Is it time for medical curriculum revolution?

[docbill]

............................

[everyoneloveschem]

As a medical student, I would be very wary of how people use the term PBL.

 

At UofO we participate in PBL, but it is not at all what I expected from prior reading about PBL. I know that our school likes to boast about how they incorporate PBL, but I find that we aren't often challenged to use critical thinking skills, which the linked article cites as a benefit. For example, we will have a PBL case, but it is always based on that week's lecture, so we know before we even read it, that it will be MS or hypertension, etc. Or our tutor won't push us to examine and read the case critically. Or classmates will simply want to focus on the specific learning objectives, rather than putting in a bit more effort to look at it from a real-life perspective.

 

All in all I have been disappointed by PBL. Periodically we get a good tutor/group and the experience may almost live up to what I expected of PBL (using a case to set learning objectives and to learn, with a focus on clinical medicine), but that is unusual.

 

Supposedly they are changing the curriculum here to something like what I think Mac has - PBL with very few lectures. Which is fine, IF they support the changes, otherwise it will simply leave 152 students to make their way through learning an enormous volume of material on their own.

 

On a side note...I love how we avoid the IMG issue as a solution to the doctor scarcity. I have no answers, but it does seem a shame to leave them driving taxis when they might provide a more useful function.

[Rock*]

I fail to understand how 3 year programs can be considered "short cuts" if "Licensing authorities have not signalled any concerns about inferior test scores, at least not publicly. Family medicine and specialty training programs have not identified deficiencies in graduates of 3-year programs"

 

If anything, the 3 year program seems to be an increase in efficiency. A 4th year may allow clerks to focus on their chosen specialty and gain more experience in them, but a lot of the last year is also composed of filler and review.

[Sergie]

On a side note...I love how we avoid the IMG issue as a solution to the doctor scarcity. I have no answers, but it does seem a shame to leave them driving taxis when they might provide a more useful function.

 

Establishing a new system is always a hurdle. Canadians are attached to their traditions, so are the med schools. Thus, it is unlikely that we should expect something really revolutionary soon. I agree, Canada still avoids making decision on IMGs or borrow interesting ideas from other coutries' health care systems. Therefore, the initiative to substitute a 4 y curriculum for 3-year could come only from universities/med schools themselves and could not be forced from above. That is to say to betray the tradition...

As to IMGs, an interesting way to use this various group of medical specialists exists in Germany. Correct me if I am wrong, but I was told that a newcomer with MD degree after an interview could be hired by the teaching hospital and allowed to fulfill some basic rotations (if it is found necessary) or, in case of several-year working experience in the field could get a restricted lincence and begin working (under supervision) - no exams! If he/she wants to take these exams, it could be done anytime (with financial help from employer). If results are sutisfactory, this leads to an increased (up to the average) salary and full lincence. If not, this person risks to lose his job. So, many IMGs prefer working and performing some simple procedures, get experience and then, several years later go for exams.

Advantage? It's kinda obvious that it facilites access to public health care, reduces waitlists, reduces expences for newcomers as well as for the system itself. Another interesting aspect that IMGs could be employed as physician assistants in any way the practitioner find it possible. And it is done in the States. Also a kinda restricted lincence.

So, with all that being said, I would rather vote for using available resources wiser from inside the country (here are around 7000 IMGs presently in Canada, even though it seems to be more... - "Ottawa Citizen", do not remember the date) to aliviate he burden, than expect med schools change their curriculum in a couple of years. This will happen itself in due time.

[Sergie]

You can also read a comment to this article. Basically says the same.

cheers.

[Nephets]

While tuition may be nearly the same between 3 and 4 year programs, starting to make money 1 year earlier isn't a bad thing...

[Nephets]

It is not a question of starting to make money 1 year earlier, it is more a question of will you have learned enough by 3 years.

 

I can't speak for Mac, but I know UofC scored in the middle on the MCCQE I and in the top 3 on the MCCQE II in 2007. Graduates match to competitive residencies. This would suggest they learn enough. The curriculum is only a few months shorter than a four year program as they go all year (however, you do miss out on some potential opportunities that are available in the summer to 4-year students but I wonder if this is worth the extra $170,000 to tax payers that is quoted).

N.

[Sergie]

>>>>The investement needs to be put in to making more residency spots. 1 to 1.1 ratio (Canadian Graduates: rescidency) of spots is not exceptable.

 

Sorry, I did not understand your message.

