Medical schools shooting for the middle

KevinMD has a post up about some people wondering whether it wouldn't be better to admit to med school those who do not get top scores. This reminds of a legal case I saw on TV a number of years ago about a police department that rejected an applicant who had scored too high. They won the case based on the fact that research shows those who score too highly under-perform as police officers. Something to do with boredom, I think.

Anyhow, I think this is interesting because I've been wondering for a while whether doctors aren't overtrained or overselected. This topic comes up indirectly at Happy Hospitalist frequently in the form of arguments over the place of MLPs. The question in my mind isn't whether PAs are adequately trained but whether it isn't possible that our current educational structure doesn't include what's really needed--something in between a PA and MD. Wasn't med school designed for a circumstance where doctors had to rely much more on their innate knowledge and intelligence and participated in a lot more guesswork? Does it make sense to train MDs for a technological and knowledge context decades old? I don't really know, but as I've written before, the experienced nurses on my unit can predict what a doctor is going to order for patients 90% of the time. If a nurse can obtain this level understanding with so little educational background, do we need all the MDs to be trained at the same level or could we get by with a mix of some with less training?

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