Changes in Medical Education

Two recent articles in The New York Times focus on how medical education is changing. Both reflect the trend away from the traditional path of four years of hard science courses in college, followed by four years of medical school, where coursework continues to focus strictly on science based topics.

One move away from this is the growth in post-baccalaureate pre-med programs, where college graduates who have not taken the necessary science courses, or who are out in the working world but want to switch to a career in medicine, can prepare for medical school. According to the Times article, more than 15% of new medical students have gained admission after completing such programs and there are now 135 post-baccalaureate programs listed with the Association of American Medical Colleges (AAMC). These students may have studied poetry, history, or psychology in college and may have had work experience as teachers, artists, or marketers. They can bring a very different perspective to their medical education and their interactions with their patients.

Another trend involves changes to the medical school curriculum itself, towards what the Times piece calls "heart and soul and social science." The AAMC is making substantial changes to the Medical College Admission Test (MCAT) in an effort to look for strengths in areas other than just science, with the goal of admitting individuals to medical school who bring a broader skill set -- including the ability to connect to their patients, not just to analyze test results. Beginning in 2015, the MCAT will include sections on "Psychological, Social and Biological Foundations of Behavior" which are designed, according to the MCAT website, to recognize "the importance of socio-cultural and behavioral determinants of health and health outcomes." In addition, another new section called "Critical Analysis and Reasoning Skills" is intended to help identify applicants from diverse backgrounds. Students entering college this coming fall will be the first group to take the new MCAT when it is put in place in 2015.

Dr. Yellin's work as a consultant to the Office of Student Affairs at New York University School of Medicine and his extensive experience performing evaluations of medical students lead him to observe that whatever changes may occur to medical school admissions and curriculum, the academic demands of medical school will continue to be an issue for future physicians."Like other strong learners," he notes, "medical students will not get very far in their studies or careers without an understanding of how they actually learn and without developing a repertoire of strategies. Often, learning strategies that have worked for them in other environments don't work for them in the demanding setting of medical school. They need to develop new strategies for the extraordinary demands of the medical curriculum and that requires them to understand how they learn, since even very successful students will have stronger and weaker areas in their academic skills."

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