1 Canadian Graduate :1.1residency spot means 10 more spots are left for FMGs per 100 succesful applications from Can Grads. Why is it not acceptable? Basically, all Canadian Grads should feel safe. According to what I read from CBC news, the number of Can Grads applying each year for the residency is ~10 times bigger than this of IMGs. As to your proportion, everyone should be happy

Unfortunately, this is not the case. Not only Canadian Grads leave for the States, FMGs are able to get a spot only in 12% (2006) and 10% (2007) cases, so they also do.

 

>>>If they invest in that, then they can take advantage of all the Canadian citizens who went away to study medicine and wish to come back for residency.

 

Take advantage of whom? How will you distinguish between the two groups of FMGs: Canadian born and naturalised citizens, or by the med schools they graduated from? This way or the other it's already done. Now, too many Canadians crying about discrimination and discrininating policies whereas on IMG web site gvnmt says: Remember, you might not be able to practice medicine upon returning to Canada.

 

>>>The US does it and they help reduce the shortage of physicians.

 

Again, what do you mean? What do the States do? Would you like to say that the American Government invests money in increasing the number of residency spots for American grads who flee the country for say Canada or UK? Do not think so. How many governmentally funded medical schools and residencies are there?

The policy is to attract more medical workers by easing some bureaucratic obstacles for professional immigration, partially subsidising some programs concerned with the shortage of med workers in remote areas, and offering VERY flexible schedule and little restrictions for those who take USMLEs (in contrast to Canada). This also includes subsideis for those who must take the licencing exams irrespectively of citizenship (even though, some conditions apply). For instance, if you are to go to Kaplan to take USMLE prep courses you might be eligible for.. the loan. If you wish to prepare for MCCEE or MCCQE in Canada you have to pay for EVERYTHING from your own pocket and agree with only 10% chance of getting a spot at the end. Where would you go? (In 2006 96% IMGs were matched for the FM and more than 50% for the specialty res positions in the States)

 

 

>>>I don't believe that Canadian grads should be so afraid to compete with Canadian FMG. However, I am not a big fan of opening up the doors completely and having non citizen recruited to Canada to fill these spots. Mainly because that will creat a shortage of physicians in other countries (developing countries) that need them.

 

Starting with the late 90s Canada already opened its doors to the highly qualified workers from more than 100 countries. Those who had skills and experience in engineering, programming, medicine and so on have been especially welcome. Professional unions also reacted to these tendencies by changing their policies and making access to the regulated professional market almost impossible. So, you do not have to worry about an average Canadian: he is very well protected from the strangers.

As to the contribution of Canada to the shortage of doctors in developping countries )))), it seems to me you'r just repeating someone's words. It does not matter how open your doors are if I do not want to come to you. Why would I want? Canada has a very aggressive immigrants luring policy abroad. You cannot imagine how done and disperate many newcomers feel after falling under the adds' influence and coming here. Talk to them! They are everywhere.

 

>>>Also Canadian citizens should have first shot at government funded spots, since they or their family are contributing to the taxes.

 

Pardon me? And how about those who are not citizens but also pay taxes? Those who just came to Canada, should they wait for... 5, may be 10 years to have paid enough? By definition, they are "newcomers". If you want to discriminate ones against the others in any way, what you would get is a bunch of additional problems and instability. No one, especially among educated and intelligent foreign grads would agree being treated as a second sort resident. Believe me, any discrimination is not a "short cut to finding a solution".

 

With that being said, shouldn't we consider first making changes to the system itself? All this, cutting one year (or even 3 months) from the med studies (meaning impose forcefully drastically canged curriculum -low long would this take?), making students pay more, investing in additional residencies, increasing doctors' pay, limiting professional unions etc, all this is just temporary half-measures as soon as there is no solid and clear plan targeting the whys and wherefores of the shortage. Let's look back, what have we done to change it so far? Pretty nothing during the last two decades! We asked FMGs to come and to help, but are not "big fans of opening up the doors completely and having non citizen recruited to Canada to fill these spots". I have to add that it is not about non-citizens only, but all FMGs.

The government talks about billions of $$ of investmens needed in a few years. What difference would a $170 000 cut that was put on a student's shoulders make for the situation as a whole? Hypocrisy. Increased number of residencies would not significantly increase the number of doctors who stay in Canada. They would still prefer the States or the retiremens (the doctors are getting older too ).

