Computer Purchase Requirements for Medical Students

Discussion Points

1. We must first give students compelling, value-added, computer applications (required use of email/WWW, CD-ROM-based instructional programs, patient management software, etc.) before we require them to purchase a computer to enter medical school. In my opinion it is absurd to force them to buy expensive equipment in the hopes that they will somehow "figure out" what to do with it.
2. It has been claimed that by requiring students to buy their own computers an institution will not have to provide as many "public" computers for student use. Several people have told me that this is a false assumption. The more students use computers, the more they expect computers, network connection points, printers, etc. to be available for their use.
3. Personal computers have become consumer items (like TV and the VCR). As such, most students will have access to one without a "requirement." Another angle on this is financial aid, where the "requirement" allows computer expenses to be added to the student's debt (a dubious benefit). In this context, an institution might consider providing "loaner" computers to students who truly cannot afford them.
4. I am ambivalent about requiring desktop/laptop computers. I believe hand-held computers such as the Palm III are much more compelling from a "what you're going to use to care for patients" point of view. As these devices become more powerful and gain connectivity to email and patient information systems they may become "required" for survival on the wards. Laptop computers are too big and too clumsy from my students' perspective. (It is very rare that our students bring laptops to class or on rounds. In contrast, many students spontaneously bring their hand-helds to class, clinic, and the hospital.) Desktop computers are going the way of the VCR - just another home appliance that more and more students will already own before they come to medical school.
5. There may be no need to "require" computers at all. Medical students are always looking for an "edge." If we create robust computer applications and a computer-based operational environment (email, WWW, clinical software for PDAs) for students, I believe most of them will buy computers on their own.

Laptops vs Desktops (added Sept 1999)

• There are several problems with laptops from my perspective:
  • Most weigh 5-8 pounds. That's a lot to carry back and forth every day.
  • What does a student do when they don't have the laptop with them?
  • What do they do when they are outside the immediate walls of the medical school? The hospitals and clinics that I'm familiar with strongly discourage ANYONE, including the attending physicians, from plugging into their network.
  • Laptops are more fragile and less reliable than desktops (not to mention more $$).
  • I wonder what the security issues are when student lockers contain $2000-$5000 laptop computers instead of just a few $100s worth of books?
  • In general, laptops are not well suited for bedside use. For starters there's usually no place to set them down. Pen-based computing makes much more sense to me in a clinical setting.