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JAMA 100 Years Ago
September 23 2009

THE CROWDED MEDICAL CURRICULUM

JAMA. 2009;302(12):1373. doi:10.1001/jama.2009.1202

During the past year one of the most important subjects of discussion has been the crowded medical curriculum. There are so many subjects in the curriculum of medical schools that it is difficult for students to get clear ideas with regard to them. This overcrowding is becoming worse every year in spite of all that has been done. At first, the overcrowding was only in the final years of the medical course and temporary improvement was effected by transferring several subjects to earlier years; but now the overcrowding, involving all years, is worse than ever. Some colleges, by increasing the entrance requirements to one or more years of collegiate work, including physics, inorganic chemistry and biology, thereby relieved the medical curriculum of those branches and secured for the medical course students better prepared to take up the medical subjects. In the Canadian schools, instead of requiring collegiate work for admission, the medical course was extended to five years, the first of which was devoted to physics, chemistry and biology. But, even relieving the medical course of these premedical sciences gives only slight relief, and teachers are justly clamoring for more time. Medical students are being ground through a cramming process with insufficient time to think. An extension of the medical course to five years has been suggested, and this may become necessary before many years . . . Austria, Belgium and Portugal have a five-year course and also require a year of science beyond the secondary school for admission, which is practically the equivalent to the requirements in Denmark, Italy, the Netherlands and Norway, as well as in the South American countries—Argentina, Brazil and Uruguay—where a six-year course, including the premedical sciences, is required. Spain has a seven-year course if we include the year in science, while Sweden has a course of eight or ten years, depending on the student's ability to pass his examination. We are not quite ready, however, for this extension of the medical course. In the meantime it should be the purpose of those interested in medical education to secure, so far as possible, the obliteration of the feeling of hurry and the sense of overcrowding in present-day medical study, both of which are fatal to any real attainment of knowledge.

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