Volume 197 - Issue 3
Does it take too long to become a doctor?
Author: Matthew H Anstey
Med J Aust 2012; 197 (3): 145-146. || doi: 10.5694/mja12.10934
Published online: 6 August 2012
Published online: 6 August 2012
To the Editor: On a similar topic to the recent series by McNamara on the length of medical education, a provocative piece published earlier in the Journal of the American Medical Association suggested that medical training could be shortened by 30% in the United States, without detriment to clinical skills. The reality is that there is a paucity of evidence for the ideal duration of ...
To the Editor: On a similar topic to the recent series by McNamara on the length of medical education,1,2 a provocative piece published earlier in the Journal of the American Medical Association suggested that medical training could be shortened by 30% in the United States, without detriment to clinical skills.3 The reality is that there is a paucity of evidence for the ideal duration of training to create competent clinicians.4
As an Australian-trained intensive care physician working in the US, I have been able to reflect on the difference between my own training and that of US residents, whose postgraduate training for areas such as general paediatrics, emergency medicine or general medicine can be as short as 3 years.3 This begs the question: how is this possible, and do extra years of general training add value?
Despite their shorter training, US physicians are well qualified. My conclusion is that graduates adapt to whichever system is training them. US graduates have already selected their training path upon admission to their residency program, and then typically work long hours (the 80 hours per week remains hotly debated5), with the rationale being that experience comes from seeing a large number of patients. As they don’t have long to gain experience, they quickly assume responsibility and “step up to the plate”. Australian graduates take time to explore the options, and while the system may treat them as “worker bees” for a couple of years, they are adequately renumerated. My suggestion is that US trainees would benefit from an extra year of general training (which would help reduce their working hours), while the Australian system could reduce the time to entry into a training program.
Competing interests
No relevant disclosures.
References
- McNamara S. Does it take too long to become a doctor? Part 1. Med J Aust 2012; 196: 528-530. 0_CBBIGIBE
- McNamara S. Does it take too long to become a doctor? Part 2. Med J Aust 2012; 196: 595-597. 0_pgfId-2577959
- Emanuel EJ, Fuchs VR. Shortening medical training by 30%. JAMA 2012; 307: 1143-1144. 0_CBBHDFDI
- Maman-Dogma J, Rousseau M, Dove M, et al. Length of training in postgraduate medical education in Canada. http://www.afmc.ca/pdf/fmec/10_Maman%20Dogma_Length%20of% 20Training.pdf (accessed Jun 2012).
- Drolet BC, Christopher DA, Fischer SA. Residents’ response to duty-hour regulations — a follow-up national survey. N Eng J Med 2012; May 30 [Epub ahead of print]. 0_i1142875