One way to cut health care costs: Cut medical training
From undergraduate education through residency, a doctor’s education now lasts 14 years. After all that education, the average doctor graduates with $160,000 student debt. Zeke Emanuel and Victor Fuchs question whether all that training - and all that spending - is actually necessary:
Why is medical school 4 years in length? The answer probably has to do with the Flexner Report’s recommendation in 1910 for 2 years of preclinical science training followed by 2 years of clinical training. Yet most physicians could be trained in significantly less time. Since 1997, the University of Pennsylvania has only 1 years of preclinical science training.
The important patient care skills can be obtained in less than 2 years of clinical training. The medical school at Harvard University requires students to complete only 15 months of clinical rotations....This change would be consistent with the increasing emphasis on individualized instruction and assessing students on core competencies rather than on time served. Consistent with this proposal, Texas Tech School of Medicine as well as 2 Canadian medical schools now offer 3-year programs.
Emanuel and Fuchs suggest reducing doctors’ training time by 30 percent, from 14 to 10 years. That would create space to train more doctors, they argue, while also reducing physicians’ debt burdens. It could also have the effect of driving down American doctors’ salaries, which are double that of doctors in most other countries, but often justified because of the profession’s expensive training costs here