Is it wrong for schools to take older nontrads?

[jj6vcb]

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I want to bring this up in the context of the physician shortage that is supposedly looming. There are 2 guys in my class who are ~15-20 years older than the rest of us. Can't predict the future, but it is a reasonable expectation that these two will practice medicine for a shorter time than someone who graduates in their twenties.

Let's say each practices for 10 fewer years than a traditional med student. That's 20 work-years lost simply because these guys are older. If we assume similar rates of non-trads across the country at (conservatively) 100 schools, we're losing 2000 work-years from each graduating class because of this.

I'm not against people following their dreams and doing the work they think is right, but sometimes I feel like these guys just got bored with their old jobs and thought med school would be interesting, so their interest comes at a cost to society.

 

[StIGMA]

It is against the law for schools to discriminate based on age. As a society, we think there is a greater good in the abstract promotion tolerance/acceptability to certain values than in the quantifiable good of other societal rights, such as healthcare. Are we denying even a single person healthcare by failing to exclude older candidates? Certainly, if we claim there is a shortage of physicians in parts of the country, then we are. Is it acceptable to filter candidates based on age? No. People can argue that older students add to the diversity of the class by bringing in additional life perspectives that aid in the practice of medicine by other members of the class, but isn't this the same perspective that the clinical preceptors provide?

If you think we should exclude candidates based on age, where should the cutoff be? Should we look at their family histories and life habits, taking an actuarial approach, and assume that certain people will practice longer because they may live longer? Should 45-50 year old's begin medical school only to begin practicing at 53-57 years old? How will their debt be paid off at that point- should medical schools unfairly ask older candidates about their finances compared to younger candidates? It should be clear why it is easier ethically to outlaw age based discrimination.

 

[Masticate3Xaday]

Those people have much more life experience than you and probably could relate to many patients much better than a bunch of young 20 somethings who have never even had a real job before. Maybe you could learn something from them.

 

[jj6vcb]

Wow, best explanation I've ever seen on here. There is a balance to be struck between the good that tolerance in our society provides and the supply of doctors. I buy that.

I do think, though, that age discrimination is a different animal than discrimination based on race or gender. Those nothing can change, ever. These people were younger once and had a chance to pursue a medical career but waited for whatever reason, which comes at a cost to society

 

[PMPMD]

The "physician shortage" is really a primary care shortage, and a geographic (rural) shortage. Go to the subspecialty boards and read the threads about job market saturaion in many specialties (gas, rads, etc). So rather than discriminate based on age, the "shortage" could be better addressed with programs that encourage students to go into primary care fields, and go to rural areas.

 

[jj6vcb]

Those people have much more life experience than you and probably could relate to many patients much better than a bunch of young 20 somethings who have never even had a real job before. Maybe you could learn something from them.

I'm really not trying to attack this group, but I think they bring up an interesting ethical dilemma. As for your point about relating to patients, sure. They might be able to relate to some patients better. On the other hand, that's what we have teachers and preceptors and other higher-ups for - there isn't a need for fellow students to show me the way when I have teachers who are trained to do just that.

 

[Cooperd0g]

I am an older non-trad applying at 35. My goal is to end up in a rural practice, which happens to be one of the greatest areas of need. I have also read quite a bit that older students tend to lean towards rural and under served primary care. If most young students are going into cities and most older students actual go to the areas that have the greatest need, one could argue that medical schools should favor older students because they actual practice in the areas where the shortage exists.

 

[Nasrudin]

This is presuming that someone or something has the ability to quantify the greater good.

Certainly the "greater good" as in the greater number of people in little rock didn't want this young lady in school.

I'm not equating this to your position. Not even slightly.

But it does come down to how. And consequences. Benefits. Ideas.

Otherwise it's just you looking at some older classmates and being vaguely, subconsciously annoyed. Do we give you control. Let you determine the cutoff.

Get real and suggest something or just lurk in speculation of the other.

 

[colbgw02]

Maybe we should not admit women because they're more likely - ya know - to get pregnant and work part-time than the average dude. GET BACK IN THE KITCHEN AND MAKE ME A SANDWICH!!!!
















Everyone calm down. I'm kidding.

I prefer quesadillas.

 

[MediumDef]

Why not women as well? Generally they will work fewer hours over the course of their professional lives then their male counterparts, and of course femal nontrads should be right out.

 

[Mr hawkings]

The "physician shortage" is really a primary care shortage, and a geographic (rural) shortage. Go to the subspecialty boards and read the threads about job market saturaion in many specialties (gas, rads, etc). So rather than discriminate based on age, the "shortage" could be better addressed with programs that encourage students to go into primary care fields, and go to rural areas.

Anectodal, but all the people i've met that fit the OP's description have tended to be going into primary care ie family med or internal med without plans of doing a fellowship. I only met 1 who was going onto emergency med but he was a former ER nurse.
I would be interested in seeing some real research into what this demographic tends to match in nation-wide.

As to your second point, i think they've been trying to "encourage" student to go into those primary care for at least 10 years now.

 

[searun]

I am an older non-trad applying at 35. My goal is to end up in a rural practice, which happens to be one of the greatest areas of need. I have also read quite a bit that older students tend to lean towards rural and under served primary care. If most young students are going into cities and most older students actual go to the areas that have the greatest need, one could argue that medical schools should favor older students because they actual practice in the areas where the shortage exists.

You make an interesting point. I have not seen any empirical evidence concerning whether older medical students demonstrate a greater interest in primary care and rural practice. But perhaps you are right. I think that it is true that young adults, as a group, have a preference for the bright lights and the array of entertainment options offered by large cities and certainly the vast majority of my classmates desired to enter competitive specialties rather than primary care.

Personally, I think that the OP's concerns are much ado about nothing.

