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Law School Revamps Final Year, Will Med Schools Follow?

Author Information (click to view)

Skeptical Scalpel

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last three years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 1000 page views per day, and he has over 6600 followers on Twitter.

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Skeptical Scalpel (click to view)

Skeptical Scalpel

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last three years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 1000 page views per day, and he has over 6600 followers on Twitter.

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The 4th year of med school has been known to be a waste of time, requiring mostly or all electives. This results in anesthesia rotations in Paris.
The New York Times reported that NYU Law School is planning to change its third-year curriculum to better prepare its graduates for the realities of legal practice today. In case you don’t know, law school graduates are having a tough time finding work, and many require on-the-job training to make up for what they didn’t learn in school.
 
From the article: “There is a growing disconnect between what law schools are offering and what the marketplace is demanding in the 21st century,” said … the chairman of the panel of alumni recommending the changes.
 
A revelation from the article is that the third year of law school has been considered a waste of time by many observers.
 
“One of the well-known facts about law school is it never took three years to do what we are doing; it took maybe two years at most, maybe a year-and-a-half,” Larry Kramer, the former dean of Stanford Law School, said in a 2010 speech.
 
There has been much debate in the legal academy over the necessity of a third year. Many students take advantage of clinical course work, but the traditional third year of study is largely filled by elective courses. While classes like “Nietzsche and the Law” and “Voting, Game Theory and the Law” might be intellectually broadening, law schools and their students are beginning to question whether, at $51,150 a year, a hodgepodge of electives provides sufficient value.
 
Although I wasn’t aware of this issue in law schools, it sounds familiar in a way. Copy the above paragraphs, take your word processing program and replace “law school” with “medical school” and “third year’ with “fourth year” and you will have an accurate story about medical education.
 
The fourth year of medical school has been known to be a waste of time for at least 40 years. Most schools allow some or all of it to be electives of the students’ choosing. This results in anesthesia rotations in Paris and dermatology rotations in New York City. In a previous blog, I have pointed out some of the problems of both the third and fourth years of med school.
 
A 2011 piece in the New York Times Magazine pointed out that some law firms are providing new associates with intensive training in the nuts and bolts of lawyering that they apparently don’t get in school. For example, although they had studied mergers in law school, graduates had no idea how to make a merger happen.
 
As an interesting parallel, some surgical residency programs have begun to offer “boot camps” (See links here and here) as a way to teach incoming first-year trainees some of the material they should have learned in medical school. Apparently, this is necessary in Scotland too, where the boot camp lists such topics as communication skills for surgeons, polytrauma, how to lead ward rounds, and handling and writing the evidence. These all seem like subjects appropriate for a med school curriculum, but lacking.
 
I hope that someday medical schools will recognize the problem as NYU Law School has done. Meanwhile, I will keep cranking out the blogs.

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last three years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 1000 page views per day, and he has over 6600 followers on Twitter.

 

2 Comments

  1. SS: as you say the last year of med school is wasted as it stands. How about teaching practical skills. I’ve always thought the See One, Do One, Teach One was a cavalier way to approach medical care and that it promoted false confidence. Before you get your back up, I do love docs. Always have. We were in the trench together, mostly for the same reasons.
    I do have a cute story. It was the middle of the night. The intern was instructed to do a cut down on this man who needed an A-line. He came to me and asked if i had ever done a cut down. I thought he was asking if I’d ever assisted. Of course, I said, dozens of them. He said: great! You do it and I can watch! Being as it was the middle of the night, that had to sink in before I delivered the bad news: No, YOU do the procedure, I am just here to help! Sometimes I miss the ICU. The work, not the politics, though. lol

    Reply
    • I agree with you that the days of “see one, do one, teach one” are long gone. So are cutdowns for A-lines. It would be nice if med schools taught practical skills or anything else useful in the fourth year.

      Reply

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