Medical education: Difference between revisions
imported>Robert Badgett |
imported>Howard C. Berkowitz |
||
| Line 62: | Line 62: | ||
===Lectures and rote memorization=== | ===Lectures and rote memorization=== | ||
Much of undergraduate medical education is rote memorization.<ref name="pmid7933403">{{cite journal |author=Regan-Smith MG, Obenshain SS, Woodward C, Richards B, Zeitz HJ, Small PA |title=Rote learning in medical school |journal=JAMA |volume=272 |issue=17 |pages=1380–1 |year=1994 |pmid=7933403 |doi=}}</ref> Perhaps as a result, one medical school noted that only 17% of students reported routinely attending lectures.<ref name="pmid17895696">{{cite journal |author=Billings-Gagliardi S, Mazor KM |title=Student decisions about lecture attendance: do electronic course materials matter? |journal=Acad Med |volume=82 |issue=10 Suppl |pages=S73-6 |year=2007 |pmid=17895696 |doi=10.1097/ACM.0b013e31813e651e}}</ref> Other schools have reported similarly.<ref name="pmid17041787">{{cite journal |author=Mattick K, Crocker G, Bligh J |title=Medical student attendance at non-compulsory lectures |journal=Adv Health Sci Educ Theory Pract |volume=12 |issue=2 |pages=201-10 |year=2007 |pmid=17041787 |doi=10.1007/s10459-005-5492-1}}</ref><ref name="pmid16925638">{{cite journal |author=Higgins R, Cavendish S, Gregory R |title=Class half-empty? Pre-registration house officer attendance at weekly teaching sessions: implications for delivering the new Foundation Programme curriculum |journal=Med Educ |volume=40 |issue=9 |pages=877-83 |year=2006 |pmid=16925638 |doi=10.1111/j.1365-2929.2006.02549.x}}</ref><ref name="pmid14660428">{{cite journal |author=Hebert RS, Wright SM |title=Re-examining the value of medical grand rounds |journal=Acad Med |volume=78 |issue=12 |pages=1248-52 |year=2003 |pmid=14660428 |doi=}}</ref> The incremental value of lectures over textbooks at improving grades may not be strong.<ref name="pmid7998607">{{cite journal |author=Hammen CS, Kelland JL |title=Attendance and grades in a human physiology course |journal=Am. J. Physiol. |volume=267 |issue=6 Pt 3 |pages=S105-8 |year=1994 |pmid=7998607 |doi=}}</ref> The use of audience response systems may help.<ref name="pmid17339392">{{cite journal |author=Preszler RW, Dawe A, Shuster CB, Shuster M |title=Assessment of the effects of student response systems on student learning and attitudes over a broad range of biology courses |journal=CBE Life Sci Educ |volume=6 |issue=1 |pages=29-41 |year=2007 |pmid=17339392 |doi=10.1187/cbe.06-09-0190}}</ref><ref name="pmid19042709">{{cite journal |author=Kaneshiro KN, Emmett TW, London SK, ''et al'' |title=Use of an audience response system in an evidence-based mini-curriculum |journal=Med Ref Serv Q |volume=27 |issue=3 |pages=284–301 |year=2008 |pmid=19042709 |doi= |url= |issn=}}</ref> | Much of undergraduate medical education is rote memorization.<ref name="pmid7933403">{{cite journal |author=Regan-Smith MG, Obenshain SS, Woodward C, Richards B, Zeitz HJ, Small PA |title=Rote learning in medical school |journal=JAMA |volume=272 |issue=17 |pages=1380–1 |year=1994 |pmid=7933403 |doi=}}</ref> Perhaps as a result, one medical school noted that only 17% of students reported routinely attending lectures.<ref name="pmid17895696">{{cite journal |author=Billings-Gagliardi S, Mazor KM |title=Student decisions about lecture attendance: do electronic course materials matter? |journal=Acad Med |volume=82 |issue=10 Suppl |pages=S73-6 |year=2007 |pmid=17895696 |doi=10.1097/ACM.0b013e31813e651e}}</ref> Other schools have reported similarly.<ref name="pmid17041787">{{cite journal |author=Mattick K, Crocker G, Bligh J |title=Medical student attendance at non-compulsory lectures |journal=Adv Health Sci Educ Theory Pract |volume=12 |issue=2 |pages=201-10 |year=2007 |pmid=17041787 |doi=10.1007/s10459-005-5492-1}}</ref><ref name="pmid16925638">{{cite journal |author=Higgins R, Cavendish S, Gregory R |title=Class half-empty? Pre-registration house officer attendance at weekly teaching sessions: implications for delivering the new Foundation Programme curriculum |journal=Med Educ |volume=40 |issue=9 |pages=877-83 |year=2006 |pmid=16925638 |doi=10.1111/j.1365-2929.2006.02549.x}}</ref><ref name="pmid14660428">{{cite journal |author=Hebert RS, Wright SM |title=Re-examining the value of medical grand rounds |journal=Acad Med |volume=78 |issue=12 |pages=1248-52 |year=2003 |pmid=14660428 |doi=}}</ref> The incremental value of lectures over textbooks at improving grades may not be strong.<ref name="pmid7998607">{{cite journal |author=Hammen CS, Kelland JL |title=Attendance and grades in a human physiology course |journal=Am. J. Physiol. |volume=267 |issue=6 Pt 3 |pages=S105-8 |year=1994 |pmid=7998607 |doi=}}</ref> The use of audience response systems may help.<ref name="pmid17339392">{{cite journal |author=Preszler RW, Dawe A, Shuster CB, Shuster M |title=Assessment of the effects of student response systems on student learning and attitudes over a broad range of biology courses |journal=CBE Life Sci Educ |volume=6 |issue=1 |pages=29-41 |year=2007 |pmid=17339392 |doi=10.1187/cbe.06-09-0190}}</ref><ref name="pmid19042709">{{cite journal |author=Kaneshiro KN, Emmett TW, London SK, ''et al'' |title=Use of an audience response system in an evidence-based mini-curriculum |journal=Med Ref Serv Q |volume=27 |issue=3 |pages=284–301 |year=2008 |pmid=19042709 |doi= |url= |issn=}}</ref> | ||
