Aside from the way healthcare is practiced, I
have also been drawing observations on how doctors are educatd here and
comparing its merits to our system.
As with most of the world, SA graduates its
doctors through a direct 6-year undergrad/med program. They start after high
school and complete at age 24. Following graduation, they begin two years of
general internship rotating through all major disciplines, followed by one year
of rural community service. At this point, they enter a specific field (i.e.
internal medicine, surgery, pediatrics) either as a simple house officer or as
a registrar, which is their residency equivalent toward becoming a consultant
(an attending).
Compared to America, there is no “time savings”
– SA physicians become attendings at the same age we do. Certainly they do
emerge from their longer clinical course with a broader proficiency in all
medical disciplines; I have been very impressed with the competency of SA
interns and registrars/residents. That being said, if they ultimately
specialize anyway, this raises the question of whether this generalist skillset
warrants the three additional years of cheap labor before they begin their
residency.
More importantly, the opportunity cost of an
early, narrow education is hefty. I am a well-satisfied product of the delayed
choice system in the US. I was not prepared to make the commitment to pursue
medicine even at age 22; how could I possibly make that at 17? I greatly valued
my general curriculum in college and having a business career before coming to
medicine. These experiences enriched my ability to relate to patients from all
walks of life, which I have found equally as important in doctoring as applying
as science, and also made me confident in this long career path. Conversely
from my own route, the undergraduate degree also offers a secure fall-back option
for the many who choose to leave the pre-med route for various reasons, leaving
them great flexibility to pursue career choices outside of the life sciences.
Choice is intrinsic to American culture; it is
in our national roots. Jefferson founded this country on the principle of the
self-made man, carving out his own plot in life. I believe our undgergrad
--> graduate setup enables American doctors to make the most informed
choices while minimizing regret.
