Three-Year Medical Degree

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The WSJ recently published an article extolling the benefits of a three-year medical degree and it is just another example of our profession trying to lower its standards.  The reasons, in the piece, given to move in this direction are:

  • Medical student debt
  • Physician shortage

None of these seem adequate to me.  I remember when I was in medical school when one of the professors stated that the Immunology course wasn’t even around when he was in school because they didn’t even know enough about the immune system yet.  Knowledge and information has grown so much since my time in school that I could say the same about epigenetics and more.  So why would we want future doctors studying less?

The medical student debt is atrocious because medical schools have raised their prices at a criminal rate to pay their administrators. You know, like the guy who wrote this article.  My med school total cost was $32,000 for four years from 1990-1994.  Twenty years later and kids are paying $200,000 or more?  That’s not inflation, that’s horseshit.

The physician shortage is bogus as well.  If you remove all the useless paperwork and admin time bestowed upon doctors for no other reason than to make third parties happy then you give them more hours to see patients.  This can be a few hours per day which when given back to them would remove the physician shortage.  End of story .

This article was written by Robert Grossman (dean and CEO) and Steven Abrasion MD (faculty) of New York University’s Langone Medical Center and the NYU School of Medicine.  They are biased because their program is now 3 years.  It’s hogwash.

We should NOT water down medical school to appease third parties.  We should not water down our degree.  We cannot complain about other providers (NPs and PAs)  having less education and less training if we are going to do it as well.  What’s next, a hybrid degree called NPMD or PAMD?

Coming soon The 4-Hour Doctor by Tim Ferris MD (sorry, Tim, I do love your stuff)

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  9 comments for “Three-Year Medical Degree

  1. Kurt
    June 16, 2016 at 11:07 am

    Ummmm, it only gives one extra class graduating the first year in operation. The excess cost is going to further pressure students to specialize and stay away from primary care. I hope they do so the ivory tower people consider they’ll either have to change FP/IM or simply they will have to
    leave it to the LELT’s.

  2. Sir Hakum of Hugo
    June 13, 2016 at 2:26 pm

    Medical school is simply not about learning a skill and applying it. Most trades over the course of human history have been passed generation to generation by an apprenticeship system.

    What we learn through all the “extra and wasted years” of education are vital.

    1. A well rounded human being. Do we need doctor-bots who know nothing else? I am aware of the high rates of burn out, suicide, and depression with accelerated programs.

    2. Do I use my calculus, organic chemistry, and knowledge of the anatomy of the hippocampus on a daily basis? No. I use that foundation of knowledge to understand the clinical aspect of medicine, to prepare my mind for a kind of learning. Although I wish I could have forgone organic (C minus 2nd semester), it was essential in the progression of things to come.

    3. The educational-industrial complex….a scam, but not my fault as a physician.

    4. The years of apprenticeship: preparing me to think, not just to know. Developing relational skills to connect with patients. No, a 4 week customer service seminar is not the same.

    11 years of education and training just to fly solo as a family doc. The flight training continues 19 years later and will never end.

    • Bill Ameen MD
      June 13, 2016 at 3:04 pm

      Sir Hakum of Hugo,
      Verily I agree with you sir. Just today I mailed a check for $100 for a memorial to my favorite physics professor who died 3 months ago at age 88. I commented that my career in medicine was over except for volunteering at a local clinic but my interest in astronomy and cosmology was lifelong. Because of a D in Organic Chemistry I majored in German and took Religion, Medical Anthropology, Abnormal Psych, and Philosophy and Ethics. (One of my high-school classmates wrote a textbook in Organic, fer Chrissakes!) We need well-rounded, sociable new physicians, not more Doctor-bots!
      Lord Womb-de-Tomb (PJ title!)

  3. Soccerdoc
    June 12, 2016 at 6:07 pm

    Assume there are two Med schools A and B with A a 3 yr program and B a 4 yr program admitting 10 students at time zero and admit 10 students each year. By year 3 school A graduates its first class. By year 4 school B starts graduating classes. At the end of year 10 school A has 80 MDs and school B has 70 MDs. How does this correct the physician shortage?

