I don't see colleges surviving. As you pointed out, too much bloat. Clinical medicine for example... All you really need is 2-3 years, clinical physiology, neuroanatomy, clinical pathophysiology, imed, OBGYN, paeds in that order. All of the above can be learnt online by channels such as Geeky Medics, ninjaNerds etc which are way better and more indepth than sitting in a lecture hall listening to someone yap about shit within a given time. After that you can move on to practical training on dummies etc mixed with real life hospital observations. All of that can be done in 3 years and maybe allow an extra year to complete for those who are slow The best thing about learning online for something as complex as medicine is you can pause, rewind and repeat in real time, it's 10x more efficient.
Then all the bloat with bullshit subjects like epidemiology, immunology, biostats, pharmacology etc are irrelevant to clinical medicine. Nobody remembers that shit. Take COVID as an example. Did epidemiology come handy for any doctor on the field? Nope, what came in handy was intubation skills and getting IV access to obese patients.
Then the biggest scam of all is Family medicine. After world war 2, America was left with more specialists than GPs. So rather than incentivize being a GP, they made a speciality called "Family Medicine". Which is basically another 4 years of learning what you already know.
And here's the kicker....countries that recognises GPs also adopted Family Medicine as a speciality. What a clown world. 🤡
And this is using clinical medicine as an example, a degree that most people against college degrees claim is probably the only degree not a scam.
As for accreditation centres. I won't even get into how ECFMG/EPIC, Royal Fellowship of (insert speciality here) are scams.
In my humble opinion. All theoretical work should be handled online and up to the student to choose whatever resources they want to learn from.
Followed by an exam that leads to a practical in person component.
The prerequisite knowledge for that exam should be in detail and given to the student before embarking on their online learning adventure. The exam should test understanding of complex concepts rather than testing on ability to recall. There's no need to have a good ability to recall these days when you can whip out Medscape on your phone.
This will initially lead to mass failures (majority can't grasp complex concepts so easily), which will lead to online communities centred around explaining those concepts, leading to better online content, leading to better graduates.
All it takes is just one country to do this and others will be forced to follow or get left behind.
Accreditation is the main hurdle to these changes. With med school, you have to deal with the AMA, and AAMC in the US, other associations elsewhere. The US already has a checklist required for 'degree equivalency' for non-US advanced degrees. IMO, other countries doing what you suggest won't matter to the US until medical tourism reaches a peak. There's already a fair amount of medical tourism to Canada and Mexico, but the common view of surgery abroad is that it is cheap, but risky.
Some of your proposed teaching changes are already recognized as better teaching practices. The 'flipped classroom model' (learn online before class then work problems in class) is especially popular. Pedagogy people also like Bloom's Taxonomy, which puts recall at the bottom and synthesis at the top. One challenge with this is the temptation to only focus on superficial concepts instead of digging deeply into the problems. Colleges HATE mass failures.
Having taught pre-meds, I disagree that everything could be done in 2-3 years total. For the top 1-5%, sure. For everyone else, it takes many times around the material before they get it. They're also shadowing for a good chunk of time before med school, too. IMO, the miracle of modern medicine is that nurses and physicians don't kill as many people as they otherwise might. However, certainly lots of room for improvement!
I don't see colleges surviving. As you pointed out, too much bloat. Clinical medicine for example... All you really need is 2-3 years, clinical physiology, neuroanatomy, clinical pathophysiology, imed, OBGYN, paeds in that order. All of the above can be learnt online by channels such as Geeky Medics, ninjaNerds etc which are way better and more indepth than sitting in a lecture hall listening to someone yap about shit within a given time. After that you can move on to practical training on dummies etc mixed with real life hospital observations. All of that can be done in 3 years and maybe allow an extra year to complete for those who are slow The best thing about learning online for something as complex as medicine is you can pause, rewind and repeat in real time, it's 10x more efficient.
Then all the bloat with bullshit subjects like epidemiology, immunology, biostats, pharmacology etc are irrelevant to clinical medicine. Nobody remembers that shit. Take COVID as an example. Did epidemiology come handy for any doctor on the field? Nope, what came in handy was intubation skills and getting IV access to obese patients.
Then the biggest scam of all is Family medicine. After world war 2, America was left with more specialists than GPs. So rather than incentivize being a GP, they made a speciality called "Family Medicine". Which is basically another 4 years of learning what you already know.
And here's the kicker....countries that recognises GPs also adopted Family Medicine as a speciality. What a clown world. 🤡
And this is using clinical medicine as an example, a degree that most people against college degrees claim is probably the only degree not a scam.
As for accreditation centres. I won't even get into how ECFMG/EPIC, Royal Fellowship of (insert speciality here) are scams.
In my humble opinion. All theoretical work should be handled online and up to the student to choose whatever resources they want to learn from.
Followed by an exam that leads to a practical in person component.
The prerequisite knowledge for that exam should be in detail and given to the student before embarking on their online learning adventure. The exam should test understanding of complex concepts rather than testing on ability to recall. There's no need to have a good ability to recall these days when you can whip out Medscape on your phone.
This will initially lead to mass failures (majority can't grasp complex concepts so easily), which will lead to online communities centred around explaining those concepts, leading to better online content, leading to better graduates.
All it takes is just one country to do this and others will be forced to follow or get left behind.
Accreditation is the main hurdle to these changes. With med school, you have to deal with the AMA, and AAMC in the US, other associations elsewhere. The US already has a checklist required for 'degree equivalency' for non-US advanced degrees. IMO, other countries doing what you suggest won't matter to the US until medical tourism reaches a peak. There's already a fair amount of medical tourism to Canada and Mexico, but the common view of surgery abroad is that it is cheap, but risky.
Some of your proposed teaching changes are already recognized as better teaching practices. The 'flipped classroom model' (learn online before class then work problems in class) is especially popular. Pedagogy people also like Bloom's Taxonomy, which puts recall at the bottom and synthesis at the top. One challenge with this is the temptation to only focus on superficial concepts instead of digging deeply into the problems. Colleges HATE mass failures.
Having taught pre-meds, I disagree that everything could be done in 2-3 years total. For the top 1-5%, sure. For everyone else, it takes many times around the material before they get it. They're also shadowing for a good chunk of time before med school, too. IMO, the miracle of modern medicine is that nurses and physicians don't kill as many people as they otherwise might. However, certainly lots of room for improvement!