M-shape Society

After the professional examination, JW remarked, "The graduate class has become an M-shape society."

The M-shape society was described by the Japanese economist Kenichi Ohmae. It refers to the decline of the middle class. In other words, the society is polarized towards extreme rich and poor. Due to globalization and the demand on information technology skills, few people in the middle class grasp the means to get rich. The majority, however, loses competitiveness and declines towards the poor.

What JW observed was that brilliant performers grew in number and did better than those in previous years. The same, unfortunately, also happened at the bottom end. A few candidates were almost unanimously failed by all examiners, indicating poor knowledge in a broad spectrum of topics being tested.

What caused the change?

Simply said, the teachers, students, examination and medicine itself all changed. The new examination system includes a number of simulated cases that demand practical knowledge. Instead of reciting textbook knowledge, candidates can only perform well if the answers are specific to the patient at hand.

The greatest challenge to students is the evolving field. Every year adds numerous new medical treatments. It has become more and more difficult for any student to cover everything before they graduate. I have seen quite many students who know the latest medical advances in one field but close to nothing in other areas.

Latest advances sound great, but are actually poisonous to students. By the time students graduate and become specialists, some of the advances would become standard treatment, while others would have been abandoned due to new evidence. Therefore, snapshot knowledge on medical advances is quite pointless. Instead, only people who continue to use the knowledge and follow the evolution of practice can fully utilize the information.

Similar to the M-shape society, the current situation is a test of whether medical students can distinguish between important general principles and trivial factual knowledge. Having said that, one should not just laugh at students who cannot adapt. After all, it is the responsibility of teachers to help students become competent doctors no matter how the field has evolved.