A complex approach to many problems faced by the country today and a clear vision of the changing inside political landscape - what is necessary here, where 250 000 newcomers arriving EVERY YEAR! (BTW not all of them are able to present their concerns in either of two national languages, IMGs are)

And the last comment about taxes. The problem is not that you or your family pay taxes, but that you pay A LOT and do not see positive outcomes. You would be willing to pay even more if you knew this ganna make a difference. However, what you see is the degrading and asthmatic health care system which once have been the best in the world. You, as all of us, are using taxpayers' money every day by taking a bus, studying in school/university, going to the doctor and so on. Probably, you do spend even more of it than me, who's been working for almost 10 years in Canada (and pay taxes) and did not get any bourse or loan when asked for it three years ago. And you know why? Cause I was a mother of 6-yo son. If my son was 5 y.o. I would be deemed eligible for a loan. But he was 6. (Can you explain this?)

Your family also exersises this right whenever possible. Why would people agree to come and live in a DEMOCRATIC country where they are to become discriminated against right upon arrival or just because they had no time to pay taxes. And how about those receiving social assistance for their whole life and doing nothing? Their discendants? Let's make them pay for everything, ah?

Sorry for a long post, but this in particular and other similar topics have been discussed several times on the forum and often are full of phobias and prejudices.

I am open to the further discussion and hope I did not hurt anyone.

Respectfully, S.

[Sergie]

That is exactly what I said, everything contributed to the problem, and disscusing only a 1 y cut while paying little attention to the doctors' age or FMG problems would not make any use for anyone, just talk.

And yes, you are right, this problem is My problem too because I am applying to the med school being an IMG and having worked in Canada for almost 10 years (paid my taxes). This only means that I could have a different prospective on it and be able to offer other point of view.

Your post touched me, I felt I want to extend the boardes of the topic cause this and that are interrelated not different sides of the same issue.

Don't be offended by my post please, I am fully aware that you are not responsible for anything what happened in my life. Moreover, I not only accepted the current situation but also trying to contribute positively.

Cordially, sergie.

[Sergie]

Dear S, I see you needed to let things off your chest. I can respect that.

 

Canada is my adopted country for the last 22 years, so I know what you are talking about. My parents suffered dearly to bring us here and to raise us here. However, one only has to wait 3 years to become a citizen (after getting landed immigration). After that everyone is equal and one can do whatever they like with their life!!! That is the great thing about Canada.

 

I love Canada because if it wasn't for this country I would of been a poor, disabled, half blind person selling newspapers or fruit on the side of a road.

 

I still believe that residency spots should only be available to FMG Canadian Citizens first then to IMG. Remember 3 years and you can apply for citizenship. I do recall that on the landed residency application, it states the specialties that are in demand... and Physician is not one there. I did not make the regulations up, and they should of been no surprise to IMG that come to Canada.

 

If an IMG wishes to come and work in N.America, the US makes it much easier.

 

Again, I am sorry for sounding so cold about the whole situation, but 3 years to apply for citizenship, is really not that long. Even though it may not be the most ideal thing to do.. it is possible to do something else in the meantime.

 

Hi docbill!

Sorry, I had no time to read your first post yesterday but I did it today.

I meant not to answer what you are saying but finally decided it's good sometimes to unmask the myth.

 

>>>However, one only has to wait 3 years to become a citizen (after getting landed immigration). After that everyone is equal and one can do whatever they like with their life!!!

 

Let alone IMGs, but in general: One have to wait 3 y to become a citizen only after becoming a permanent resident - first. All together could take whole life, BTW.

Since we are talking about med education and immigrants vs native Canadians, here this aspect is especially obvious. (If you want specific examples, please feel free PM me - I will give you not only examples but a bunch of links on official sources as well as private blogs)

Please note, I am not saying it is bad or good, since this is no the case, I just continue discussing something you said where my opinion is different

 

>>>I still believe that residency spots should only be available to FMG Canadian Citizens first then to IMG. Remember 3 years and you can apply for citizenship.

 

That is what I asked you before, what criteria do you use to distinguish btw groups of foreign (international) graduates? I am confused. Do you mean that as soon as an IMG becomes a citizen after 3 y (not always in 3-year period though), one will have the same chance (and rihgt) to apply for residency along with Can grads?

That's a good idea. it is already being done in Ontario and somewhere else in Canada but ONtario does not look at the citizenship of foreign grads (only at thier score) , even though all IMGs (residents and citizens) became eligible to participate in first round since.. 2005 (?)

To pass exams in Canada rarely takes less than 3 years. So, most of them are citizens this way or the other. It is not a question at all if you did not mean born-Canadian vs naturalised.

