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4 years of medical school
Aug
22
Maybe I'm straying from pediatric subject matter to make this comment. But I can't be the first one to wonder if the 4 years of medical school are absolutely necessary. Are all the basic science courses with labs taught by research oriented PhD's really the ideal way for MD students to learn science? Couldn't these courses be taught on an undergrad level and made requirements to apply to med school? I imagine the whole 4 year curriculum could be revised and updated. Maybe a year or so could be eliminated.
Of course, it could never happen. Grants and funding for basic research seems to be inseparable from the goals of training future clinicians (does it really have to be that way?) There are powerful entrenched interests in the medical education system and the politics is really intense. This is something I noticed when I was employed by a medical school for a few years after graduation. The cardiologist for whom I was coordinating a clinical trial liked to read espionage novels (the John Grisham equivalents of the late 70's) because he said they reminded him of the medical school.
Stephanie Walker FNP
I think that when
> someone
> tries to say that the average NP is just as good as the average
> doctor
> it is an insult to every doctor who had to bust their hump
> through 4
> years of medical school and then work crazy hours and shifts
> through
> residency. When NP school is a 4 year program + a 3 year
> residency is
> the day that I will start to compare NPs to doctors or
> alternatively we
> can shorten the MD program -- I don't think that idea will get
> that
> much support from the public.
>
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FW:
This press release was sent out by email to Wisconsin pediatricians this
week. Enjoy. PKW
_____
From:
Sent: None
Subject:
FYI and light reading
Halim
Halim Hennes, MD, MS
_____
From: Dan Walter [mailto:hidden@email-address]
Sent: Tue 8/21/2007 1:54 PM
To: undisclosed-recipients
Subject: AAP: Advocacy Flash 8/21/07
AAP Division of State Government Affairs
August 21, 2007
_____
CMS ISSUES NEW GUIDANCE ON:
*"Crowd Out" requirements for states with SCHIP eligibility at or above 250%
of the federal poverty level (FPL)
* Medicaid tamper-proof prescription pads
* Emergency department cost sharing for non-emergency care
_____
Late last week, the Centers for Medicare and Medicaid Services (CMS) issued
new guidance on several issues, including:
* "Crowd Out" requirements for states with SCHIP eligibility at or above
250% FPL
In this August 17, 2007 letter
to State Health
Officials, CMS is instituting new requirements to prevent "crowd out"
(substitution of private coverage with public coverage) in the SCHIP
program. These requirements will mean that states expanding SCHIP coverage
to children in families with incomes at 250% FPL and above will have to
implement new strategies to assure CMS that children are not leaving private
coverage for public coverage. Initial analysis indicates that these
requirements would be difficult for most states to meet.
Among these requirements, within the next 12 months, states must: (1) assure
that cost sharing for children in SCHIP over 250% FPL is virtually the same
as that of private insurance; (2) establish a minimum of a 1 year period of
uninsurance prior to receiving SCHIP coverage; (3) provide assurance that
95% of children in the state below 200% FPL who are eligible for
Medicaid/SCHIP are covered; (4) assure that the number of children "in the
target population" insured through private employers has not decreased by
more than 2 percentage points over the prior 5-year period.
Initial analysis indicates that these rules will have a negative effect on
state plans to provide coverage past 250% FPL. The Academy will provide
additional information on this issue as it evolves.
* Medicaid tamper-proof prescription pads
Following the May 25, 2007 enactment of the US Troop Readiness, Veterans'
Care, Katrina Recovery and Iraq Accountability Appropriations Act of 2007,
Medicaid will be requiring the use of tamper resistant prescription pads for
prescriptions written for Medicaid enrollees beginning October 1, 2007.
After consideration of the AAP's and other medical societies' concerns about
this new law, CMS issued guidance on August 17, 2007 in a State
Medicaid Director
letter and state
health
policy backgrounder, providing clarification of this requirement.
