Medical education has become a "brutal academic experience," with too much scientific detail and not enough emphasis on the basic skills of treating patients, a study panel set up by the nation's medical colleges charged yesterday.
"We believe there should be a decrease in the enormous pressure that is put on students in the medical schools," said panel chairman Steven Muller, the president of Johns Hopkins University.
"We are doing an excellent job in training clinical scientists," Muller declared at a briefing for reporters. "But there are some things they are not getting, in part because of the extraordinary dosage of science they receive."
Muller said a final report with detailed recommendations for a major overhaul in the medical curriculum would not be issued by the panel until late 1984.
But after its first year of study the 18-member group decided to publicize the "fundamental assumptions" of the changes it will seek.
The panel was established by the Association of American Medical Colleges to take the most comprehensive look at medical education since its basic modern form was established by the reports of Abraham Flexner in 1912 and Willard Rappleye 20 years later.
The group has a $1 million budget for a wide array of working groups and hearings.
Muller said the contention that medical school faculties are "currently submerging students in overwhelming detail" was part of a prevailing consensus reflected in questionnaires returned by over 1,000 medical school administrators, professors and students.
Most of the nation's 67,000 medical students spend 30 to 40 hours a week in classrooms and laboratories, Muller said, compared to a maximum of 16 hours per week for undergraduates and 12 hours for other graduate students.
With their reading added in, Muller said, most medical students "can only get by working roughly 18 hours a day."
"They don't do anything else," he declared. "All they do is go through that curriculum. . . .How much of it are they really going to use?"
"It absorbs them so much that they don't have time to develop as human beings," added Dr. John A. D. Cooper, president of the medical college association, who also spoke at the briefing at the Dupont Plaza Hotel.
Muller said the panel was concerned that this "total immersion" might be "dehumanizing" and may lead to a "fascination with technology that makes the device more important than the patient."
In the clinical part of medical education, the panel said, "specialized knowledge and the application of sophisticated technology...detract from students learning the fundamental skills of examining patients that all physicians should have."
More emphasis should be put on taking a patient's history, using instruments such as a stethoscope, and treating minor problems and injuries, the panel said, leaving more specialized skills to be acquired in the residencies which 95 percent of the students now take after graduation from medical school.
In medical school itself, Muller suggested, students should spend more time in independent learning rather than memorizing, in solving basic clinical problems, and in developing approaches for "lifelong interaction with patients."
"We should also pay more attention to the promotion of values and attitudes that physicians must have to withstand the stress of their own careers," he said, "and to serve patients in a humane manner."
Although cost was not a prime reason for the change in direction the panel seeks, Muller said a shift away from detailed science and high technolgoy will help to hold down further increases in the $20,000-a-year average expense of educating a medical student.
He said it also might make new physicians themselves "increasingly cost-conscious."
Last spring Dr. Daniel C. Tosteson, dean of Harvard Medical School and a member of the study panel, proposed a similar shift in the medical curriculum and also suggested admitting students after two years of college.
Muller said the panel would examine "how sacred the eight years are" that usually elapse between high school graduation and the M.D. degree.
Curriculum detail has gotten more burdensome, Muller said, because over the past three decades "every time there was a significant advance in either science or technology...it has been deemed essential that students be exposed to it."
Although faculty members agree that the pressure on students should be reduced, he said, "nobody wants to give up anything and some want to add things. It puts you in a conundrum...We have to decide what we're going to give up."