Ezekiel Emanuel: evaluation

Transcript context

…Cut it down? Why does that make it better? Or does it just make it cheaper? No, I think it will make it better. So, we have a lot of memorization, a lot of . . . So, let’s go back to the start. The four years of medical school: two years of preclinical in the classroom learning about biochemistry, genetics, anatomy, microbiology; and the two years of clinical time in the hospital, on the wards. That dates from 1910. We haven’t really updated it much, except in this one way: we’ve cut down the preclinical time because — less of it — and it changes so fast, by the time you learn it in medical school, get out as a doctor, it’s out of date, A; and B, it’s more or less irrelevant to managing most patients. Learning what kind of virus HIV is or herpes virus is — is it a lentivirus? Is it some coronavirus? Really irrelevant to medical practice. Totally irrelevant. Why we teach it, I have no idea. Similarly, the Krebs cycle, I learned it — I counted — six times; never used it once in practice. What are we doing? So, just think about the future. In the future, all these preclinical courses are going to be online. You’re going to have great teachers who are teaching online. Well, what’s a medical school doing, other than showing you videos? And we already know, today, a third of students show up to class. Two-thirds of them look at the videos of their class already. So I think increasingly we’re going to go to, you’ll do the preclinical work before you get to med school, and then med school’s really the clinical work. And then, by the way, in med school, spending your time in a hospital is not the future. The future of American medicine is out of the hospital. So we need more rotations, more experiences for students out of the hospital. No med school has made that big shift, and those are the shifts that are going to have to happen over the next 15 or so years. Should I need an undergraduate degree to go to medical school, if I can pass a bunch of tests?…

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