Lousy MD's got through med school

[CaptainObvious]

I bring this up only for the sake of conversation.

Med school is hard. The road to GET to med school is tough. As I understand it, it isn't something just anybody can do. One must be highly motivated and, I would think, possess above average intelligence.

Over the years, I've met some lousy docs. I mean some REALLY bad ones. I've met them both in my professional career as well as personally while raising a family. Don't get me wrong. Most docs I've encountered appear to be very capable, knowledgable professionals. But then there are those who can barely find their way out of the exam room. We've all met one. That person with the MD on their labcoat that makes you ask yourself, "How is this person a doctor?" And I'm not talking about the brilliant clinician that can't hold a conversation or look you in the eye. I'm talking about a doc trying to teach a subject say, like CHF, and barely has a grasp of the general concept much less the physiology behind it. Or the doc that can't tell appendicitis from a cracked rib - after football practice - on the LEFT side. Yup. True story.

My question deals with this discrepancy. How is it that one can get all the way through this grueling, multi-year process and come out on the other side barely capable of practicing medicine? I can't imagine that one could coast through med school or hide in the shadows of a residency and fool everyone along the way. What gives? Or am I just being overly critical?

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[Dianyla]

Lots of people underperform, in all industries. It could be that these doctors you're encountering are burnt out, having an off day/month/year, or just don't care anymore. Don't confuse being disinterested with being incapable.

The road to GET to med school is tough.

I get the impression that it hasn't always been as difficult as it is nowadays to secure a seat at a medschool.

 

[Richardh]

i think some doctors are more knowledegable in certain things than others. even though a doctor may forget the most simple thing related to medicine, he/she might be an expert in the most advance topic in medicine

 

[jl lin]

Sometimes it is a matter of catching someone at a bad moment, or after or when they are under a lot of stress w/ tons of stuff flooding through their head. Sometimes people just get nervous and seem not too swift --and then that is made worse by our preconceived notions about how people should be--on or off the pedal stools we try to put under them--or pull out from under them, as the case may be.

Sometimes you really have to give yourself a fair number of experiences and interactions with someone before you assume they are a total idiot. People can be tough graders of others. It's a harsh pass or fail w/o considering things fairly or w/o us fully taking into consideration our subjectivity in the evaluation process.

Remember you will be in their shoes under similar stresses or circumstances or worse, and you may not put on your best approach or communicate things as well as you could have. Eventually the rigid standards by which we judge others will eventually come back to us. Be ready. . .and remember. . .


And then of course, you could be right. Some people are. . .well. . .it can baffle the mind how daft some people seem or, well, are. Course I know I've had my moments.

Most of the docs I've worked with have been pretty sharp and dedicated. The issues that stand out in my mind about things missed or problems that turned unnecessarily into disasters sadly had to do with pride and power struggles. And that is heartbreaking to watch. And a very rare few sad and preventable problems were d/t to, well, some that just didn't seem to care enough.

That's people for you. Forrest Gump says "Life is like a box of chocolates. You never know what you will get." And that goes double for people.

 

[ShyRem]

Once you get into residency you lose a lot of the basics. I have met plenty of OB docs who were absolutely abysmal at ACLS - couldn't remember doses, algorithms, etc. Psych docs who couldn't get an IV line or even tell you anything about the abdomen.

Medicine has become very specialized. And yes, there are plenty of docs who passed the classes that I personally wouldn't ever trust even diagnosing a simple sinus infection. Fortunately there are many many more who are capable dedicated professionals.

 

[brdmadgrl82]

Interesting post, it made me think of a book I am reading "How Doctors Think"...I highly recommend it, gave me some great insight (maybe your doctor had 10 appendicitis cases right before you and a bad day so he/she jumped to a conclusion? or felt close to you since you have been seeing him for years and didn't want to cause discomfort and missed the cracked rib?), errors in thinking can happen and unfortunatley do...read the book you might enjoy

Personally I have met med students who while they had it all on paper (high mcat, gpa) they didn't have the personality or communication skills (how they pulled off the interview is beyond me)...we can only hope most med schools help in bringing those traits out to produce better docs.

When it comes to personality I think it is also important when choosing a specialty (e.g. some outgoing friendly docs do great in primary care). I don't know if I'm right or wrong with my opinion here since it is still a looong road for me, I agree with all the posters above too...

 

[Molyb]

http://en.wikipedia.org/wiki/Fundamental_attribution_error

 

[akinetopsia]

I'd assume if there was an easy way to quantify who's "lousy" from who is excellent and every where in between, the graph would look a lot like a normal distribution, i.e. 68% of doctors are in the middle, and there are as many lousy docs at one extreme as there are exceptionally talented and excellent at the other end.

 

[wholeheartedly]

I swear I forgot how to add after I took calc..... anyway, I think there are a lot of possibilities here. As some have mentioned, burn out, an off day, and things like that could contribute. I also can't count the number of people I've met that are book smart, but seem totally clueless applying that info or taking it from a different direction. Then you've got some average folks who are very insightful.

 

[CaptainObvious]

Some interesting responses. I should also say that Dr.'s aren't the only professionals where I've seen this happen. I just thought it would be an interesting point of discussion.

I did find it funny that there is actually a term for what I've described. And the article made some sense. Thanks Molyb.

