Sunday, September 14, 2008

More Medical Students = Worse Doctors?

It is a well documented fact that both Canada and the USA are dealing with a shortage of physicians. This is best noticed in the primary care field because fewer and fewer people actually have a family doctor. Most people rely on walk-in clinics for their medical needs and thus do not build a long term relationship with a physician, which results in poor continuity of care. The physician shortage is also seen in other specialties where patients have to wait months before they can meet with a neurologist, nephrologist, etc.

One solution to this problem is to open up more seats in medical school and pump out more doctors. This seems like a brilliant idea because it means we can ensure that these new doctors are trained in an accredited school (i.e. exactly how we (the Canadian Medical Association) want them to be trained).

The potential problem that this can cause is that opening up more seats does not NECESSARILY mean that you will have more qualified applicants that graduate to become excellent doctors.

One key attribute I want in my doctor is intelligence. Now, becoming a physician requires a lot more than just intelligence, a doctor also has to be good with people, organized, caring, etc. However, intelligence IS still a key attribute that I would want ALL of my doctors to possess. My fear is that creating more seats may result in a lower bar to get into medical school, which in turn leads to the production of less capable doctors. I am fairly confident that I will be able to accurately judge the quality of any doctor my friends or family are going to see within four years, after I complete med school. However, I sincerely doubt that the average patient will be able to accurately judge a physician's competence without having an extensive medical background themselves. Thus, I wonder how much creating more medical students will help our nations medical problems.

Obviously, the problem I am discussing here disappears if every single med school seat is filled with a brilliant, qualified applicant, or if the unqualified applicants who do get in do not make it through the arduous journey of medical school (though it is very difficult to fail out of med school, which I will discuss later). Also, remember that this is just an issue I am thinking out loud about at this point. After only three weeks of medical school, I am hardly qualified to judge the state of the Canadian medical education program :)

Another issue that I think may reduce the quality of our next generation of medical doctors is the medical school admissions committee's focus on diversity. However, due to the controversy surrounding that topic, I am going to hold off on that post for a while!

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