Rote memorization, and evaluation on it, may lead to interpersonal dynamics, among students and faculty, which are not necessarily in the best interest of patient care. <ref name=>{{citation | |||
| title =Secrets and Lies | |||
| author = Deborah Bowman; Daniel Sokol | |||
| title = Stud BMJ | |||
| year = 2009 | |||
| url = http://www.medscape.com/viewarticle/587834_print | |||
| volume = 9| issue = 2 | pages = 50-51}}</ref> Pass-fail grading may reduce stress, increase group cohesion and increase quality. <ref>{{citation | |||
| doi= 10.4065/81.11.1443 | |||
| journal = Mayo Clinic Proceedings | |||
| date = November 2006 |volume = 81 | issue= 11 | pages = 1443-1448 | |||
| title = The Benefits of Pass-Fail Grading on Stress, Mood, and Group Cohesion in Medical Students | author = Daniel Rohe ''et al.'' | |||
| url = http://www.mayoclinicproceedings.com/content/81/11/1443}}</ref> | |||
==References== | ==References== | ||
Revision as of 17:29, 19 February 2009
Template:TOC-right In modern times, regulation of the medical profession includes legal licensure to practice medicine in most countries. Part of being able to qualify for such a license involves meeting certain achievement standards in medical education. Usually those standards are met by having some sort of "medical degree" that is obtained in formal study in an accredited professional school. This is called undergraduate medical education. Those degrees, and the requirements for obtaining them, are different depending on region. In some countries, there is more than one type of medical degree, depending on the type and extent of medical education.
There is more to having a license to practice medicine than meeting an educational standard. Licensure also requires completion of some sort of clinical "apprenticeship", called internship and residency, as well as passing grades on one or more standardized tests.
In some countries, there are still additional requirements called graduate medical education in order to practice specialties within medicine.
Classification
Undergraduate medical education
Undergraduate medical education is the "period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D."[1]
Graduate medical education
Graduate medical education (GME) includes "educational programs for medical graduates entering a specialty. Internship and residency are "programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities."[2] Fellowship training is focused on qualification for subspecialties.
They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree."[3]
GME may also combine with research, policy, or management graduate education, often leading to the additional academic qualification of Doctor of Philosophy, Master of Public Health or a clinical outcomes area, or a graduate degree in hospital or health policy management.
Continuing medical education
Continuing medical education is "educational programs designed to inform physicians of recent advances in their field."[4]
Variations by geographic region
The Foundation for Advancement of International Medical Education and Research (FAIMER) [1] is dedicated to improving world health through education of the medical educators. They also maintain an open access International Medical Directory [2].
Canada
Most medical schools in Canada require at least three years of postsecondary education towards a bachelor's degree prior to admission although the majority of entrants hold at least a bachelor's degree, usually in the sciences. The most notable exception to this is at McGill University, where a subset of the entering class are accepted directly after completion of CEGEP.
Schools typically admit applicants based on their undergraduate record (GPA), tatement, MCAT score, non-academic (extracurricular) score, and interview.
Medical school in Canada is usually four years in length although McMaster University and the University of Calgary offer accelerated programs which run three years in total. Students in the first two years cover basic sciences such as anatomy, physiology, immunology and pharmacology and are given preliminary clinical exposure. Education is delivered through traditional lectures and small group learning, including problem-based learning. Years 3 and 4 are known as the clinical years or the clerkship, in which students learn in a hospital-based setting through clinical rotations in such fields as Internal Medicine, Emergency Medicine, Surgery and Pediatrics.
