To the Editor:

I read the editorial by Fred and Gonzalo1  in the June 2018 edition of the Texas Heart Institute Journal. It saddens me that so many medical schools are completely going along with this “reframing” movement without questioning it. “Let's replace some of the traditional skills needed to become a doctor and to practice medicine, why don't we?” Have you watched medical students try to take complete histories? Have you watched them attempt, much less perform, complete physical examinations? Do they know how to identify anything other than normal heart sounds, let alone understand and characterize what they're hearing? How about their ability to examine the fundi? Have you ever tried to review electronic medical records and figure out in timely fashion what's actually going on with the patient?

As an “old school” student, I learned Health Systems Science (HSS) from mentors and other practitioners and did all right during my 26 years in private practice and academic medicine. If students and new doctors are supposed to need so much HSS information, why not start medical school 2 or 3 months earlier? That would be better than distracting students from old-fashioned stuff like anatomy, physiology, pathology, history, and physical examination skills. When I asked our Associate Dean for Curriculum why we were changing our course requirements to eliminate several of these necessities, the best that he could say was, “Because other schools are doing it.” I can't believe he had the gall to verbalize it!

I'm glad that I'm retired now and don't have to try to explain why physicians need to be able to interact with patients, and why we need to be the team captain for health-related professional people who bear no responsibility or liability for patient care and outcomes. However, I'll ensure that all my personal doctors are at least 50 years old. If they are, I can be confident that they spent their educational years learning medicine.


Reframing medical education
Tex Heart Inst J