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Dr Hamilton makes the reasonable point that modern teaching techniques and formats have introduced some efficiencies in learning and some elimination of duplication. Many medical school curricula (including ours) have adopted an organ system approach and find it highly satisfactory. It does not, however, make "the new knowledge... easier to learn faster."
Several statements made by Dr Hamilton are refutable and do not warrant discussion. Examples include the following: "Unfortunately, most basic science is taught by PhDs who usually cannot integrate their disciplines into organ systems"; "most medical school deans and faculty are unable to change their traditional ways"; and "as far as postgraduate training goes, much of it is wasted."
The suggestion that a five-year health professions course be available is also not unreasonable. We simply must then recognize what skills and limitations such individuals have and certify their functions appropriately. Nurse clinicians undoubtedly approach this from
Hejna WF. Length of Medical Education-Reply. JAMA. 1976;236(12):1352. doi:10.1001/jama.1976.03270130015008
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