Secondly, many just do not want to apply for Canadian citizenship and keep their resident card for years and years (you should know that if you are from an imm. family).

Sorry, does not work.

 

>>>I do recall that on the landed residency application, it states the specialties that are in demand... and Physician is not one there. I did not make the regulations up, and they should of been no surprise to IMG that come to Canada.

 

 

Dear docbill!

I don't know when you last time looked at the list of specialties in demand in Canada, but just a few years ago programers and physicians were placed first and second accordingly. And yes, physicians are not there any more because according to common wealth countries' opinion Canada was allegetly delinquent in everything we've already talked about, and list has been recently changed.

 

>>> Again, I am sorry for sounding so cold about the whole situation, but 3 years to apply for citizenship, is really not that long. Even though it may not be the most ideal thing to do.. it is possible to do something else in the meantime

 

Oh, common! You should not be sorry! Your opinoin is yours, mine - is mine.

We are just talking! And I am happy that I have so nice and patient opponent

Last thing to ask you: Ideally, if one is able to apply for citizenship in 3 y ( according to the imm law it gives a right to vote, which a resident does not have) what would this change?

If it was not about formal right to vote but only about residency application, how to catch up with your practical skills by driving a taxi if you'r a surgeon for instance?(ironically, most North American programs require maximum of 6 months of doing nothing - and they are absolutly right!) And, if it takes more than 3 y, what something else can some one do in the meantime, can you be more precise, please? And how, after all, can one explain this "something" to a med school admission committee or to a residency program director?

 

I understand, u've never asked yourself these and other questions (good for you, no irony here!) These are just to ponder over, if you want to.

In all my posts here I tried to explain my position as to why it is easier and much more logical to pay attention to IMG problem than to cut 1 y from a med student. In short - I am against. Each shool worked out its unique curriculum that fits ecxactly in the period of time it does. Let it be or let it be changed by the schools themselves.

[BDog]

ffp,

 

I'm a first year at one of the 3 year programs and I completely agree with your sentiments. Despite the fact that it may not impact the quality of physicians at the end of a 5 years residency, I still find myself wishing I had just a little bit more time to read my physiology and pathology book so I can fully integrate this knowledge. The curriculum comes at you with such breakneck speed that it's incredibly difficult to be proficient in basic science and assimilate it into the clinic. I daresay this cannot be done without superlative dedication to the material - a fact that puts the student that have extracurricular inclinations at a disadvantage.

 

Although my perspective will change in the coming years, I still think this program is better than a 4 year one. The earlier on the ward, the better. The efficacy of medical education will always be a hotly contested subject, but there's no getting around the fact that there is simply a ridiculous amount information that each student will need to learn once, twice, three times and so on. I do not have a PhD in education delivery, but I can tell you that I can remember every detail of every patient I've seen on the ward thus far.

[leviathan]

so our PBL "patient" would be called Mrs. Ann Gina the week of the ischemic heart disease lectures, and guess what she would be presenting with?

I'm curious if you or anyone else has any suggestions for how to remedy this?

 

It seems like it's a necessary evil to present a PBL case surrounding the topic that is being taught that week in order to facilitate learning about that same topic. It would seem strange to me to be doing a case during PBL time about a patient with a pheochromocytoma when you are learning about acute coronary syndromes in class, especially if you haven't yet learned about adrenal tumours.

 

During my paramedic training, we ran simulation calls relating to the topic we were learning at that time. Near the end of the program, we did a few courses titled "Complex cases" where anything was thrown at us, and you were required to think critically to come to a proper preliminary diagnosis and treatment plan. Perhaps something similar could be done in medical schools?

[djw]

I am a med II at a 4 year school and can say that I have seen the entire spectrum of tutors, and have seen the reactions of many classmates to PSL (PBL). I happen to really enjoy PBL, it’s nice to get out of the lecture theatre and discuss these topics (we are about half and half between lectures and tutorials). Although I agree that there is no real way around giving you a case that is about the topic you are currently being lectured, I don’t see it as being that big of a deal (imagine the opposite, where you’re being lectured to on heart failure and your case is about an acoustic neuroma). I don’t believe PBLs are meant to give you actual clinical skills, but they are meant to reinforce the notion that you are not just learning topics and diseases, you are learning about illnesses and patients. Although our lectures and PBLs do overlap, it always seems as though it’s just enough so that the group can continue on an educated discussion (as opposed to simply saying “nope, don’t know that one”).

