In Lessons Blog

In 1931, more than a century after the Yale School of Medicine (YSM) was founded, the school instituted a unique approach to medical education. Specifically, it did away with exams and grades.

Medical school, after all, should be about acquiring knowledge, experience and professionalism, not about simply memorizing facts or competing over A’s on exams.

All students must pass the National Board examinations in years two and four – and complete an original thesis prior to graduation (a requirement unique to Yale) – but the institution’s fundamental belief is that when you respect students and trust their intrinsic desire to learn the science and practice of medicine, they will. And they become better physicians for it.

When I was applying to medical school, Yale was the only university I wanted to attend. Today, I am a proud beneficiary of the so-called Yale System of Medical Education, and maintain the greatest degree of gratitude for this teaching philosophy.

As such, it was with great honor that I returned to campus this week for the Alumni Grand Rounds series, which brings YSM alumni and students together for career-focused discussions about medicine.

Photo courtesy of Terry Dagradi/Yale University.

The invitation followed a recent article in the YSM Alumni Bulletin about my book, “Mistreated: Why We Think We’re Getting Good Healthcare—And Why We’re Usually Wrong.” While preparing my remarks for the students in attendance, I realized just how much of that book and my views on healthcare were influenced by my days in New Haven, Conn.

For example, “Mistreated” lays out the four pillars necessary to transform American healthcare, each of them aligning with one or more aspects of the YSM experience.

The first pillar, integration, demands that primary, specialty and diagnostic care teams work together for the benefit of patients, in much the same way the Yale School of Medicine encourages students to help each other become great physicians, rather than perceiving each other as exam competitors. The importance of paying for value in healthcare (the second pillar), reflects a medical culture striving to do the right thing out of pride and professionalism, not out of transactional motivation. Third, students at Yale are required to compose an original research thesis, instilling in them the desire to be on the cutting edge of medical practice, while furthering their desire to embrace new approaches and technologies. Finally, I believe that the drive to lead arises through mentorship, not through the fear of failure. Countless Yale professors helped guide me toward my career as a physician leader and healthcare CEO, and I could not have done it without them.

The world of medicine has changed profoundly since I graduated from the Yale School of Medicine, but after speaking with several students on campus, I can see that the drive to make a difference burns as strongly in them as it did in me.

Photo courtesy of Terry Dagradi/Yale University. 

The American healthcare system is broken and in desperate need of those who can transform its future. YSM may be a 200-year-old institution, but if more schools followed its educational model, the world of medicine would be much better prepared to address its biggest challenges.

Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s the bestselling author of “Mistreated: Why We Think We’re Getting Good Health Care–And Why We’re Usually Wrong” and a Stanford University professor. Follow him on Twitter @RobertPearlMD.

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