Baseball Personnel Business Manager Scorekeeper (also includes softball scorekeeping) Umpire Farrier (includes some veterinary courses) Gunsmith Tool and Die Design (Includes plastic molding courses; also includes both separate and combined courses-i.e., certain schools offer separate courses in tool design and die design, and others combine them with one another and/or with tool and die making.) A. J. REICHES, M. D. SUITE 207-209 150 NORTH MERAMEC ST. LOUIS (CLAYTON), MO 63105 PLANNING TO IMPROVE MEDICAL SCHOOL TRAINEES We are aware of the knotty problem of doubling the number of medical graduates. Most of the suggestions have been to double the number of medical schools. However, the trouble is and will be that a decade or so is needed to activate and educate a medical class in a new school. Comparitively few articles have been written about modernizing and streamlining medical education so that more students could be trained with the present facilities. In looking for a new approach we decided to question the physician himself, as to what was important in his educa. tion. Let us enumerate some of the opinions and reactions which we collected and some of the possible implications. Group L was composed of 50 physicians, 44 internists and 6 G.P.'s. Each spends at least 2 hours a week reading medical literature: 6 spends up to 6 hours per week. No one in this group had either opened or read a textbook on anatomy, embryology, chemistry, or histology since they were in medical school., only 7 had read either a portion of a textbook or a paper on pharmacology textbooks, 14 had reviewed some part of pathology textbook, all have read about virus vaccines and teratogenic viruses, but none have looked a bacteriology textbook. All largely depend upon clinical pathology laboratories and microbacteriologic laboratories and do very little reading on these subjects. One physician doubted that either he or any of these physicians could trust results if they did such tests. Group II was composed of 16 surgeons. All had kept up on anatomy and pathology. Some of those interviewed felt that so much of the time spent on basic sciences and preclinical subjects was a hangover form the time when little clinical knowledge was available. It appears obvious that the pre-clinical years have not been satisfactory and newer modifications have not changed this. uch changes which have occured have largely been in clinical ears. Because of the prestat emergency (an anticipated 0,CC0,000 increase in population and only at best a 15% inrease in medical graduates in the next ten years) and to revent a chaotic medical situtation we believe that it is ime to take the bull by the horns and try new educational rocedures. For example, compress the pre-clinical two years uration into one year or 10 or 11 months duration and tailor he new curriculum so that additional thousands of medical tudents can be trained in our present medical schools. uch of the pre-clinical studies apparently are not of great alue to the well trained physicians. Many of the physicians interviewed thought that the pre-clinical subjects should be taught in such a manner as to give a broad background and not to teach subjects in great detail that are seldom ised and soon forgotten. Subjects such as anatomy, for those interested in surgery or surgical specialities, would be of greater value if taught in detail during surgical training. Not to mention that biochemistry after a general background study in the first year be given in great detail during the 4th, 5th, and oth years for those who might be interested in investigation, etc. All those questioned agree that the intern year has outlived its usefulness. Impressions: 1. The two pre-clinical years could be changed 2. The second and third year could be made 3. The fourth, fifth and sixth year should be 4. Eliminate the internship. (It has out- May we suggest, if it were possible to do the above, the following might be attained. A. It would result in a more effective and efficient program. B. By breaking the bottleneck during the preclinical years it would enable each medical school to double the present enrollment, A.J. Reiches, M.D. Richard L. Reiches, B.A. A. J. REICHES, M. D. BUITE 207-209 150 NORTH MERAMEC ST. LOUIS (CLAYTON), MO 63105 August 14, 1970 Mr. Robert Finch Executive asst, to the President White House 1000 Pennsylvania Ave. washington D.C. Dear Mr. Finch: We listened to your recent televison discussion about the shortage of physicians, and the large number of foreign trained physicians in this country. We are however aware that foreign governments are making a strenous effort to keep their medical men at home. We, in the past, have written to you when you were Secretary of Ha, to inform you about our investigation of medical training, and suggested a plan that has possibilities of meeting our medical needs. We were answered by one of your assistants, tellin us that this a problem for the medical schools and HEN would not be interested in attempting to do anything about the medical shortage. A letter to your fornier assistant, Dr. Egebert, still has not been answered, (ile's probably to cusy with other problers Cur idea is to double medical school enrollments by cutting the time spent in the pre-clinical years of medical schools by students For example, 100 students are given a course on anatomy that lasts 4 months instead of 9 months, there will be 100 vacantcies which can be filled by another 100 students during the remaining 41⁄2 months. Without detailing the whole plan, we believe it is workable. Most pre-clinical medical courses are taught by PHUS, and if necessary it would be comparitively easy to train fore PID in a short time. we are aware of no other plan that is able to solve the medical problem which is gradually getting worse. The cutting of the pre-clinical years to one years has been accepte by a few schools, such as Duke, Dartmouth, Pennsylvania, and Vermont. The next step is to double the enrollment and fill these empty places in one or two medical schools. within a short time we will definately know if the idea is workable. |