 

With respect to making PBLs BETTER, well, I heard a rumour at my school that the reason why we had massive televisions put in to each of our tutorial rooms (no cable, but they are hooked up to a computer so you CAN watch youtube if so inclined) was because eventually our PBLs will scrap the sheets and move to actual video recorded cases (a simulated patient, or an actual patient with REAL findings). Although this would be insanely hard to do, it would be a good move, because, for example, instead of reading out a description of a venous stasis ulcer, you could describe what you actually see on the screen, and then go from there (same could be said for observing gait disturbances, tremors, ECHOs, etc etc)

 

As for 3 years versus 4 years, all the power to you if you can handle a 3 year program and keep your wits about you, but I would never want to switch to a 3 year program – this pace is just right for me. (As an aside, think about how much further medical education has come in the last 30 years… if it took 4 years to train a physician in 1970, and we’ve learned so much more about the human body in the interim, then students must be getting a whole lot smarter… or we’re skipping over some stuff).

 

d.

[studentz]

The Americans have literally thousands of residency spots in excess of the number of graduating seniors each year because, unlike here, not all of their positions are tied to university programs. Many, many large community hospitals in the US offer residency positions in specialties they can accommodate.

 

http://www.nrmp.org/res_match/tables/table6_2007.pdf

 

From a purely professional point of view (i.e. ignoring post-9/11 US immigration issues) it is MUCH easier for IMGs to get the training they need to practice in the US than in Canada. While I think that we should put the qualified IMGs that we have to good use, I'm not for plundering the developing world of their physicians because we are too cheap or not creative enough to solve our shortages domestically.

 

As for the 3-year debate, I'm happy with the two full summers I had in my program which allowed me to do research, gain clinical experiences, travel and maintain my sanity. I wouldn't have gone to UC or Mac unless it was a last resort for that reason. However, if the government and the ever-ubiquitous "experts" decide that more med schools are the answer, then it is their right to make them 3 year schools. The shorter duration may appeal to some, and for those who don't like it, don't go; somebody else will take your spot. I'm not sure it will save the government money in terms of subsidized tuition since the expenses associated with a 3 year (all-year) program vs. a 4-year part-year program are likely to be similar.

 

I just hope that if new schools are built, not all of them will try to be "research centres of excellence" or whatever term institutions like to call themselves in recognition of all the MDs they have who spend 20% of their time actually seeing patients. We have too many of these already, and not enough schools focussed on primary care. This is something we can learn from the Americans.

 

Finally, it wouldn't make a damn difference if I could snap my fingers and make 2000 family docs appear out of the ether if the rationing and hospital budget constraints continue. The family docs will certainly be able to deal with things they are trained to look after, but more family docs won't get around the issue of wait times when referrals are needed and as long as hospital departmental budgets dictate that orthopods get 1.5 OR days a week, we will have no/few new orthopod hires and horrendous wait times. This applies to virtually every specialty.

[leviathan]

I think the cases can still be useful if they are a little more complex than getting Ms. Ann Gina for your patient. There's a lot of value to working up a patient named Ms. Smith with chest pain, and talking in class about how to differentiate between an ACS, stable angina, esopageal rupture, pneumothorax, aortic dissection, pneumonia, etc.

[Sergie]

I think the cases can still be useful if they are a little more complex than getting Ms. Ann Gina for your patient. There's a lot of value to working up a patient named Ms. Smith with chest pain, and talking in class about how to differentiate between an ACS, stable angina, esopageal rupture, pneumothorax, aortic dissection, pneumonia, etc.

 

Hi leviathan!

That's exactly what we had during our PBL sessions. If we studied respiratory system, we would often see a real patients at the respiratory diseases hospital department (later in ER) and try to come up with diagnosis and explain how to differentiate one syndrom from the other, or at least to say what else we should think of. At the very beginning all cases were simple and no diff diagnostic skills were required, later they became of more and more complexity, finally we were not given any clue (in ER) at all.

s.

[Sergie]

The Americans have literally thousands of residency spots in excess of the number of graduating seniors each year because, unlike here, not all of their positions are tied to university programs. Many, many large community hospitals in the US offer residency positions in specialties they can accommodate.

 

http://www.nrmp.org/res_match/tables/table6_2007.pdf

 

From a purely professional point of view (i.e. ignoring post-9/11 US immigration issues) it is MUCH easier for IMGs to get the training they need to practice in the US than in Canada. While I think that we should put the qualified IMGs that we have to good use, I'm not for plundering the developing world of their physicians because we are too cheap or not creative enough to solve our shortages domestically.

