Skip to content

My article in Times Higher Education Magazine

Is here (scroll down), based on a prior post on this blog. In it I make the somewhat radical suggestion that medial and legal degrees should be removed from universities also. One of the commentators there took issue:

I worry about Wilkins’ views about medicine and law. As he rightly observes, these subjects have long been part of universities, precisely because they were “theoretical and needed research”. That remains the case today. Does anybody want a doctor without the research competency to engage with contemporary papers about the efficacy of particular treatments, or a lawyer who cannot engage in research about new issues relevant to their client? If that is the situation in Australia I am very glad that my healthcare is provided elsewhere!

Wilkins does not seem to understand that in some professions (what used to be called the “learned professions”), research and practice are inextricably intertwined. Without engagement with research and researchers, “professionals” cease to be that and become mere technicians, incapable of responding to a changing world. Good undergraduate degrees in “professional” subjects provide just that exposure and skills, even if the students do not engage in much research themselves.

I have three things to say about this:

1. The “research skills” that undergraduate medical and legal students require are little more than those taught around year 10, and these days involve little more than the ability to use website and library search facilities. A student who completes a basic medical degree has information provided to them in books and by popular journals. A specialist might need greater skills, but they are not what I suggested should be removed from universities. The same thing goes for legal research (which is usually even simpler). I do not think the commenter knows what “research” actually means.

2. Medicine and law do not involve research in practice. I worked ten years at a leading medical research institute and the scientists would tell me that they had to spend around three years teaching medical graduates how to do research, especially in the area of experimental design and inference. I saw this myself in a number of cases. When people are doing medical and legal research, they are usually not at the same moment practising medicine or law. Bedside and courtroom practice do not involve research, or else you aren’t doing it right.

3. Most of the time, and for most law and medicine, it is just technical work. Medical doctors are no better than any other profession at critical thinking or investigation. In some countries, where the blowout of medical qualification has been resisted from necessity (like China or Cuba), basic medical training is similar to basic military medical training. Surgeons and specialists need extensive further training in every country (and in most cases they still aren’t doing research even so), but the “union ticket”, the basic degree, is not something that has to be in universities. Law and Medical schools can be independent without damage for those degrees.

And I think the commenter should take a hard look at the relative deliverables of Australian health versus the United Kingdom’s or United States‘. We have one of the most efficient and effective such systems in the world, despite many government and special interest attempts to prevent it. Australian life expectancy is beaten only by Japan and Switzerland, our infant mortality is much lower than both the US and UK, and we do it with fewer doctors. We spend less than half the US per capita and only a little more than the UK. Basically I’d much rather live here than in the UK.

13 Comments

  1. “We have one of the most efficient and effective such systems in the world, despite many government and special interest attempts to prevent it.”

    Canada has one of the most efficient and effective such systems in the world as well. Would you like to live in Canada?

    • Susan Silberstein Susan Silberstein

      John has been trying to get a job in Canada for years. It’s a nice place, despite rioting hockey fans. I’d live there.

  2. Chris Moore Chris Moore

    Good article. And I largely agree, I was 30 before I got my career proper going. And while I am the type to be inclined to go back for a doctorate, I feel it’s very high risk (financially and landing a tenured position) compared to the intellectual rewards. But to go back to the general point, most of us go get a BA, ’cause that’s what you do, and then emerge, blinking at the realization that it qualifies you to do exactly nothing. Mostly, just a screening process.

  3. Chris Moore:
    Good article. And I largely agree, I was 30 before I got my career proper going. And while I am the type to be inclined to go back for a doctorate, I feel it’s very high risk (financially and landing a tenured position) compared to the intellectual rewards. But to go back to the general point, most of us go get a BA, ’cause that’s what you do, and then emerge, blinking at the realization that it qualifies you to do exactly nothing. Mostly, just a screening process.

    Hi John and Chris, I’m writing about the THE article on my blog (http://digitalliteracywork.wordpress.com/). I agree with some things you say John but I think there is another way to change things. I don’t think we can go backwards, forwards is the only place available to us.

    Chris I hope you don’t mind if I use some of your comment. I really agree with you that students, “emerge, blinking at the realization that it qualifies you to do exactly nothing”. The first six months after qualifying is a terrifying experience. It is only after that time that you start to realise exactely how to apply all the knowledge you have created.

  4. I know a large number of jurists and medics and not one of them did a single days serious academic research whilst obtaining their degrees. They were trained to do a job and not taught to do academic research.

  5. Roger Roger

    The phrase “mere technicians” is damning. The implied hierarchy is elitist propaganda from a self-aggrandized academic. However, it isn’t novel, rather the contrary, and that is the best argument against relegating medical and legal degrees to the “applied” category. The reasoning is complex with the best metaphor being that “calculated inefficiency” surrounding holding excess inventories over just_in_time_delivery models that save money until a small hiccup cascades into a large scale work stoppage. The connection is that those academics prone to self-aggrandized self-conceptualizations have that much more of a need to be rubbing shoulders with authentic diversity — the good and the bad, the academic and the applied. Sequestration of ruthlessly, pragmatically, applied training from some purist academic ideal feeds the misconceptions underlying the concept of “mere technicians”.

  6. Allen Hazen Allen Hazen

    One of the options at some (many?) American universities is a combined MD/PhD program. This is typically a six year affair. (The American MD is four years (after an unspecialized BA or BSc: the thinking behind the six year program is that the first two (preclinical) years of the medical degree are essentially the equivalent of the pre-dissertation part of a PhD program in some medicine or medical-research relevant area of science, and that the extra two years should be enough for a good student to research and write a thesis. Doing the common two years, then the research two, and finishing with the clinical two is, I think, the recommended order for students who want to go on to be practicing doctors; doing the clinical before settling down to research is perhaps just as good for those who are going to make medical research a career.)

    I think (without much first-hand knowledge to go on) that this is a GOOD THING. Removing the normal medical training from the university would make it administratively much harder to manage. Which I think is a consideration, though maybe not an over-riding one.

  7. AK AK

    Given a choice, I’d just as soon have a doctor who’d actually done some research, and was less likely to treat what he’d learned, and read in recent journals, as the Revealed Word.

  8. Lesley Weston Lesley Weston

    Susan Silberstein:
    John has been trying to get a job in Canada for years. It’s a nice place, despite rioting hockey fans.I’d live there.

    I do. It is. And the riots are only once every few years. There are plenty of universities here, surely one of them will realise soon that they need John.

    • I hope they realize this soon as I’m now unemployed.

  9. Marichi Marichi

    John,

    Your proposal if implemented would create a tertiary system very similar to India’s. The idea behind creating the now famous IITs was to have institutions that trained professionals to manage and grow India’s economy. It was believed then that the universities of the day were well equipped to further studies in the sciences and the humanities and that they should not be burdened with producing professionals. Who could argue with that at a time when the likes of Saha, Bose, Raman, GNR, Haldane and Mahalanobis dictated the intellectual fashions of the day.

Comments are closed.