  4. Ken
    June 12, 2016 at 11:48 am

    Agree with cutting back on premed courses. Excessive studing of physics, inorganic/ organic chemistry was just a waste of time. But the first 2 years of medical school can certainly be trimmed also. Do medical students really need to know the size of a nuclear pore? The structure of the amino acids?

  5. John Parkin M.D.
    June 12, 2016 at 9:49 am

    How about knocking off a year of pre-med instead ? When was the last time you did anything remotely connected to calculus ?

  6. Bill Ameen MD
    June 12, 2016 at 9:48 am

    G’morning, Dr. Doug! A lot to think about in this post. When I think back to my 4th year, I was only 24 and still had much experience and info to assimilate. I did mostly elective rotations and even spent some time studying in London, which was invaluable. And that was before the computer age! True, it would reduce medical education debt, but we could consider forgiving some debt if young docs would commit to underserved areas for a specific period of time. Agreed that the cost of education has climbed ridiculously, partly to pay for outrageous salaries for teaching hospital bureaucrats. Finally, I agree the physician shortage IS bogus. Personally I think we have a patient surplus…People with self-inflicted illnesses, i.e., diabetes, hypertension, anxiety, etc., who are overloading the system.

  7. Seneca
    June 12, 2016 at 9:40 am

    A serious but ridiculous sounding suggestion: Make primary care training longer and invert the pay pyramid such that primary care docs are at the top. Most of my specialist friends say that they don’t know how we provide such a broad scope of services, and they’re right–it is more difficult than performing a limited set of procedures.

    The only way that anything will even approximate this in the next century is to get truly patient centered (as opposed to payor centered) care where the patient actually has some financial skin in the game for his care. Unless the current system collapses under its own administrative weight, this will never happen. There are far too many administrators whose comfortable livelihood depends on the current system so eloquently and succinctly described by Dr. Farrago as Horseshit.

    • Dr Dave
      June 12, 2016 at 6:23 pm

      I agree with everyone so far but this last part is a bit unrealistic.
      So as a specialist the society wants me to do MORE training for LESS money??? Seriously?? I did more post doc training then any PCP did in TOTAL training and yet you want to invert the pyramid to have me paid less and to be there when you need me?
      Lets face it if we look back far enough all docs were total functional PCP’s they were trained in everything from basic care to surgery to amputations and even Dental extractions. Then as we learned more we had to find ways to harness the volume so that one wasn’t expected to know everything there was to know and still render quality care.
      Specialists are here not as a result of patient need but a result of physician need. When a PCP was up to his armpits in areas he was not well versed in he looked to colleagues who were. Hence the specialty system was created. Now if we flip things over and we are no longer there to protect and serve the PCP then the only loser is the patient. I see specialists as the servant of the PCP while most want to think of us as a servant of the patient I disagree and have trained LOTS of students to do the same and the community is better off for them in that role.
      As far as cutting back what I can say after 30++ years of teaching Residents and Fellows how to function without creating too much malpractice is; we don’t need less we need MORE
      We need to take kids right out of high school and start them right there. NO more undergrad nonsense right to Medical School and then spend 6 years not 4 and then into Residency that gets them on the streets 2 years earlier AND saves them money
      Next we need to use the cost savings in technology to educate these kids over the Internet at 1/3 the cost not 10 times the cost as Doug suggested. It is shear nonsense that a medical education should cost a quarter of a million dollars. That is shear greed
      Dump the tenure system at universities if you are not teaching you aren’t earning. PERIOD!!!
      Enough of this work for 5 and research for 40 nonsense.
      Education is shear rote memory and can be put on the net for all to read at a far shorter cost then $200K
      Shorten things up by dumping undergrad lower the cost by technology expand medical school to get these kids into clinic FAR earlier then the 3rd year and pump up the volume of providers so we no longer have the itch to scratch with things like NPs and PAs
      Dr D

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