Expected benefits of streamlining undergraduate medical education by early commitment to specific medical specialties

Abstract

Undergraduate medical education is too long; it does not meet the needs for physicians' workforce; and its content is inconsistent with the job characteristics of some of its graduates. In this paper we attempt to respond to these problems by streamlining medical education along the following three reforms. First, high school graduates would be eligible for undergraduate medical education programs of 4 years duration. Second, medical school applicants would be required to commit themselves to a medical specialty and choose one of four undergraduate paths: (1) "Interventions/consultations" path that would prepare its graduates for residencies in secondary and tertiary specialties, such as cardiology and surgery, (2) "continuous patient care" path for primary care specialties, such as family medicine and psychiatry, (3) "diagnostic laboratory medicine and biomedical research" path that would prepare for either laboratory-based careers, such as pathology, biochemistry and bacteriology, or research in e.g., immunology and molecular genetics, and (4) "epidemiology and public health" path that would include population-based research, preventive medicine and health care administration. Third, the content of each of these paths would focus on relevant learning outcomes, and medical school graduates would be eligible for residency training only in specialties included in their path. Hopefully, an early commitment to a medical specialty will reduce the duration of medical education, improve the regulation of physicians' workforce and adapt the curricular content to the future job requirements from medical school graduates.

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“…In addition, a realist evaluation study could elucidate by which mechanisms and in which circumstances the intervention generates its outcome [91,92]. Furthermore, similar effects from other thematic transitional years could triangulate our findings and support the idea of specialty streaming [93][94][95][96].…”

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“…[22][23][24][25] For example, the British medical education system has created foundation years, 26 and the Dutch a transitional year, 27 to bridge undergraduate and postgraduate training and to lower the costs of the lengthy training of medical practitioners. [22][23][24][25] For example, the British medical education system has created foundation years, 26 and the Dutch a transitional year, 27 to bridge undergraduate and postgraduate training and to lower the costs of the lengthy training of medical practitioners.…”