 

As for the 3-year debate, I'm happy with the two full summers I had in my program which allowed me to do research, gain clinical experiences, travel and maintain my sanity. I wouldn't have gone to UC or Mac unless it was a last resort for that reason. However, if the government and the ever-ubiquitous "experts" decide that more med schools are the answer, then it is their right to make them 3 year schools. The shorter duration may appeal to some, and for those who don't like it, don't go; somebody else will take your spot. I'm not sure it will save the government money in terms of subsidized tuition since the expenses associated with a 3 year (all-year) program vs. a 4-year part-year program are likely to be similar.

 

I just hope that if new schools are built, not all of them will try to be "research centres of excellence" or whatever term institutions like to call themselves in recognition of all the MDs they have who spend 20% of their time actually seeing patients. We have too many of these already, and not enough schools focussed on primary care. This is something we can learn from the Americans.

 

Finally, it wouldn't make a damn difference if I could snap my fingers and make 2000 family docs appear out of the ether if the rationing and hospital budget constraints continue. The family docs will certainly be able to deal with things they are trained to look after, but more family docs won't get around the issue of wait times when referrals are needed and as long as hospital departmental budgets dictate that orthopods get 1.5 OR days a week, we will have no/few new orthopod hires and horrendous wait times. This applies to virtually every specialty.

 

Excellent point, studentz!

 

This discussion has a lot in common with "one vs two-tier health system" thread.

In general, it seeems there is a multiple-target governmental reform is urgenly needed. There are many options to improve the situation but not enough of political will and grass-root activism to initiate it.

Another comment. I would prefer to see less obstacles on the way to a med school ( aka high cuoffs, previous degree and so on), much more students accepted and graduated, higher fees and easier loans, pseudo-two-tier system, IMGs included, 4-y programms preferencially, private med schools.

I believe that allowing some more competition on the market would refresh it allowing for higher offer/demand ratio, and would regulate the number of med schools as well as the number of private services according to the market needs.

What do you guys think?

Anxious to see your answers.

s.

[NLengr]

There simply isn't the capacity to have a massive switch from 4 to 3 year programs for every school at once. They basically would have to double the amount of postgrad spots for a single year.

 

There's only really 2 options available:

 

1. Gradually phase in three year programs on a school by school basis every year. Increase residency spots as needed. They'd still need to expand residency, but not nearly as much.

 

2. Skip a year of medical school admissions across the country. The blank year prevents a double cohort. For a single year, no admissions at all. Then back to normal the following year. Increase residency spots as needed.

[Inspired17]

2. Skip a year of medical school admissions across the country. The blank year prevents a double cohort. For a single year, no admissions at all. Then back to normal the following year. Increase residency spots as needed.

 

:eek:

 

I am going to have nightmares about that!!!

 

LOL

 

No, but seriously that is a scary idea. Especially for premeds... & the health care system, which would lose out on quite a few physicians (whom are desperately needed).

[NLengr]

:eek:

 

I am going to have nightmares about that!!!

 

LOL

 

No, but seriously that is a scary idea. Especially for premeds... & the health care system, which would lose out on quite a few physicians (whom are desperately needed).

 

Technically you wouldn't lose out compared to the old system because the first 3 year class would graduate right after the last 4 year class. The healthcare system would see a steady steam coming out from one year to the next. It wouldn't be so bad for the students either, since they would still graduate the same year as they would if they kept the old 4 year system. Not ideal, but no the end of the world.

 

It sucks if you want to get in that year, but honestly, it'll suck more if you get through 4 years of school and suddenly half of your class has no residencies because of a double cohort.

 

Either way I'm sure that they'll have that stuff figured out before any possible firm go ahead on a change to a 3 year system.

[Inspired17]

Technically you wouldn't lose out compared to the old system because the first 3 year class would graduate right after the last 4 year class.

 

Lol. You're right. That didn't quite click in my head. I guess that I immediately thought about it from the perspective of an applicant (which is what I am this year). That's funny...

 

And, yes, it would be worst for recent MD graduates to be stuck without residency matches. I do feel that the gradual phasing in option is better though. Transforming a 4 yr program into a 3 yr program is a logistical feat, and if the schools were to do it one at a time, they could learn from each other's mistakes and collaborate better in order to determine the best way to reform the program.

[Dr.Cave]

All you really need is wikipedia. They should have WikiMedschool. Free admission you just have to pass the tests:D