Friday, September 2, 2011

Medical school reform

The bus is taking quite a long time to show up, so I'd thought I'd just post something taken from a brief conversation with my coworker and colleague Connor. Basically, its about the medical school system, which I personally believe needs to be seriously looked at. Now, don't get me wrong, the medical school system isn't the only system that needs to be changed. How grad school is structured and the way that researchers/young scientists are being abused and manipulated also needs to be changed but that is for another post. Also, I'd like to caution the readers to take my post here with a grain of salt, these are only my thoughts and I view the medical system through the other side as a grad student. However, I have worked with many medical students while working in lab during 1st year grad, my department contains many medical students so I've had the chance to take classes with them, and the building in which I work is where most of the medical school lectures occur. Also keep in mind that my information may not be accurate for all medical schools, but it is for the one I'm the closest to.

The medical system as it is now requires the premed student to satisfy 3 major requirements: good marks in undergrad (to the point where I've seen premed students sabotage other premed students, I hope this is only a rare occurrence), MCAT and volunteer work. But there is another factor that most students forget: the designated number of seats available to you depending on where you live, what university you went to, and what degree(s) you have completed. Speaking of which, right off the bat, I want to mention that students in a nonscience disciplines (especially Arts) should NOT be given a chance to apply to med school. This is not because I hate arts, but you CANNOT compare a student who has taken 4 years of full on science training to a student who has only taken the science courses required to gain admittance to med school. We need to streamline students into medicine and health from undergrad.

Getting back to my original point, universities will restrict seats from you if you're out of province, if the medical university doesn't acknowledge your home university's grading system, or if you've completed a PhD prior to applying to med school. What this basically means is that you're restricted to follow the idea of a predetermined entrance "model". On top of this, each medical university has their own board that decides who should get in (which needless to say can be full of bias). This system can restrict a very capable and ambitious premed student from entering a very good medical school simply because he/she doesn't live close enough.

This needs to be changed. The Canadian government already administers the MCAT, I suggest that they take over the admission system too. Basically, all your marks (which the goverment already has) along with your MCAT marks are attached to your medical school application that one government board decides your entrance into medical school. The student would also name their top 3 universities. This way, if a student in Victoria wanted only to study medicine in McGill, Univ. of Toronto and Queens, he/she would have an equal chance with a student already living and studied in Ontario. Plus, different universities have different admission requirements: some put more weight on marks over volunteer work or the MCAT while others do something different. Having one government body evaluating med admissions would also standardize the admission requirements, which would just be a bonus.

I also realize that this might be a lot of work for that committee, but consider this. Medical universities pretty much take a year just to let students know if they're admitted or not. I'm sure this committee, being responsible for only one purpose each year, could easily finish their task in the same time frame.

Anyways, just my thoughts. I may continue this topic again sometime in the future.
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2 comments:

  1. Hi Ash,

    the MCAT is not administered by the Canadian govt, but by a private entity, the Association of American Medical Colleges. Also, as you said, each university makes the decision, not a "government board".

    I understand what you are saying: your main point is that health education should be handled at the federal level, as this would take care of people who are "geographically challenged", so to speak, as they do not live close to the school they want to attend.

    However, one would have to balance all of this with academic freedom, which one could argue would be impaired by having all admission decisions being made by a central organ. This is why, at the moment, there is no central decision-making process.

    I am afraid I disagree with limiting admission to science grads; I am sure that there are amazingly smart and deserving people out there who could make major contributions to the medical profession without having first spent 4 or 5 years dealing with flies/nematodes/(put your favourite model organism here). And that is why admission decisions consider each individual carefully. Or, at least, they should!

    Just my two cents :)

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  2. Thanks Gio for your comments! I really wanted to just put some of my random thoughts out there and open up some discussion.

    I was harsh about my statement that Arts students should be restricted from applying, but I do think that being able to at least have a solid science background in their undergrad is extremely important and that should be heavily taken into account in their application decision. Granted as a med student, you may not have to know how heparin regulates coagulation or how genetic recombination allows the immune system to differentiate host vs foreign but it is an asset. I think it makes the difference between a good doctor and a great doctor. Also, being in science, you will understand the new research that is constantly going on and may lead to new therapies. When new research comes out about, for example, experimental viral therapies for cancer, or using genetically engineered HIV particles to treat leukemia, you'd have some idea how this may impact patients. An Arts student may not because they may be unfamiliar with how HIV infects and is retained in slow dividing T cell pools, or what the potential limitations/risks are present to patients when using viral therapy. This is one of the reasons why there is such a big divide between current medicine practices and medical research, and why it takes so many years before new therapies are even applied (excluding the time it takes to determine safety by clinical trials).

    Thanks for reading and the comments! =)

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