Over the past 20 years, a progressive movement has reformulated the curricula at most medical schools, under the direction of the Liaison Committee on Medical Education (LCME). Instead of having first and second-year students complete systematic courses on anatomy, histology, biochemistry, physiology, pharmacology, and physical diagnosis, all of those topics (...and more) are now jumbled together in "integrated learning exercises." It is difficult to build a house if you don't know what nails and hammers are, and I would argue that the same analogy applies here. We now have students trying to understand pathophysiology before they know normal physiology, and trying to identify morphological abnormalities before they learn any anatomy or histology.
Educators of today are fond of bashing the conclusions drawn in Abraham Flexner's famous report on the status of U.S. medical schools in 1910 (link-- Flexner Report), decrying as "antiquated" the need for the 2-year curriculum in basic science which he recommended (link- The Flexner Report 100 years later). Indeed, a paper published in JAMA by Emanuel & Fuchs in 2012 concluded that medical school education could be truncated by 12 months, as could residency training across-the-board, "without compromising physician competence or quality of care."
I could not disagree more with these assertions. Being a physician used to mean that one had a breadth and depth of knowledge that few other professionals possessed. Today, pragmatics have thrown that personification into the trash heap. Doctors of Medicine will soon be little different--if any-- than Doctors of Nursing Practice or Doctors of Pharmacy (PharmDs), with regard to their funds of knowledge or abilities to deal with complex medical problems. And, after all, patients don't know the difference between those various doctorates, anyway.
In pathology, the task of training residents has now become one of rapid remediation, before any real learning can occur. First-year trainees who know little or no anatomy, histology, physiology, or biochemistry certainly are not ready to learn anatomic & clinical pathology. Hence, we currently provide a "cram" course for them on subjects that medical school used to provide for everyone.
It remains to be seen if the diploma-mills of Flexner's day will return to the scene, at least in substance. If and when they do, patients will need to beware, and plaintiffs' attorneys will have more business than ever.