There are recent changes to medical school training that have one orthopedic surgeon worried about the potential future of the orthopedic and musculoskeletal fields.
Schools moving away from cadaver labs, the overflow of research publications on residency applications and the shift toward flexibility and predictability over procedure-driven specialties are some of the concerns of Brian Curtin, MD, a hip and knee specialist at OrthoCarolina Hip and Knee Center in Charlotte, N.C.
Note: Responses were lightly edited for clarity and length.
Question: Are there any aspects/trends of medical school today that make you concerned about the future of orthopedics?
Dr. Brian Curtin: There are probably three things with medical school training today that concern me:
- Some schools are moving away from cadaver labs and thus reducing the early excitement of learning human anatomy, which can’t be replicated on a simulator. Gross anatomy was probably the best part of first-year medical training. Musculoskeletal education will likely suffer for all fields and potentially reduce the number going into surgical fields as often if that fire is not lit early in medical school.
- Residency applications are now becoming so overloaded and inflated with research publications and projects that often had little student involvement. This introduces a bias to those med schools with strong research programs and may limit the chances for those really good applicants from less research-heavy programs to match in top residencies. Changing Step 1 to pass/fail has also potentially skewed the residency selection process to those students at the top schools in a similar fashion. It is hard to impress a residency program with a “pass” score on Step 1.
- There has been a big shift by medical students toward lifestyle specialties with better call, set office hours and predictable pay. Orthopedics requires physically demanding work, long hours, routine call responsibilities and sometimes fluctuations in pay. If the current system continues to train physicians who increasingly value flexibility and predictability over procedure driven specialties, orthopedics may face a significant shortage of surgeons in the future.
