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Pre-specialization – Considerations for more focused and personalized educational modules in the twenty-first century

Abstract Background: This essay provides a multidisciplinary discussion of the current medical education curriculum and the increasing need to adapt it to our rapidly evolving and expanding healthcare environment. Methods: Thorough literature search on the topic of medical school curriculum, ranging from its historical origins to contemporary practice as well as statistics, was conducted. Results: The authors give a brief historical overview of and rationale behind the current structure of the medical education system in America. The recent trends towards information overload and rapid evolution of the evidence-base are discussed. Specialization, as a means of responding to the burgeoning abundance of information in medicine, is described. The authors further provide current as well as foreseeable limitations of today’s medical training paradigm as the trend towards specialization continues. The potential negative influences of a specialist-focused training paradigm on the overall length of training and the degree of autonomy exercised by generalists are described. A proposal toward pre-specialization at the level of medical school is introduced and elaborated upon. The authors incorporate social psychology principles and analyze trends toward career specialization, highlighting potential benefits to a different-size-for-all approach. The importance of optionality and flexibility of such a curriculum is emphasized. Conclusions: The authors describe the inevitable trend toward specialization, and the need to fundamentally re-configure American medical education system to behoove trainees' experiences and quality of training during the 21st century.