Monday, August 24, 2009

Some Progress

Many of us whine about doctors' lack of understanding of the diabetes research that we read. One reason for this knowledge gap is that current standards for medical education don't require that medical students be give significant instruction in some areas -- for example, statistics, nutrition, and disease prevention rather than disease treatment.

A fairly recent (well, OK, it was June 5; I get behind in my reading) editorial in the journal Science suggests that medical education in some of these areas may improve if the recomendations of the Association of American Medical Colleges and the Howard Hughes Medical Institute are followed. (The full text is free if you register.)

The report, titled Scientific Foundations for Future Physicians, says that "physicians must have a firm grounding in the biomedical sciences and understand their relation to the physical sciences and mathematics. For physicians to be prepared for inquisitive, critical thinking and lifelong learning, they should also be able to incorporate the methods of science into their practice, including skeptical and critical analysis."

Wow! Skeptical and critical analysis instead of listening to drug reps and reading medical magazine summaries. Wouldn't that be wonderful!

To achieve these goals, the groups recommend changing medical education starting in the undergraduate years: "Students should arrive at medical school prepared in the sciences, including some areas not currently required, such as statistics and biochemistry."

The idea is that if first-year studenst already have a grounding in the basics, then medical school can focus on more advanced concepts, for example, "the synergistic relationships among biomedical science, research, and clinical medicine."

They also recommend more emphasis in medical school on "the physical sciences and mathematics in biomedical research and clinical practice."

They also recommend assessing incoming students by their competency, rather than according to what courses they've taken. This should allow creative students to design their own ways of learning rather than forcing them into taking certain undergraduate courses.

Whether or not these recommendations will be followed of course no one knows. And even if they are, it will take a long time before physicians trained with the new guidelines -- better equipped to do critical statistical analyses of the latest blockbuster study of a new kind of cholesterol drug, for example -- constitute a significant percentage of the practicing physician population.

Even when they do, the problem that even a physician with a firm grasp of physical sciences, statistics, mathematics, and biochemistry as well as medicine and with a burning desire to do critical analyses still needs to have the time to do it. Not all physicans spend their afternoons on the golf course. Many of them are overworked.

Still, just the idea that people in the field are recognizing the deficiencies in the training of physicians is a good thing. Let's hope something comes of it.


For anyone not subscribed to Health Central, here are links to my most recent posts there.

Thinking Outside the Box is about how success in diabetes control often stems from being able to think outside the box, applying what you learn to your own individual physiology rather than following the cookie cutter advice you may get from your health care team.

Is Type 2 Diabetes Your Fault? discusses the myth that "you brought it on yourself." Needless to say, it stimulated a lot of discussion.

Finally, Avoiding Diabetes, is an allegedly humorous post about how to avoid getting diabetes. When I read the Comments, I wondered if some people had taken it seriously!


I'm afraid I've been absent lately, working through a Blogger Identity Crisis.

I've been thinking about how to deal with two blogs, this one and the one at Health Central. Initially, I was using this site for longer posts and writing shorter versions of the same thing for Health Central. But that came to be too much of a chore, figuring out how to say the same thing in a briefer way, and I found I was sometimes putting off writing something for just that reason.

So I've decided to abandon that approach and write brief, more general posts for Health Central, discussing the things people always want to seem to talk about, like diet, feeling overwhelmed, exercise, trying to lose weight, whether or not to take meds, etc. I also promised to write diabetes humor posts for them.

At this site I'll focus more on new research, both in-depth discussions and brief notes about research or other items that catch my eye.

I'll be assuming that anyone reading this blog is intelligent, already knows at least a little about diabetes, and wants to understand things in greater depth. I hope this works and I won't need to undergo another Blogger Identity Crisis!