Editor—I wish to draw attention to what I think is a serious problem in medical education. Since I became a consultant in 1985, some senior staff have been complaining that medical students nowadays do not know as much as they used to. This complaint has been given greater impetus by the invention of “new” medical curricula, which means that teachers now believe that they have an identifiable reason why today's medical students are not as good as they used to be. My impression is that these complaints long predate any new curricula. It is demoralising for new students to be given the impression that they are not as knowledgeable as they should be or as others were at an equivalent stage.
Most teachers cannot possibly remember what they did and did not know at any particular point in time, especially when there is a 20 year gap between the two. It is common to imagine that one's knowledge and skills were similar in the past to what they currently are. The burden of medical knowledge is much greater than it was 20 years ago. When I was a student, patients with uncomplicated acute myocardial infarction used to receive virtually only oxygen and pain relief, but now the key required knowledge base for this common disease has to include thrombolytic treatment, aspirin, β-blockers, angiotensin converting enzyme inhibitors, statins, risk stratification, etc. The length of the medical course is still five years. Yet if students should now know all their teachers used to know, plus all the new key knowledge, it needs to be expanded to much longer than that.
Medical teachers who complain about students' lack of knowledge should wake up to several facts.
Firstly, they probably overestimate what they knew when they were students.
Secondly, the knowledge base has expanded so dramatically since they qualified that students could not possibly know all they used to, plus all the new facts.
Thirdly, it is probably not the new curricula that have caused this, but they may be a convenient scapegoat.
Fourthly, complaining to the students not only demoralises them but also decreases any esteem that they may then feel towards that teacher. It could even explain why medical graduates are increasingly turning towards non-medical careers. If there is a genuine problem, then we need to address it, but it is counterproductive to make the students feel substandard or infer to them that their medical course is substandard.