Editor - I refer to Abi Colemans letter in which she makes the case for increased patient contact during the preclinical years of medical school.1 Increased development of interpersonal skills, at the expense of medical education, may not be an effective use of teaching time at this stage of medical training.

It is still the aim of the first two years at medical school, no matter how integrated a curriculum is supposed to be, to provide a foundation in the medical sciences needed to progress through clinical school. Teaching communications skills and sociology, as well as the provision of patient contact through a general practitioner, is diminishing the amount of time available to teach the scientific knowledge needed to underpin later clinical competence.

Perhaps a more efficient method of producing a good doctor would be for the student, who we are repeatedly reminded is eager for self directed learning, to take up work in a healthcare setting out of term. This real patient contact - rather than contrived role plays or token patient contact in general practice - would leave the university time to teach medical science to a greater depth, thereby producing doctors who are both better educated and better able to communicate effectively with patients. Why does progress always seem to be at the expense of medical knowledge? Are the current fashions of medical teaching using the excuse of producing rounded doctors to dumb down and cheapen medical education in order to feed the politicised leviathan of the NHS?