The August 17, 2007 CMS letter indicates that, to be considered tamper
resistant on October 1, 2007, a prescription pad must contain at least one
of the following three characteristics:
1) Features to prevent unauthorized copying
2) Features to prevent erasure or modification of information written on the
form
3) Features to prevent use of counterfeit forms
By October 1, 2008, a prescription pad must contain all three of the above
characteristics to be considered tamper resistant. Of note, those states
with existing state requirements for tamper resistant prescription pads are
deemed to meet or exceed the CMS standard. States are free to exceed the
above standard, and CMS indicates that states should make their own
determination whether to allow pharmacists to accept an out-of-state
prescription that meets the tamper resistant requirements of another state.
The CMS letter also provides exemptions to the requirement, which will not
have to meet the tamper-proof standard. These include:
1) Prescriptions provided in nursing facilities, intermediate care
facilities, and other specified institutions
2) Refills of written prescriptions presented at a pharmacy before October
1, 2007
3) Electronic, faxed and telephoned prescriptions
4) Prescriptions paid for by managed care entities
Of note, if a state elects to purchase compliant prescription pads for
Medicaid prescriptions and provide them to prescribers at no cost or a
discounted rate, the cost of the prescription pads to the state is
reimbursable as an administrative expense under Medicaid. Therefore, AAP
chapters may wish to advocate that states purchase such pads in bulk and
provide them at no cost to participating physicians.
The Academy is concerned about the impact and short implementation time
frame of this requirement and has taken action, signing onto a letter with
other medical organizations calling on the US Department of Health and Human
Services (HHS) to delay implementation. The Academy will continue to provide
information on this issue in the next edition of AAP OnCall.
* Emergency room cost sharing for non-emergency care
On August 15, 2007 CMS issued a State
Medicaid Director
letter providing additional information on the state option to impose cost
sharing for non-emergency use of the emergency room under Medicaid, as
created by the Deficit Reduction Act of 2005 and altered by the Tax Relief
and Health Care Act of 2006 (THRC). The letter clarifies restrictions on
this alternate cost sharing for individuals below 100% FPL; further spells
out the requirements for hospitals to impose such cost sharing; defines the
"alternative non-emergency services provider" services that must be
alternately accessible in order for the cost sharing to be imposed; and
clarifies that there are limits on such cost sharing to children under age
18 who would otherwise be exempt from other alternative cost sharing.
"Mandatory" eligible Medicaid children may only be charged an amount that
does not exceed a "nominal" amount as defined by statute.
CMS also issued a State
Plan Amendment
preprint template for states to use when seeking to implement such cost
sharing in Medicaid for non-emergency services provided in the emergency
room. Simultaneously, CMS released a grant
announcement for state Medicaid agencies seeking to develop alternative
non-emergency service providers. The DRA made $50 million in grants
available over 4 years for states to develop such systems of care to avoid
non-emergency use of the emergency department.
We will continue to provide more information on these issues as it becomes
available. If you have questions or need additional information, please
contact Dan Walter at 800/433-9016 ext. 4086 or hidden@email-address.
_____
The Division of State Government Affairs sends this update to the Academy's
Executive Committee, Board of Directors, District Vice-Chairs, Chapter
Presidents, Chapter Vice Presidents, Committee on State Government Affairs,
Committee on Federal Government Affairs, Chapter Executive Directors, and
other interested AAP members and staff.
For additional state legislative information, strategy suggestions, in-depth
resources on issues of pediatric interest, and past editions of this update,
log onto the AAP Member Center and see the State Government Affairs area at
http://www.aap.org/moc/statelegislation
.
For more information on the issues contained in this e-mail update, please
contact Dan Walter at
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RE: 4 years of medical school
Message from Kevin M. Windisch MD, FAAP hidden@email-address
I was going to stay out of this one but since you insist...
Biochem, Psychology, Physiology, and Cell Biology are already taught at the
undergrad level. They are required pre-requs for med school. They are
taught again at the graduate level (and believe me they are way more
intense)because that is what is necessary to be a good physician.
