This year, Johns Hopkins is instituting its enormous revamping of the medical school curriculum. This means that I will be in the pilot group of students trying it out. It also means that I’m going to get a bit screwed in the process since I did my first 2 year of medical school under one curriculum, and will be doing the last 2 under another. The old curriculum was particularly student-friendly in that students could choose when they would do their basic clerkships (medicine, OB-Gyn, pediatrics, Emergency, surgery, pyschiatry-neurology, ambulatory) at any time during the 3rd or 4th year, so long as they completed all before they graduate. This allows them to experience electives (any other specialty, basically) during their 3rd year, in time to gain enough experience to make an informed decision as to which specialty to pursue. The new curriculum now dictates that all basic clerkships must be completed during the 3rd year, and only 1 block can be taken for electives. This means that if you don’t happen to like the one elective that you took in your 3rd year, you have to wait till your 4th year (after you have begun to apply to residency programs) to take another. For example, if you are interested in Dermatology, Radiology, and Anesthesiology, but unsure how to decide, you can only pick one to do a rotation in before you have to apply to residencies. Don’t like that one? Oh well, hope you like one of the other two.
There are a variety of reasons for this. One is that when 4th year students took basic clerkships, they pretty much already decided their specialty, so it is hard to engage them in your subject when they’ve already decided against it. This is the best one I’ve heard, that isn’t exactly my conspiracy theory.
My theory is that Hopkins is trying to push us medical students into primary care specialties such as internal or family medicine, pediatrics, ob-gyn, ect. By not giving us a chance to experience an “elective” specialty, it ensures more will go into the ones they have experienced and have had time to prepare a strong resume for. While I understand the need to do this, maybe 10% of Hopkins graduates went into a primary care specialty when my med school class graduated (not uncommon), I feel that rather than force us into it by limiting our options, we should be working to increasing the incentives to go into a primary care field. Helping humanity at ridiculous hours and poor pay doesn’t pay back the 300K+ worth of loans you racked up in med school alone. I hate for it to come down to that, but it does. However, you tell students that you’ll pay off their loans or even a good portion of them if they go into primary care specialties, I guarantee that you’ll people flooding into to them. I really just bristle at people telling me what I can and can’t be when I grow up, even if its just by making those other choices less available. It is the start of an extremely alarming trend, in my opinion.