Should we specialize medical education?

It's common wisdom that surgeries are better done at high-volume centers. Specialists should do what they're best at - this reduces errors.

By analogy, medical schools should do what they're best at. Different medical schools are (I speculate) better at educating different types of doctors: NYU might be better at training primary care physicians, while Columbia (to pluck a name out of the air) might be better at training future cardiologists.

So why can't medical schools specialize? Why not telescope the long and tiresome haul of medical school-residency-fellowship into a single training program?

We know "physician" is a variegated profession. Why must all doctors be trained the same? Wouldn't it make sense for a medical school to be able to choose an area of specialty, rather than trying (fruitlessly) to be all things to all possible future doctors?


  1. Anonymous4:34 PM

    Having spent almost 3 months in a hospital tending to a dying relative, I think specialty has become a bad joke. We often, at lucid times kidded about the "left nostril specialist." Doctors who were so specialized that they seemed to know less than a layman about specific questions we had did not inspire confidence. The only doctor who did so was an internist, and the specialists were annoyed at having to give him their findings so he could help me make decisions. I think we need less specialization.

  2. I completely agree with you about over-specialization. I believe in primary care, and there need to be more "unspecialized" doctors (I'm one of 'em!).

    Unfortunately, though, primary care has become a specialty among specialties.

    So to educate the best primary care doctors, it might be advisable to "specialize" medical education. That is, some medical schools would specialize in training primary care physicians, some in dermatologists, and so on.

    Maybe a properly regulated market in health care would reward medical schools that preferentially educated primary care physicians?