Medical education

In modern times, regulation of the medical profession includes legal licensure to practice medicine in most countries. Part of being able to qualify for such a license involves meeting certain achievement standards in medical education. Usually those standards are met by having some sort of "medical degree" that is obtained in formal study in an accredited professional school. This is called undergraduate medical education. Those degrees, and the requirements for obtaining them, are different depending on region. In some countries, there is more than one type of medical degree, depending on the type and extent of medical education.

There is more to having a license to practice medicine than meeting an educational standard. Licensure also requires completion of some sort of clinical "apprenticeship", called internship and residency, as well as passing grades on one or more standardized tests.

In some countries, there are still additional requirements called graduate medical education in order to practice specialties within medicine.

Classification

Undergraduate medical education

Undergraduate medical education is the "period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D."

Internship and residency

Internship and residency are "programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities."

Graduate medical education

Graduate medical education (GME) included "educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree." GME may include internship, residency training, and fellowship training.

Continuing medical education

Continuing medical education is "educational programs designed to inform physicians of recent advances in their field."

Variations by geographic region

The Foundation for Advancement of International Medical Education and Research (FAIMER) [1] is dedicated to improving world health through education of the medical educators. They also maintain an open access International Medical Directory [2].

Canada

Most medical schools in Canada require at least three years of postsecondary education towards a bachelor's degree prior to admission although the majority of entrants hold at least a bachelor's degree, usually in the sciences. The most notable exception to this is at McGill University, where a subset of the entering class are accepted directly after completion of CEGEP.

Schools typically admit applicants based on their undergraduate record (GPA), personal statement, MCAT score, non-academic (extracurricular) score, and interview.

Medical school in Canada is usually four years in length although McMaster University and the University of Calgary offer accelerated programs which run three years in total. Students in the first two years cover basic sciences such as anatomy, physiology, immunology and pharmacology and are given preliminary clinical exposure. Education is delivered through traditional lectures and small group learning, including problem-based learning. Years 3 and 4 are known as the clinical years or the clerkship, in which students learn in a hospital-based setting through clinical rotations in such fields as Internal Medicine, Emergency Medicine, Surgery and Pediatrics.

At the end of Year 4, students enter the Canadian Resident Matching Service (CaRMS) and are matched to a speciality and location depending on their particular preferences. Students typically graduate with the title Doctor of Medicine (MD).

Postgraduate training, or residency, varies in length from two years (such as in Family Medicine) to six years (such as in General Surgery). Most residency programs last about five years.

To receive full certification, physicians must be certified as a Licentiate of the Medical Council of Canada (LMCC) by completing the Medical Council of Canada Qualifying Exam (MCCQE) Part I at the end of Year 4 and the MCCQE Part II at the end of PGY-1. Furthermore, they must receive certification from an appropriate certifying body: The College of Family Physicians of Canada (CFPC) for family physicians and the Royal College of Physicians and Surgeons of Canada (RCPSC) for specialists.

Finally, physicians must register with the appropriate regulating body to be eligible to practise in a particular province. For example, physicians wishing to practise in British Columbia must register with the College of Physicians and Surgeons of British Columbia (CPSBC).

Problems in medical education

Lectures and rote memorization

Much of undergraduate medical education is rote memorization. Perhaps as a result, one medical school noted that only 17% of students reported routinely attending lectures. Other schools have reported similarly. The incremental value of lectures over textbooks at improving grades may not be strong. The use of audience response systems may help.

See also

• Abraham Flexner