You oversimplify the necessary knowledge base.
kmw
-----Original Message-----
From: hidden@email-address [mailto:hidden@email-address] On Behalf Of
hidden@email-address
Sent: Wednesday, August 22, 2007 10:11 AM
To: hidden@email-address
Subject: 4 years of medical school
Maybe I'm straying from pediatric subject matter to make this comment. But I
can't be the first one to wonder if the 4 years of medical school are
absolutely necessary. Are all the basic science courses with labs taught by
research oriented PhD's really the ideal way for MD students to learn
science? Couldn't these courses be taught on an undergrad level and made
requirements to apply to med school? I imagine the whole 4 year curriculum
could be revised and updated. Maybe a year or so could be eliminated.
Of course, it could never happen. Grants and funding for basic research
seems to be inseparable from the goals of training future clinicians (does
it really have to be that way?) There are powerful entrenched interests in
the medical education system and the politics is really intense. This is
something I noticed when I was employed by a medical school for a few years
after graduation. The cardiologist for whom I was coordinating a clinical
trial liked to read espionage novels (the John Grisham equivalents of the
late 70's) because he said they reminded him of the medical school.
Stephanie Walker FNP
I think that when
> someone
> tries to say that the average NP is just as good as the average
> doctor
> it is an insult to every doctor who had to bust their hump
> through 4
> years of medical school and then work crazy hours and shifts
> through
> residency. When NP school is a 4 year program + a 3 year
> residency is
> the day that I will start to compare NPs to doctors or
> alternatively we
> can shorten the MD program -- I don't think that idea will get
> that
> much support from the public.
>
No virus found in this incoming message.
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RE: 4 years of medical school
i think i forget much of it as soon as the courses are
over, so repetition helps. although i've forgotten
most of it after a few years of private practice
anyhow. so what was the point again?
--- "Kevin M. Windisch MD, FAAP"
wrote:
> I was going to stay out of this one but since you
> insist...
>
> Biochem, Psychology, Physiology, and Cell Biology
> are already taught at the
> undergrad level. They are required pre-requs for
> med school. They are
> taught again at the graduate level (and believe me
> they are way more
> intense)because that is what is necessary to be a
> good physician.
>
> You oversimplify the necessary knowledge base.
>
> kmw
>
> -----Original Message-----
> From: hidden@email-address
> [mailto:hidden@email-address] On Behalf Of
> hidden@email-address
> Sent: Wednesday, August 22, 2007 10:11 AM
> To: hidden@email-address
> Subject: 4 years of medical school
>
> Maybe I'm straying from pediatric subject matter to
> make this comment. But I
> can't be the first one to wonder if the 4 years of
> medical school are
> absolutely necessary. Are all the basic science
> courses with labs taught by
> research oriented PhD's really the ideal way for MD
> students to learn
> science? Couldn't these courses be taught on an
> undergrad level and made
> requirements to apply to med school? I imagine the
> whole 4 year curriculum
> could be revised and updated. Maybe a year or so
> could be eliminated.
>
>
> Of course, it could never happen. Grants and funding
> for basic research
> seems to be inseparable from the goals of training
> future clinicians (does
> it really have to be that way?) There are powerful
> entrenched interests in
> the medical education system and the politics is
> really intense. This is
> something I noticed when I was employed by a medical
> school for a few years
> after graduation. The cardiologist for whom I was
> coordinating a clinical
> trial liked to read espionage novels (the John
> Grisham equivalents of the
> late 70's) because he said they reminded him of the
> medical school.
>
> Stephanie Walker FNP
>
> I think that when
> > someone
> > tries to say that the average NP is just as good
> as the average
> > doctor
> > it is an insult to every doctor who had to bust
> their hump
> > through 4
> > years of medical school and then work crazy hours
> and shifts
> > through
> > residency. When NP school is a 4 year program + a
> 3 year
> > residency is
> > the day that I will start to compare NPs to
> doctors or
> > alternatively we
> > can shorten the MD program -- I don't think that
> idea will get
> > that
> > much support from the public.
> >
>
>
> This message is from PEDTALK - a Pediatric Focused
> email discussion group.
> Admin questions: "hidden@email-address" or
> "http://www.pcc.com/lists/"
> To unsubscribe: mail "hidden@email-address" with
> "unsubscribe"
>
> No virus found in this incoming message.
> Checked by AVG Free Edition.
