams and quizzes are administered online through Blackboard, allowing students to take their exams in the comfort of their own bedroom.
In the COVID-19 era, this method of teaching has gained traction due to strict social distancing precautions. Some medical schools have even turned to online 3D virtual modeling to teach their anatomy course to substitute for the in-person cadaver dissections. Some clinical rotations already have an online component, such as watching morning rounds or attending didactic lectures on Zoom or completing an OSCE via Zoom .
Additionally, medical schools must also contend with the ubiquitous use of electronic visual aids for subjects such as pathology, microbiology, pharmacology, and biochemistry. Pixorize and Sketchy are two such tools being used by medical students nationwide to understand these subjects via the use of visual mnemonics [7, 8].
Due to the national physician shortage and rising student debt, some medical schools have introduced accelerated programs so that students can graduate in 3 years instead of 4 . Shortening of the preclinical year course to 1.5 years can provide students with more time to explore various specialties by shadowing, research, and attending conferences. Additionally, students can learn on the wards sooner in their medical school journey, a boon for students who learn more actively by “doing” rather than by reading a textbook.
However, there are skeptics of accelerated programs. Dr. Gail Morrison and Dr. Richard Schwartzstein from the University of Pennsylvania and Harvard Medical School have voiced concerns about student burnout. Dr. Morrison stated that eliminating a whole year of medical school could inadvertently result in a shortage of educational experiences regarding humanism and professionalism, soft skills that are not concretely taught until students are on the wards.
Finally, residency programs have historically utilized the USMLE Step 1 exam to weed out potential residency candidates. Now that the USMLE Step 1 Exam is transitioning from a three-digit numerical score to Pass-Fail in January 2022, it is likely that more emphasis will be placed on Step 2 CK scores and clerkship grades and evaluations. Step 2 CS will continue to be reported as Pass/Fail. The rationale provided for the change is mentioned by the American Medical Association, which stated that the current residency selection system and over emphasis on Step 1 board scores have caused a significant amount of distress for students . However, with this change, there is concern that international medical graduates (IMGs) and osteopathic students may be adversely affected by the new scoring system.
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