Changes in Medical Education
Introduction
The education system has evolved for many years, and medical education is a continuous process. It is thus critical to always have current medical education. The aim of this paper will be to analyze the changing aspects of medical education from the 1800s to the present. Furthermore, It will compare the apprentice medicine model and the academic medicine model. In addition to this, the paper will discuss how these two models affect the quality of healthcare. Finally, the paper will discuss the importance of examining medical education and ways of improving this education in the future. Our assignment writing help is at affordable prices to students of all academic levels and academic disciplines.
Changing Scope of Medical Education
Medical education in the United States did not start in universities, and there were no regulatory guilds. Some medical schools exist in the United States. The Medical College of the University of Pennsylvania was established in 1766 (Custers & Cate, 2018). The format of medical education in the mid-19th century was through extended apprenticeship. There was weak coverage of the theoretical framework. There were few textbooks, and students were quizzed irregularly. The curricula were very brief. However, the length of curricula steadily increased, and by the end of the 19th century, the best medical schools had a 3-year curriculum, but most still retained the two years (Custers & Cate, 2018). Students went to schools that had shorter curricula. In 1847, the American Medical Association (AMA) recommended standardization of academic terms to six months and medical graduates to take two lecture courses and presence apprenticeship evidence (Custers & Cate, 2018). However, these were just recommendations, and up until the 20th century, a medical student could graduate without stepping into a hospital.
William Osler established a structured postgraduate internship at John Hopkins in the late 19th century (Custers & Cate, 2018). The hospital staff consisted of many doctors in training. The AMA established standards for residency programs in 1919, but before that, the length of most programs varied (Custers & Cate, 2018). Osler’s residency program is spread across the country and globally. This system became the standard for medical education after World War II. The one-year internship program that enabled medical interns to mature was abandoned in the United States around 1970 (Custers & Cate, 2018). It deprived graduate doctors of the additional experience before pursuing residency.
During the 1950s and 1960s, there was increased dissatisfaction with the curriculum. There was curriculum overload, which prevented the efforts to make medical education more practical. Flexer condemned the lock-step curriculum, which did not have electives and did not give individuals a platform for expressing themselves (Custers & Cate, 2018). It was critical to analyze the characteristics and qualifications of doctors in terms of skills, social, and personality traits. After the Flexner revolution, there was a specification of educational objectives by leading medical institutions. This led to competencies rather than the number of weeks in training as the standard for assessing early graduates (Custers & Cate, 2018). The length of the Medical curriculum has gradually increased. The length of medical education remained the same, but there were increased entry requirements with premedical and basic sciences done in the preparatory years. The Liason Committee on Medical was created in 1942 (Custers & Cate, 2018). It brought to life the quality and regulation of medical education.
In the mid-20th century, all U.S. medical graduate students were eligible to continue with post-education training (Custers & Cate, 2018). The internship was made to be the first year of training. In 1951, the United States National Intern Matching Program was formed to regulate placements (Custers & Cate, 2018). This led to reduced generalist training time, which led to the production of more generalists, making internal medicine more attractive. The Accreditation Council for Graduate Medical Education was established in the 1980s (Custers & Cate, 2018). This council governed the content, length, and qualifications of medical education. In 2003 and again in 2011, ACGME restricted the duty hours for residents to at most 80 hours per week (Custers & Cate, 2018). This led to a complaint due to a decreased availability of residents and the limited time to train quality surgeons.
Apprenticeship Model vs. Academic Model
Apprenticeship Model
This model prepares medical students that the healthcare workforce is the ultimate destination. It involves the early introduction of the student into the clinical environment, enabling them to acquire practical and applied knowledge (Rassie, 2017). In the apprenticeship model, the medical students become familiarized early enough with common medical issues and their clinical presentations. This facilitates them from becoming observers to participate, followed by supervised execution and, finally, autonomy. This model allows for the progressive conferment of responsibility (Rassie, 2017). There is, however, close supervision of the student to ensure patients’ safety is safeguarded. This model also allows for further development and refinement of trainees’ skills.
This model further allows students to familiarize themselves with the medical workforce’s cultures, expectations, and processes (Rassie, 2017). The students become more comfortable interacting with their patients and mold their clinical behavior based on their seniors. This model allows one to learn the theories of medicine and then encounter these problems in clinical life.
Academic Model
In the academic model, there are more standards and requirements that one meets before pursuing a medical career as a doctor. A student must learn how to improve the quality of life of patients by integrating restorative and curative medical care in the clinical environment (Buja). Medical schools have established policies and curricula that educate their students on patient triage, treating patients with terminal conditions, and managing patients with complex needs. This model requires medical professionals to attend continuous education programs to ensure they are current with new treatment protocols. In the academic model, an individual attends medical school for four years and enrolls in a residency program before becoming an autonomously practicing doctor (Buja, 2019).
If both models are integrated, they could result in an exceptional doctor. Both models have the ability to direct change and learning opportunities for potential physicians. According to Flexner and Osler, practicing doctors must have education, clinical experience, and clinical skills to be great physicians (Custers & Cate, 2018). Over the years, the academic and apprenticeship models have been integrated into medical schools. The four-year curriculum has been revised, and it is now combined with a residency program. This introduces the concept of the academic and apprenticeship model.
Both of these models are beneficial to medical students. However, the apprenticeship model is something of the past before there were regulatory bodies to regulate medical education. The academic model is being used in many medical schools in the United States. Healthcare professionals must have medical knowledge and pass medical exams to prove their competencies as physicians.
Improving Medical Education by Understanding History
Understanding the history of medical education allows us to understand the changes that the education system has made. This history has shaped our current medical education. This motivates us to plan for the future of medical education while reflecting on the challenges of the past medical systems. This history enables us to take positive lessons while being keen not to repeat previous mistakes. We are in the era of new technology, and technology is more and more influencing the current healthcare delivery and education models. History allows knowing how knowledge was produced, which encourages clients to have confidence in the face of uncertainty.
Conclusion
Medical education has undergone tremendous changes. In the 1800s, there were only four medical schools in the United States, but this number has significantly changed. The education system is now regulated as compared to the past. The medical curricula are now uniform across the country with four-year curricula and one-year internship programs. The two models that can be used for training are the academic and the apprenticeship model. The integration of these two models is critical in producing quality physicians. Finally, understanding the history of medical education will help us not repeat previous mistakes and improve the quality of medical education in the United States and globally.
References
Buja, L. M. (2019). Medical education today: all that glitters is not gold. BMC Medical Education, 19(1), 1-11. https://doi.org/10.1186/s12909-019-1535-9
Custers, E. J., & Cate, O. T. (2018). The history of medical education in Europe and the United States, with respect to time and proficiency. Academic Medicine, 93(3S), S49-S54. https://doi.org/10.1097/acm.0000000000002079
Rassie, K. (2017). The apprenticeship model of clinical medical education: time for structural change. The New Zealand Medical Journal (Online), 130(1461), 66. https://pubmed.ncbi.nlm.nih.gov/28859068
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