Education Evolution: Changes in Medical Learning

Alexa M. Mieses


July 20, 2015

I often hear physicians say that medical education has changed tremendously over the past several decades. But has it really? To answer this question, I reflected on my own current experiences as a medical student and spoke with several other physicians whose education occurred in the past in various specialties.

I consider myself a well-rounded person. Although I have always enjoyed science and excelled in that subject in school, I also played three instruments, tap danced, and wrote poetry. In college, although I was a biology major, I also worked full-time, took classes outside of my major (such as creative writing), and actively served my community. I was a science geek, sure, but I also tried to be sort of a Renaissance woman. I thrive on experiential diversity. Luckily, this is also the sort of thing that medical schools were looking for: a student who was more than just a study machine, and one that could relate well to patients.

Neil Calman, MD, chair of the Department of Family Medicine at Mount Sinai and founding president of the Institute for Family Health, earned his MD degree from Rush University in the 1970s. He thinks that what medical schools are looking for today is different from in the past and says, "The students are smarter and more accomplished in life than they were when I was in school. Schools look more for well-rounded students. When I applied, it was grades—science mostly—and exam performance. The more we move away from that, the better we will be at developing caring, humanistic, and smart doctors."

My first year of medical school was not what I expected it to be. As a premedical student, I had read countless books written by residents and physicians chronicling their medical school experiences. I spoke with current medical students and visited programs through my premedical club. I thought I knew exactly what to expect. However, nothing prepared me for how "un-clinical" the first year of medical school would be.

My first semester included embryology, followed by anatomy and then a biochemistry/molecular biology class. Basic science classes felt more like graduate than medical school, and attempts made by our professors to frame things in a clinical context did not substitute the real thing and did not satisfy my desire to work with patients. To make matters worse, my free time was spent studying for countless hours. I knew I would have to study a lot, but the fact that my primary responsibility was to do so somewhat stripped the wonder and enchantment from how I envisioned medicine to be. I had to work extra hard to make time for the things I enjoyed doing, like community service; I felt that the first year of medical school reduced me to the study machine I didn't want to become. I honestly thought to myself, "If this is what medicine is like, I have made the wrong decision."


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