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The Indigestible Curriculum

Joseph S. Alpert, MD; Robert Coles, MD
Arch Intern Med. 1988;148(2):277-278. doi:10.1001/archinte.1988.00380020021003.
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Pity the plight of the contemporary medical student: his or her curriculum holds more material than can be digested even by the most zealous of students. The technological and scientific knowledge explosion since World War II has deluged the medical student with an enormous learning burden. The volume of information that must be committed to memory in order to pass National Board Examinations is truly staggering, not to mention the intellectual gymnastics required to integrate and employ such knowledge in the daily practice of clinical medicine.1 Is it any wonder that more and more of our medical students and junior house staff seek psychiatric support for troubled emotional lives, divorce, and substance abuse? Furthermore, professional fatigue or "burn out" is all too common in middle-aged physicians.24

We contend that an important factor in the genesis of these adverse emotional states is the extraordinary pressure generated by the large


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