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Earning an MD Degree in Six Years to Reduce the Debt-Load of Medical Students

Posted Jul 02 2009 6:32pm

I was admitted to medical school without an undergraduate degree nearly 50 years ago. I had completed the obligatory courses for admission and the University of Michigan Medical School accepted me. Medical schools and professional medical associations are now under pressure to reduce the number of years required to obtain an M.D. because of the increasing debt-load of newly graduating physicians (see: AMA Looks to Put Brakes on Debt Load of Med Students ). Below is an excerpt from this article with boldface emphasis mine:

Medical students who went into debt could figure on owing $126,714 in 2007 on average, up from $88,331 in 2000, according to the Association of American Medical Colleges. You can figure the debt tab has only gone up since then. Such statistics are being cited by American Medical Association as docs prepare for their [upcoming] confab in Chicago next week....Suggestions under consideration would take approval by powers greater than the AMA. They include providing tax deductibility for tuition and loans, and expanding state and federal scholarship opportunities. But another cost-cutting approach is investigating ways to reduce the length of medical schooling—perhaps through competency-based curriculums, or through combined B.A./M.D. programs. Some schools already offer a variety of such combination programs, though only a handful actually shorten the total length of training. For those that normally don’t worry about the school loans carried by docs, remember that the med school debt load can have broader implications. It’s one of the most common reasons given for problems like the shortage of physicians and the skewing of medical professionals toward specialty practices.

How about consideration of programs to reduce the number of years required to obtain an M.D.? I personally believe that developing a combined B.A./M.D. degree programs is the wrong approach. This was attempted in the past at the University of Michigan Medical School -- the six-year program was called Inteflex and was ultimately abandoned (see: Be flexible -- Eliminating Inteflex would limit students' option s). One of the reasons for its demise was that the 18-year-olds admitted to the program were being guaranteed admission to medical school after completion of their undergraduate courses. For many and because the pressure for admission to medical school was eliminated, they decided to take it easy, often receiving their degrees in eight or more years. Many also decided belatedly that the medical career path was not suitable for them.

Here's my modest proposal for shortening the number of years to earn an M.D. without spending a dime and without burdening medical school deans and curriculum committees with additional work. In order to understand this proposal, you need to understand that for most medical schools, the fourth year studies are comprised mainly, or even totally, of electives rather than mandatory courses.

  • Medical schools should begin to accept students, as in former years, after three years if they have fulfilled all of their undergraduate course requirements. If this is impossible given the number of such prerequisites, this number should be reduced such that it is possible for most applicants to quality for the new program.
  • On a selective basis, medical school should allow some students to skip their fourth year and graduate in three. This should only be an option for the most mature students who have amply demonstrated their ability to function well as they pursue their post-graduate medical training.

The likelihood of such a plan being adopted is probably slim. It will require minimal planning and, after all, medical school deans are compensated for their curricular planning expertise. The deans and presidents of undergraduate institutions would also probably oppose such a plan as they did when I pursued it many years ago. They will argue that physicians need the broader liberal arts background. However, I am not convinced that one more year of undergraduate studies will achieve this goal.

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