> Version: 7.5.484 / Virus Database: 269.12.2/966 -
> Release Date: 8/22/2007
> 9:05 AM
>
> No virus found in this outgoing message.
> Checked by AVG Free Edition.
> Version: 7.5.484 / Virus Database: 269.12.2/966 -
> Release Date: 8/22/2007
> 9:05 AM
>
>
> This message is from PEDTALK - a Pediatric Focused
> email discussion group.
> Admin questions: "hidden@email-address" or
> "http://www.pcc.com/lists/"
> To unsubscribe: mail "hidden@email-address" with
> "unsubscribe"
>
>
____________________________________________________________________________________
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RE: 4 years of medical school
Message from Kevin M. Windisch MD, FAAP hidden@email-address
I haven't forgotten my basic sciences- sure some of it is covered with rust
scales but it is still accessible information when necessary.
kmw
-----Original Message-----
From: hidden@email-address [mailto:hidden@email-address] On Behalf Of Viet
Mai
Sent: Wednesday, August 22, 2007 11:00 AM
To: hidden@email-address
Subject: RE: 4 years of medical school
i think i forget much of it as soon as the courses are
over, so repetition helps. although i've forgotten
most of it after a few years of private practice
anyhow. so what was the point again?
--- "Kevin M. Windisch MD, FAAP"
wrote:
> I was going to stay out of this one but since you
> insist...
>
> Biochem, Psychology, Physiology, and Cell Biology
> are already taught at the
> undergrad level. They are required pre-requs for
> med school. They are
> taught again at the graduate level (and believe me
> they are way more
> intense)because that is what is necessary to be a
> good physician.
>
> You oversimplify the necessary knowledge base.
>
> kmw
>
> -----Original Message-----
> From: hidden@email-address
> [mailto:hidden@email-address] On Behalf Of
> hidden@email-address
> Sent: Wednesday, August 22, 2007 10:11 AM
> To: hidden@email-address
> Subject: 4 years of medical school
>
> Maybe I'm straying from pediatric subject matter to
> make this comment. But I
> can't be the first one to wonder if the 4 years of
> medical school are
> absolutely necessary. Are all the basic science
> courses with labs taught by
> research oriented PhD's really the ideal way for MD
> students to learn
> science? Couldn't these courses be taught on an
> undergrad level and made
> requirements to apply to med school? I imagine the
> whole 4 year curriculum
> could be revised and updated. Maybe a year or so
> could be eliminated.
>
>
> Of course, it could never happen. Grants and funding
> for basic research
> seems to be inseparable from the goals of training
> future clinicians (does
> it really have to be that way?) There are powerful
> entrenched interests in
> the medical education system and the politics is
> really intense. This is
> something I noticed when I was employed by a medical
> school for a few years
> after graduation. The cardiologist for whom I was
> coordinating a clinical
> trial liked to read espionage novels (the John
> Grisham equivalents of the
> late 70's) because he said they reminded him of the
> medical school.
>
> Stephanie Walker FNP
>
> I think that when
> > someone
> > tries to say that the average NP is just as good
> as the average
> > doctor
> > it is an insult to every doctor who had to bust
> their hump
> > through 4
> > years of medical school and then work crazy hours
> and shifts
> > through
> > residency. When NP school is a 4 year program + a
> 3 year
> > residency is
> > the day that I will start to compare NPs to
> doctors or
> > alternatively we
> > can shorten the MD program -- I don't think that
> idea will get
> > that
> > much support from the public.
> >
>
>
> This message is from PEDTALK - a Pediatric Focused
> email discussion group.
> Admin questions: "hidden@email-address" or
> "http://www.pcc.com/lists/"
> To unsubscribe: mail "hidden@email-address" with
> "unsubscribe"
>
> No virus found in this incoming message.
> Checked by AVG Free Edition.
> Version: 7.5.484 / Virus Database: 269.12.2/966 -
> Release Date: 8/22/2007
> 9:05 AM
>
> No virus found in this outgoing message.
> Checked by AVG Free Edition.
> Version: 7.5.484 / Virus Database: 269.12.2/966 -
> Release Date: 8/22/2007
> 9:05 AM
>
>
> This message is from PEDTALK - a Pediatric Focused
> email discussion group.
