Zeke Emanuel and Victor Fuchs have a great suggestion in JAMA:
there is substantial waste in the education and training of US physicians. Years of training have been added without evidence that they enhance clinical skills or the quality of care. This waste adds to the financial burden of young physicians and increases health care costs. The average length of medical training could be reduced by about 30% without compromising physician competence or quality of care.
YES. This problem is particularly severe in post-graduate medical education. A case in point is the triple boarded child psychiatrist. These doctors do an extended residency/fellowship program after completing standard medical training,
Triple Board residents spend 5 years in an integrated training program focused on pediatrics, general psychiatry, and child and adolescent psychiatry. At the end of the training, residents are board-eligible in all three disciplines.
'Board-eligible' means that graduates of a triple board program can take board examinations examinations in pediatrics, general (i.e., adult) psychiatry, and child psychiatry. Studying for and passing these exams may require several additional years.
To my knowledge, however, there are no interventions that can only be delivered by triple-boarded psychiatrists, and I am unaware of a clinical function that can only be carried out by a such a specialist. I am not aware of any evidence that triple-boarded child psychiatrists are 'better' at child mental health care than ordinary child psychiatrists, but it wouldn't surprise me at all if there was a slight advantage. I count several triple-boarded child psychiatrists among my close friends, and they are impressive individuals. They would have to be to get through all of this, no? What I question is whether the extra training is what makes them better. Similar examples can be found throughout specialty medicine.
(h/t Sarah Kliff)