Want More Doctors? Shorten Process To Become One, Some Experts Say

By Tom Joyce | April 25, 2020, 23:28 EDT

Busy doctor with too much work in hospital

Becoming a medical doctor is a long process anywhere — especially in the United States.

Amid the coronavirus pandemic, business in the United States is being restricted to flatten the curve of the virus spreading. This is being done so that the health care system is not overburdened.

One of those health care resources is doctors — something the United States has about one-fifth fewer of per capita (2.7 per 1,000 people as of 2015) than the average country of the 36 pro-democracy, market-oriented countries in the Organisation for Economic Co-operation and Development (3.4 per 1,000 people as of 2015).

Two of the biggest obstacles to becoming a doctor in the United States, even more so than in other countries, are time and cost. According to NerdWallet.com, the average medical school graduate in 2018 finished with $196,520 in student loan debt.

Some argue that it is time to shorten that process to encourage more people to become doctors.

Robert Orr, a policy associate at the politically moderate Niskanen Center, proposed a way last month.

Orr pointed out that among the countries associated with the Organization for Economic Co-operation and Development, only the United States and Canada require its medical school students to have a bachelor’s degree before entering.

In the United States, ordinarily students first must attend college for four years and then attend at least four years of medical school. Then, they must complete between three and seven years of residency or fellowship, according to Study.com.

In some other countries, like Sweden, South Korea, and Norway, there is a single six-year program in place. Orr thinks the United States should replicate it, and he told New Boston Post there would be benefits both for doctors and patients.

“First, the massive combined cost of college plus medical school dissuades individuals from pursuing medicine, resulting in scarcity of providers and reduced competitive pressures,” Orr said in an email message. “Second, physicians have to pay off the staggering amount of student debt that they accrue, and it’s health care consumers that ultimately end up paying the price here.”

Reducing the debt burden, Orr wrote in his Niskanen Center report in March, would allow doctors to choose lower-paying fields like primary care, which are experiencing shortages.

According to the U.S. Health Resources and Services Administration, by 2025 there is projected to be a primary care physician shortage of 23,640 nationwide.

Orr recommends that state governments establish these six-year programs using their jurisdiction over their respective public university systems.

Dr. Jeffrey Singer, a senior fellow at the libertarian CATO Institute and the founder of Valley Surgical Clinics in Arizona, agrees with Orr and says that a shortened degree would maintain the country’s health care quality.

“You don’t need to be able to quote Shakespeare or recite from Homer in order to be a good doctor,” he told New Boston Post in an email message. “Many countries combine undergraduate education with medical education, putting would-be doctors on a five or six-year track to get their medical degree. This would help get doctors out there much more quickly and, based upon experience in other countries, will not impact the quality of care.”

According to Zippia.com, a careers web site, medical school students come into their respective programs with a wide array of majors. These include biology, biochemistry, economics, history, and English, among others.

What about shortening medical school?

Some have made that case, including Dr. Akhilesh Pathipati, a principal at MVM Partners, a health care investment firm with offices in Boston and London.

In 2018, Pathipati, then a resident physician at Beth Israel Deaconess Medical Center that, argued an op-ed for The Washington Post that even medical school itself could be shortened from four years to three. 

“In my experience, close to half of preclinical content was redundant,” he wrote, in reference to the first two years of medical school. “Between college and medical school, I learned the Krebs cycle (a process that cells use to generate energy) six times. Making college premedical courses more relevant to medicine could condense training considerably.”

Pathipati could not be reached for comment earlier this week.