> Admin questions: "hidden@email-address" or
> "http://www.pcc.com/lists/"
> To unsubscribe: mail "hidden@email-address" with
> "unsubscribe"
>
>
____________________________________________________________________________
________
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http://surveylink.yahoo.com/gmrs/yahoo_panel_invite.asp?a=7
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9:05 AM
RE: 4 years of medical school
Interesting to compare the medical school education in different
countries. In some "first world" countries it is 6 years of education
(including clinical practicum) after secondary school.
http://en.wikipedia.org/wiki/Medical_school
Stephanie Walker, FNP
On Aug 22, 2007, at 3:52 PM, PedTalk Digest wrote:
> Subject: RE: 4 years of medical school
>
> I was going to stay out of this one but since you insist...
>
> Biochem, Psychology, Physiology, and Cell Biology are already
> taught at the
> undergrad level. They are required pre-requs for med school. They
> are
> taught again at the graduate level (and believe me they are way more
> intense)because that is what is necessary to be a good physician.
>
> You oversimplify the necessary knowledge base.
>
> kmw
4 years of medical school
yes but what you don't realize is most of those countries have a higher
level and broader high school education. For example if you come to an
American school with and Israeli matriculation test (Bagrut) it is worth
30 college credits. So these countries all have a higher level of
education before they get to college. These programs are then very
focused and intensive you don't get to take basket weaving electives.
Lets also remember that despite the clinical practicum we in the US
still require them to go through residency.
Stephanie Walker wrote:
> Interesting to compare the medical school education in different
> countries. In some "first world" countries it is 6 years of education
> (including clinical practicum) after secondary school.
>
> http://en.wikipedia.org/wiki/Medical_school
>
> Stephanie Walker, FNP
>
> On Aug 22, 2007, at 3:52 PM, PedTalk Digest wrote:
>
>> Subject: RE: 4 years of medical school
>>
>> I was going to stay out of this one but since you insist...
>>
>> Biochem, Psychology, Physiology, and Cell Biology are already taught
>> at the
>> undergrad level. They are required pre-requs for med school. They are
>> taught again at the graduate level (and believe me they are way more
>> intense)because that is what is necessary to be a good physician.
>>
>> You oversimplify the necessary knowledge base.
>>
>> kmw
>
> This message is from PEDTALK - a Pediatric Focused email discussion
> group.
>
>
--
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RE: 4 years of medical school
Message from Kevin M. Windisch MD, FAAP hidden@email-address
May be true but... While our system is definitely broken we do have the best
physicians in the world. Perhaps due to our stringent requirements does
this happen.
Unless of course you WANT mediocre care.
kmw
-----Original Message-----
From: hidden@email-address [mailto:hidden@email-address] On Behalf Of
Stephanie Walker
Sent: Thursday, August 23, 2007 4:49 AM
To: hidden@email-address
Subject: RE: 4 years of medical school
Interesting to compare the medical school education in different
countries. In some "first world" countries it is 6 years of education
(including clinical practicum) after secondary school.
http://en.wikipedia.org/wiki/Medical_school
Stephanie Walker, FNP
On Aug 22, 2007, at 3:52 PM, PedTalk Digest wrote:
> Subject: RE: 4 years of medical school
>
> I was going to stay out of this one but since you insist...
>
> Biochem, Psychology, Physiology, and Cell Biology are already
> taught at the
> undergrad level. They are required pre-requs for med school. They
> are
> taught again at the graduate level (and believe me they are way more
> intense)because that is what is necessary to be a good physician.
>
> You oversimplify the necessary knowledge base.
>
> kmw
No virus found in this incoming message.
Checked by AVG Free Edition.
Version: 7.5.484 / Virus Database: 269.12.2/966 - Release Date: 8/22/2007
9:05 AM
No virus found in this outgoing message.
Checked by AVG Free Edition.
Version: 7.5.484 / Virus Database: 269.12.2/967 - Release Date: 8/22/2007
6:51 PM
4 years of medical school
actually you forgot very little of it --it teaches a method of thinking
not just facts --it teaches the art of medicine not only the science and
most importantly it teaches you how to find the answers you need should
you need to.