At the end of Year 4, students enter the Canadian Resident Matching Service (CaRMS) and are matched to a speciality and location depending on their particular preferences. Students typically graduate with the title Doctor of Medicine (MD).
Postgraduate training, or residency, varies in length from two years (such as in Family Medicine) to six years (such as in General Surgery). Most residency programs last about five years.
To receive full certification, physicians must be certified as a Licentiate of the Medical Council of Canada (LMCC) by completing the Medical Council of Canada Qualifying Exam (MCCQE) Part I at the end of Year 4 and the MCCQE Part II at the end of PGY-1. Furthermore, they must receive certification from an appropriate certifying body: The College of Family Physicians of Canada (CFPC) for family physicians and the Royal College of Physicians and Surgeons of Canada (RCPSC) for specialists.
Finally, physicians must register with the appropriate regulating body to be eligible to practise in a particular province. For example, physicians wishing to practise in British Columbia must register with the College of Physicians and Surgeons of British Columbia (CPSBC).
Auxiliary medical education
If one is interested in the medical field, but does not wish to become a doctor, other alternative careers include:
- Nursing
- Physician assistant
- Emergency Medical Technician up to Paramedic level
- Art therapy
- Dance therapy
- Occupational therapy
- Physical therapy
- Respiratory therapy
- Clinical laboratory technology
- Radiological technology
- Medical informatics
- Biomedical illustration
- Biomedical photography
- Biomedical engineering
These fields do not require attending medical school. The premedical courses are usually combined with another field that provides support to the medical industry.
Problems in medical education
Lectures and rote memorization
Much of undergraduate medical education is rote memorization.[5] Perhaps as a result, one medical school noted that only 17% of students reported routinely attending lectures.[6] Other schools have reported similarly.[7][8][9] The incremental value of lectures over textbooks at improving grades may not be strong.[10] The use of audience response systems may help.[11][12]
Rote memorization, and evaluation on it, may lead to interpersonal dynamics, among students and faculty, which are not necessarily in the best interest of patient care. [13] Pass-fail grading may reduce stress, increase group cohesion and increase quality. [14]
References
- ↑ Anonymous (2024), Undergraduate medical education (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anonymous (2024), Internship and residency (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anonymous (2024), Graduate medical education (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anonymous (2024), Continuing medical education (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Regan-Smith MG, Obenshain SS, Woodward C, Richards B, Zeitz HJ, Small PA (1994). "Rote learning in medical school". JAMA 272 (17): 1380–1. PMID 7933403. [e]
- ↑ Billings-Gagliardi S, Mazor KM (2007). "Student decisions about lecture attendance: do electronic course materials matter?". Acad Med 82 (10 Suppl): S73-6. DOI:10.1097/ACM.0b013e31813e651e. PMID 17895696. Research Blogging.
- ↑ Mattick K, Crocker G, Bligh J (2007). "Medical student attendance at non-compulsory lectures". Adv Health Sci Educ Theory Pract 12 (2): 201-10. DOI:10.1007/s10459-005-5492-1. PMID 17041787. Research Blogging.
- ↑ Higgins R, Cavendish S, Gregory R (2006). "Class half-empty? Pre-registration house officer attendance at weekly teaching sessions: implications for delivering the new Foundation Programme curriculum". Med Educ 40 (9): 877-83. DOI:10.1111/j.1365-2929.2006.02549.x. PMID 16925638. Research Blogging.
- ↑ Hebert RS, Wright SM (2003). "Re-examining the value of medical grand rounds". Acad Med 78 (12): 1248-52. PMID 14660428. [e]
- ↑ Hammen CS, Kelland JL (1994). "Attendance and grades in a human physiology course". Am. J. Physiol. 267 (6 Pt 3): S105-8. PMID 7998607. [e]
- ↑ Preszler RW, Dawe A, Shuster CB, Shuster M (2007). "Assessment of the effects of student response systems on student learning and attitudes over a broad range of biology courses". CBE Life Sci Educ 6 (1): 29-41. DOI:10.1187/cbe.06-09-0190. PMID 17339392. Research Blogging.
- ↑ Kaneshiro KN, Emmett TW, London SK, et al (2008). "Use of an audience response system in an evidence-based mini-curriculum". Med Ref Serv Q 27 (3): 284–301. PMID 19042709. [e]
- ↑ Deborah Bowman; Daniel Sokol (2009), Stud BMJ, vol. 9, at 50-51
- ↑ Daniel Rohe et al. (November 2006), "The Benefits of Pass-Fail Grading on Stress, Mood, and Group Cohesion in Medical Students", Mayo Clinic Proceedings 81 (11): 1443-1448, DOI:10.4065/81.11.1443