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A
Specific Plan For Medical Education Reform
Shaun
Kerry, M.D.
Diplomate,
American Board of Psychiatry and Neurology
We
must remove unnecessary obstacles in the
system that increase cost, intensify stress, and consume
valuable time. |
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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 Medical
Assistant: Program Review and Exam Preparation 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 Current
Medical Diagnosis and Treatment 2001. This
book will serve as an excellent reference tool. |
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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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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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