Don't discount the value of your hard work.
Viet Mai wrote:
> i think i forget much of it as soon as the courses are
> over, so repetition helps. although i've forgotten
> most of it after a few years of private practice
> anyhow. so what was the point again?
>
> --- "Kevin M. Windisch MD, FAAP"
> wrote:
>
>
>> I was going to stay out of this one but since you
>> insist...
>>
>> Biochem, Psychology, Physiology, and Cell Biology
>> are already taught at the
>> undergrad level. They are required pre-requs for
>> med school. They are
>> taught again at the graduate level (and believe me
>> they are way more
>> intense)because that is what is necessary to be a
>> good physician.
>>
>> You oversimplify the necessary knowledge base.
>>
>> kmw
>>
>> -----Original Message-----
>> From: hidden@email-address
>> [mailto:hidden@email-address] On Behalf Of
>> hidden@email-address
>> Sent: Wednesday, August 22, 2007 10:11 AM
>> To: hidden@email-address
>> Subject: 4 years of medical school
>>
>> Maybe I'm straying from pediatric subject matter to
>> make this comment. But I
>> can't be the first one to wonder if the 4 years of
>> medical school are
>> absolutely necessary. Are all the basic science
>> courses with labs taught by
>> research oriented PhD's really the ideal way for MD
>> students to learn
>> science? Couldn't these courses be taught on an
>> undergrad level and made
>> requirements to apply to med school? I imagine the
>> whole 4 year curriculum
>> could be revised and updated. Maybe a year or so
>> could be eliminated.
>>
>>
>> Of course, it could never happen. Grants and funding
>> for basic research
>> seems to be inseparable from the goals of training
>> future clinicians (does
>> it really have to be that way?) There are powerful
>> entrenched interests in
>> the medical education system and the politics is
>> really intense. This is
>> something I noticed when I was employed by a medical
>> school for a few years
>> after graduation. The cardiologist for whom I was
>> coordinating a clinical
>> trial liked to read espionage novels (the John
>> Grisham equivalents of the
>> late 70's) because he said they reminded him of the
>> medical school.
>>
>> Stephanie Walker FNP
>>
>> I think that when
>>
>>> someone
>>> tries to say that the average NP is just as good
>>>
>> as the average
>>
>>> doctor
>>> it is an insult to every doctor who had to bust
>>>
>> their hump
>>
>>> through 4
>>> years of medical school and then work crazy hours
>>>
>> and shifts
>>
>>> through
>>> residency. When NP school is a 4 year program + a
>>>
>> 3 year
>>
>>> residency is
>>> the day that I will start to compare NPs to
>>>
>> doctors or
>>
>>> alternatively we
>>> can shorten the MD program -- I don't think that
>>>
>> idea will get
>>
>>> that
>>> much support from the public.
>>>
>>>
>>
>
>> This message is from PEDTALK - a Pediatric Focused
>> email discussion group.
>> List address: "hidden@email-address"
>> Admin questions: "hidden@email-address" or
>> "http://www.pcc.com/lists/"
>> To unsubscribe: mail "hidden@email-address" with
>> "unsubscribe"
>> in the body of the message.
>>
>> No virus found in this incoming message.
>> Checked by AVG Free Edition.
>> Version: 7.5.484 / Virus Database: 269.12.2/966 -
>> Release Date: 8/22/2007
>> 9:05 AM
>>
>> No virus found in this outgoing message.
>> Checked by AVG Free Edition.
>> Version: 7.5.484 / Virus Database: 269.12.2/966 -
>> Release Date: 8/22/2007
>> 9:05 AM
>>
>>
>>
>
>> This message is from PEDTALK - a Pediatric Focused
>> email discussion group.
>> List address: "hidden@email-address"
>> Admin questions: "hidden@email-address" or
>> "http://www.pcc.com/lists/"
>> To unsubscribe: mail "hidden@email-address" with
>> "unsubscribe"
>> in the body of the message.
>>
>>
>>
>
>
>
> ____________________________________________________________________________________
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>
>
>
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