Prerequisites for a profession

When is it education and when is it training? The problem of defining a proper schooling for a medical doctors came up in a story about one med school that allowed some of its students to bypass pre-med university courses in the hard sciences. David Gorski has a good discussion of the implications in “Hard science” and medical school

What bothers me about Muller and Kase’s thesis is, as I have said before, the way that it seems to view science as an obstacle to getting into medical school and becoming a doctor, as opposed to being a necessary prerequisite to being able to put the flood of information taught in medical school into context. The humanistic part of medicine is very important to being an effective, but if those humanistic elements are not also wedded to a firm understanding of the science of clinical practice, we risk producing a generation of physicians who are very good at holding their patients’ hands and offering encouragement to them but not so good at actually treating their medical problems.

One way to look at this is that med schools are regressing to an equivalence with chiropractic schools in eliminating calculus and hard science as prerequisites. That reinforces Gorski’s fear about the spread of alternative medicine and the abandonment of science in developing effective therapies.

Science informs what is good medicine, and physicians should have a sufficient grounding in the scientific method to be able to recognize what is and is not good scientific and clinical evidence for a therapy.

One of the problems is that of training versus education. It takes training to acquire the skills a physician must have yet it takes education for them to evaluate to extend and extrapolate and evaluate those skills and the reasons for them. Training is easy to teach and to test and those are very attractive attributes. Education is a matter of values and viewpoints and ways of understanding that make it more difficult to teach and to test. The question for medicine, as well as for many other professions, is that of a proper balance.

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