Why was Physical Education incorporated into school curriculum?

Medical School: How would you construct a curriculum for a modern education in medicine?

• Should there be more specialized disciplines at an early stage? Is anatomy taught in an efficient manner? Should a student be able to skip some parts of the body in order to focus on others? Is there enough focus on the practical aspects of practicing medicine? Should dealing with malpractice lawyers be a part of the curriculum? Not being in the field, I can't be more specific than giving a few examples of what might be of interest.

• Answer:

  Every time this question is asked, all students scream for "earlier patient contact" in training. And have gotten their wish in part, but are still not at the point that they have as much contact in year 1 as in year 4. Somebody said it's as hard to relocate a graveyard as change a medical school curriculum. In my ideal curriculum, new first year students would spend all their time for a month learning how to do a history and physical exam (using each other and models), and then I'd launch them onto the wards to look at ill patients immediately. They can then spend part of the day learning basic physiology and pathophysiology, with what they've seen in ill people, in mind. But they should start with ill people almost immediately, and keep at it. Sometimes people teaching the first two years are not physicians and haven't seen ill patients themselves. I would remove nearly all these people, as they have no clue as to which parts of knowledge are likely to be important to a practicing doctor. Of course, all the written tests would have to moved, as now in the US we have major exams at certain parts of the 4-year process, that students study for. Lectures (most of the first two years) are taught to the exam. In my third year in school I was on the wards at night and saw a man having difficulty breathing. My resident said "Is he in congestive heart failure?". I had no idea. Or even more than a vague idea how to tell. It was a trick question because it's a difficult clinical diagnosis. But this kind of thing should be puzzling first year students, not third year students. Most doctors report that they learn to be effective physicians in their fifth year (internship). Also that was my experience. But that's too late to teach basics.