In almost every situation in which people judge, it is always easier to judge a person or group of people or a profession when you're looking in from the outside. That is to say, without having stood in the shoes of the judged.

 

[CW 2010]

I get the impression that it hasn't always been as difficult as it is nowadays to secure a seat at a medschool.

I completely agree. A lot of professional schools, such as Med. Schools, PA, Nursing, etc., are becoming very competitive. Just looking at the GPA trends brings you to conclusion that 20-30 years ago it wasn't as hard to get in as it is now. *sigh*

 

[eablackwell]

I'd assume if there was an easy way to quantify who's "lousy" from who is excellent and every where in between, the graph would look a lot like a normal distribution, i.e. 68% of doctors are in the middle, and there are as many lousy docs at one extreme as there are exceptionally talented and excellent at the other end.

Because I am a math geek, I have to agree with this.

I've had more than my share of docs over the years. Some absolutely awesome, others not so awesome. I especially loved the one who spent nearly an hour trying to convince me I needed a colostomy bag just because I was in a wheelchair. I mean WTF dude, I was there for strep throat.



But you know, there are good and bad in all professions. Can't help it.

 

[CaptainObvious]

Because I am a math geek, I have to agree with this.

I've had more than my share of docs over the years. Some absolutely awesome, others not so awesome. I especially loved the one who spent nearly an hour trying to convince me I needed a colostomy bag just because I was in a wheelchair. I mean WTF dude, I was there for strep throat.



But you know, there are good and bad in all professions. Can't help it.

LOL! See..I knew it wasn't just me!

 

[PostHaste]

I swear I forgot how to add after I took calc.....

I say this a lot, too; once I hit Calc 2 I was never able to do arithmetic the same again. My husband, for whom algebra is like an allergy, is my calculator.

I also can't count the number of people I've met that are book smart, but seem totally clueless applying that info or taking it from a different direction.

There's a Midwesternism for this: "Smart in school, dumb on the bus." I only know because my mother used to say that about me.

 

[eablackwell]

I say this a lot, too; once I hit Calc 2 I was never able to do arithmetic the same again. My husband, for whom algebra is like an allergy, is my calculator.


There's a Midwesternism for this: "Smart in school, dumb on the bus." I only know because my mother used to say that about me.

I actually think smart in school dumb on the bus is more akin to having no common sense with real life issues. I, too, suffer from this disease

However, the problem above is definitely a critical thinking skill issue. I see it all the time with my students. Every year it seems to get worse...I don't know if they are teaching less critical thinking in elem or what, but I have students that can get from pt A to pt B just fine, but ask them to go from A to E and tell them there's possibly more than one route, and you can see heads explode

 

[Old Grunt]

Every time I think something in medicine is "obvious" and some physician who has been doing this for 40 years is an idiot for not being able to differentiate appendicitis from a cracked rip on the left side, I run into some sort of zebra that I was completely ignorant of and am humbled by it.

http://books.google.com/books?id=2S...&resnum=8&ved=0CDEQ6AEwBw#v=onepage&q&f=false

 

[MacVA]

As 3 older doctors put it to me, medical school was harder to get into than it is now. And alot of us went into it solely for monetary purposes because it was the easiest way to millions.

 

[peppy]

#1: The skills needed to pass tests are not necessarily the same skills that make someone an excellent clinician.

#2: As mentioned above, once you are specialized you tend to forget a lot of what you used to know about the other specialties. I'm pretty sure you will never meet a cardiologist who can't explain CHF or a general surgeon who would mistake a cracked rib for an appy.

#3: It's quite possible that these bad docs really were never all that good, just barely graduated med school, scrambled into a last resort residency.

 

[1fastmedic]

Over the years, I've met some lousy docs. I mean some REALLY bad ones. I've met them both in my professional career as well as personally while raising a family. Don't get me wrong. Most docs I've encountered appear to be very capable, knowledgable professionals. But then there are those who can barely find their way out of the exam room.

This is so true. Before I committed to go pre-med, I had some self doubt. However, after working with some lousy docs I thought "If they can get through med school, I know I can!" Now, I'm gonna have to put my money where my mouth is and prove it of course!

I would like to be optimistic and agree that factors such as burnout, personal/family issues, etc. can cause a doc to veer off course. Hope this doesn't happen to me. Yet, I've seen some over the years that I would not even let treat a corpse. However, apparently they were deemed satisfactory at some point, enough to become licensed and practice. Who knows.

 

[MCAT guy]

#1: The skills needed to pass tests are not necessarily the same skills that make someone an excellent clinician.

#2: As mentioned above, once you are specialized you tend to forget a lot of what you used to know about the other specialties. I'm pretty sure you will never meet a cardiologist who can't explain CHF or a general surgeon who would mistake a cracked rib for an appy.

#3: It's quite possible that these bad docs really were never all that good, just barely graduated med school, scrambled into a last resort residency.

Especially #1. Remember, old school was GPA + MCAT = MD. Now the application process is more sophisticated.

Plus skills get rusty. Not every obese person was that way 10 years ago. If you don't stay sharp, then you decline.

 

[MCAT guy]

One other point.

Respect the volume of material people have to go through. It is easy to be a critic.