What Medical School Is Missing

By Francesca Mathewes

The landscape of medical education and residency training is evolving rapidly, driven by economic pressures, workforce shortages and changing educational priorities.

Four physicians joined us to discuss what they think should change about medical school to meet the demands of today’s healthcare environment:

Editor’s note: Responses have been lightly edited for clarity and length.

Ed Corbett, MD. Physician Leader, Former Medical Officer (South Jordan, Utah):

Looking at the future, I would say that better integrating data and AI literacy into medical education will be vital to helping medical students to competently practice in the future. Medical education needs to pivot from the current focus on memorization and regurgitation for board tests. Effective instruction will need to help students understand how to use technology to enhance the art of medicine. Ideally this would be done through an innovative comprehensive curriculum guided by AI-personalized teaching methodologies and innovative hands-on and virtual clinical skills training. The way we instruct and train future physicians will require a new focus on balancing the art of medicine with foundational skills in data science, AI literacy, critical evaluation of AI insights and the ethical implications of AI. The essential tools of future practitioners will be a blend of traditional human-centric skills, medical knowledge and technological aptitude.

Frederick Hoenke, MD. Family Medicine Physician and Geriatrician at Marquette General Health System(Marquette, Mich.):

Medical schools need to refocus on basic clinical skills of how to interview a patient, how to actively listen while really caring about the responses, how to do a quality physical exam and how to assimilate the preceding into a solid diagnosis and treatment plan. This is the core of what we do and it is frequently not, despite all of the curriculum experiments that I have witnessed, being done as well as in past years. Medical schools need to stop the social/political engineering initiatives that are not successful and divert time and attention from needed skill development. It is a losing strategy to try to teach caring, social engagement, morality and empathy to highly educated older adult learners. These qualities should already be in place and have been recognized in the acceptance process, and should be built on by faculty modeling these critical attributes. I do continue to have increasing concern [regarding] the clinical teaching of medical students regarding the availability of quality clinical experiences coupled with the duty hour restrictions that have not been shown to improve quality patient outcomes.

Brandon Ortega, MD. Orthopedic Surgeon at Long Beach (Calif.) Lakewood Orthopaedic Institute:

Medical schools need to focus on the “business of medicine” as part of the core curriculum — not as an optional elective or something you pick up on the fly.

Most med students graduate knowing every step of the Krebs cycle but have zero clue how to read a contract, negotiate their first job, understand RVUs, billing, coding or even what a P&L statement looks like. Then they finish residency and suddenly they’re expected to navigate salaries, collections, productivity bonuses, malpractice coverage, and maybe even run a private practice or manage staff — without ever having been taught how.

There should be a required, practical course on:

- Contract negotiation (what’s a red flag, what’s negotiable)

- Billing and coding (how you actually get paid)

- Insurance and reimbursement systems

- How health systems make money (and where physicians fit in)

- Financial literacy (debt management, investing, retirement planning)

- Leadership and practice management (how to run a team or even your own practice)

Po Raval, DPM. Active Foot & Ankle Associates (Waldwick, N.J.):

The biggest thing that needs to change in medical school is that there has to be a Business 101 class that should be taught before students graduate. It should talk about basic accounting, practice management, practice software options, guide to opening a business from scratch and the basics of buying a practice.

After 35 years in practice, I am hopeful that we prioritize patient-driven care and not corporate-driven care. The American healthcare system’s greatness was always about treating the complexity of a patient with the wealth of healthcare options and referrals rather than singling out what is or is not covered under a corporate systems’ limited resources. Patient-driven care also allows a patient to visit that physician who practices the way that is meaningful to them and helpful for them. It helps single out physicians who also prioritize patient care.

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