GETTING TO 30%: THE 6 YEAR MEDICAL SCHOOL MODEL

This post debuted on 5/13/2012 on KEVINMD.com: 

As a teenager in the mid-late 1990s, my father, an engineering educator, and I would talk about the ills of the healthcare system and how physicians lost control of healthcare: primarily because they concentrated on medicine rather than the forces changing healthcare delivery. I realized this was due to an outdated medical education system and reforming it might actually improve healthcare in this country! That was my Sputnik Moment!

Since graduating high school in 2000, I have been involved in medical education without interruption. I completed my BA/MD from the University of Missouri Kansas City’s (UMKC) 6-year program in 2006, and then moved on to be an administrative chief resident in the OBGYN Department at Emory University. I currently serve as a Fellow in the Division of Reproductive Endocrinology and Infertility at Washington University-St. Louis School of Medicine.

My Sputnik moment was re-ignited after reading the recent article by Ezekiel Emanuel, MD PhD, and Victor Fuchs, PhD, which highlights the 100-year-old dilemma that is medical education in this country. Their commentary describes the pathway to becoming a subspecialty physician in this country, and proposes reducing the length of medical training by 30 percent in an effort to reduce health care costs.

While it’s easy to become polarized by the political elements of Dr. Emanuel’s proposals, we are ultimately distracted from the main point:  medical school is expensive and a more efficient, cost effective
,
path toward a medical degree should be available.

UMKC’s School of Medicine’s model of medical education has thrived for over 40 years, graduating more than 3,000 physicians since it’s beginning in 1971. The pathway for medical education reform should involve guiding students from high school into medical school, where they can be placed into learning teams, and avoid the MCAT and its predatory preparatory course costs. Over 60% of graduating medical students report taking a prep course, which can cost upwards of $9,000. A year round, 6-year approach is more efficient and does not sacrifice quality or leadership in building the next generation of physicians.

With an average medical student debt burden of $157,944, by shortening my medical training a full two years, I effectively reduced the cost of my medical education by 25% (my tuition varied over the six years; approximately $18-22,000 over 6 years from 2000-2006). And let’s not forget that the $157,944 figure represents the loan burden after four years of medical school. Furthermore, the AAMC’s figure does not account for the additional $12,400 average tuition related debt per undergraduate degree accumulated prior to entrance into medical school.

In 2011, 47.3% of graduating medical students reported their decision to become a physician came before or during high school, while 24.2% decided to become a physician in the first two years of college Youth are more informed and able to access information, utilize technology and exchange ideas much easier than when Abraham Flexner’s report on medical education came out in 1910. The complexity of medical knowledge has changed immensely, but our education system has been slow to catch up. One-hundred years later, it is time to revisit Flexner’s report

A 30% reduction in training length is attainable by providing an option for pursuit of a combined BA/MD degree in the vein of my alma mater. Such a track will lower costs and shorten the time to workforce entry, while adding time for research fellowships and/or humanitarian opportunities. Additionally, as women comprise half of all medical school graduates, as a reproductive endocrinologist, I must point out that a condensed approach has positive ramifications on future fertility in the era of delayed childbearing and increasing infertility.

 Ultimately, such a 6-year track may not be for everyone, but for the high school graduate who wants to have a career in medicine, be it as a clinician, physician/scientist or public health guru, an option for an accelerated path to achieving an MD degree provides a highly employable skill set with a lower debt burden that will only benefit the delivery of healthcare in the 21^st century.

Kenan Omurtag, MD is a board certified OBGYN and Fellow in Reproductive Endocrinology and Infertility at Washington University-St Louis School of Medicine and is a 2006 graduate of the University Missouri Kansas City School of Medicine.  You can follow him @stlinfertility