Here’s how medical school works…The first 2 years of medical
school cover the acquisition of medical knowledge.This occurs through lectures, reading, study,
and testing.The acquisition of this
knowledge occurs through individual interaction and involvement with the
subject matter.The last 2 years of
medical school include monthly clinical rotations at hospitals and clinics in
the subspecialty areas of Medicine.The
student treats patients under the supervision of residents, faculty, and
attending physicians.Supervised clinical
practice uses the knowledge acquired from the first 2 years of school on real
patients for the last 2 years.Here are
examples of how 3 real medical students approached
their learning.
“John” attended the University of Illinois Medical School in
the early 1970s, earning the honorary designation of “James Scholar”.This honor entitled him to the exclusive use
of a study carrel at the medical school, and the privilege of designing his own
course of study, as long as he passed all requirements and exams.John’s method of study involved reading each
medical text book cover to cover, not attending class, and graduating in 3
years.
“Mary” attended a US
medical school in the South.Her method
of study for the first 2 years was as follows.She listened to her online class lectures at an accelerated rate of
speed on her computer.She varied her
locations between her apartment, Starbucks, and Panera Bread Company.Her clinical rotations were taken at a
variety of hospitals and clinics in the greater metro area around her medical
school.
“Joe” attended An international medical school.He attended class lectures, read, studied,
and took exams.His clinical rotations
took place in the New York City metropolitan
area for the last 2 years of medical school.
These 3 students each had a different approach to the
didactic portion of their medical knowledge.The clinical rotations were a fairly uniform experience, all taken in
the US.They all graduated from accredited medical
schools with an MD degree.They all
passed USMLE parts I and II.They all
applied for residency through NRMP.Haven’t
they all fulfilled their side of the “Social Contract”?Don’t they all deserve the opportunity to
complete the final step in their training?
The program directors as represenetives of the hospitals would shift the blame on Congress by enacting the BBA of 1997. They would tell you that Congress funded only 2 positions for the 3 students whom you mentioned and one of them has to be without position but they forgot that there were unmatched doctors before the BBA oF 1997 and Congress didn't tell them to keep qualified doctors out of residency. I think that until adult supervision by Congress or the court intervenes to make a reform to the GME, a better argument can be made that the 3 students above have 2 years of medical knowledge and 2 years of clinical rotations, much better than the physician assistant who has only one year of medical knowledge and one year of clinical rotations. If the physician assistant can practice medicine the 3 students above should be able to practice at least in the same capacity.
The program directors as represenetives of the hospitals would shift the blame on Congress by enacting the BBA of 1997. They would tell you that Congress funded only 2 positions for the 3 students whom you mentioned and one of them has to be without position but they forgot that there were unmatched doctors before the BBA oF 1997 and Congress didn't tell them to keep qualified doctors out of residency. I think that until adult supervision by Congress or the court intervenes to make a reform to the GME, a better argument can be made that the 3 students above have 2 years of medical knowledge and 2 years of clinical rotations, much better than the physician assistant who has only one year of medical knowledge and one year of clinical rotations. If the physician assistant can practice medicine the 3 students above should be able to practice at least in the same capacity.
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