In any event, as I recall, there were only two or three students in my med school class who were in their late thirties and they were outstanding med students who will make meaningful contributions to the lives of their patients.

 

[PMPMD]

Anectodal, but all the people i've met that fit the OP's description have tended to be going into primary care ie family med or internal med without plans of doing a fellowship. I only met 1 who was going onto emergency med but he was a former ER nurse.
I would be interested in seeing some real research into what this demographic tends to match in nation-wide.

As to your second point, i think they've been trying to "encourage" student to go into those primary care for at least 10 years now.

Hey, I didn't say it was effective! Lifestyle is a powerful motivator after 8 years busting one's @$$ in college/med school.

 

[Seven of Nine]

what about physicians who only work "part-time" (granted that can still be 40 hrs/week)?

are we going to set rules dictating how many hours per week we must work to fulfill this "obligation" to society? where do we as physicians draw the line? yes, most of us take our federal loans to fund our undergraduate medical education. yes, taxes go towards residency programs. yes, we are serving society. are we also sacrificing our entire life?



do you pick the older applicant who wants to work overtime or the younger applicant who admits s/he only wants to work part-time?



(currently looking online for a really good article from a random medical journal i got in the mail)


EDIT:
here's a couple
http://www.ama-assn.org/amednews/2011/09/26/bisa0926.htm#s1
http://www.nytimes.com/2011/06/12/opinion/12sibert.html?_r=1
http://www.nytimes.com/2011/06/15/opinion/l15doctors.html

 

[Nasrudin]

I'm not even sure I disagree with the OP. Even though it would have eliminated me from contention for a medical school seat.

I just don't like the feel of the post. Kind of sneaky as if just an item for discussion. When it's clear s/he just doesn't think old people should be there.

They should state that forcefully and then for maximum effect compare our system to some other health education system.

I am fairly certain that the US is somewhat unique globally for opening it's doors to vast numbers of older students. If not unique. At least in a very small group. Should be plenty of data to prove this is bad from a "greater good" perspective. And I would probably agree.

But don't just hate. Because I was livin, gettin laid and blowin my mind in the world, while you were placing first in middle school science fair. And you think that's some kind of violation of nature.

Man up.

 

[Wordead]

I used to think that way too. But after being in classes with them for 2 years, I'd say they're much more balanced and sane people, while 75% the 21/22 year olds coming straight out of college are a bunch of idiots who aren't prepared to take care of a cactus much less a patient.

 

[Mr Karatepants]

I want to bring this up in the context of the physician shortage that is supposedly looming. There are 2 guys in my class who are ~15-20 years older than the rest of us. Can't predict the future, but it is a reasonable expectation that these two will practice medicine for a shorter time than someone who graduates in their twenties.

Let's say each practices for 10 fewer years than a traditional med student. That's 20 work-years lost simply because these guys are older. If we assume similar rates of non-trads across the country at (conservatively) 100 schools, we're losing 2000 work-years from each graduating class because of this.

I'm not against people following their dreams and doing the work they think is right, but sometimes I feel like these guys just got bored with their old jobs and thought med school would be interesting, so their interest comes at a cost to society.

I bet going from having a stable income and career, being able to provide for your family, and seeing eye-to-eye with your peers to being a bottom-of-the-pole, make-no-money, claw your way back up situation is something people do all the time on a whim. Never mind the fact that everyone they know as colleagues/classmates/friends will be continuing on and moving up in the world while they have to go back and make nice with fresh-out-of-undergrad know-everything kids.

I'm sure going back and taking premed classes (after being out of school for a decade no less) and studying for the MCAT WHILE working a full time job and feeling silly for rebooting your life from scratch is pretty much no big deal. Nevermind that after they get in, it'll be at least another seven years in training.

Yep, it sounds like something old guys do all the time just for kicks. Did it ever occur to you that if you took all the M1's in the country and put them in a 35 year old nontrad's shoes, only a fraction of them would really, really want it enough to do it? Think that should count for something?

 

[TwinsFan]

I bet going from having a stable income and career, being able to provide for your family, and seeing eye-to-eye with your peers to being a bottom-of-the-pole, make-no-money, claw your way back up situation is something people do all the time on a whim. Never mind the fact that everyone they know as colleagues/classmates/friends will be continuing on and moving up in the world while they have to go back and make nice with fresh-out-of-undergrad know-everything kids.

I'm sure going back and taking premed classes (after being out of school for a decade no less) and studying for the MCAT WHILE working a full time job and feeling silly for rebooting your life from scratch is pretty much no big deal. Nevermind that after they get in, it'll be at least another seven years in training.

Yep, it sounds like something old guys do all the time just for kicks. Did it ever occur to you that if you took all the M1's in the country and put them in a 35 year old nontrad's shoes, only a fraction of them would really, really want it enough to do it? Think that should count for something?

This is the truest thing I have ever read on SDN.

The reasons someone with a prior life and successful career would go into medicine will typically exclude the common ones tradional students have (money, prestige, lifestyle etc.) for more altruistic ones. The decision to do it also carries a lot more weight, giving up a good career and a life to be a peasant pre-med/med student has a whole lot more opportunity cost than choosing a bio major (with a few hundred hours for shadowing, MCAT, clinical etc. tacked on) instead of a business one. I would argue these reasons typically make non-trads a better fit, and help serve the greater good. Judging by admissions, schools seem to be recognizing this too.

Obviously, there is a balance. Someone who can only practice a couple years has less opportunity to make an impact than the 28 year old fresh out of residency.

 

[DrMidlife]

The same freedom that allows an old fart to change careers into medicine allows traditional physicians to change careers out. Paging kevinmd.com...

In the future, I sincerely hope you young punks are glad you did medicine, when you're 30, 40, 50+. Otherwise, you'll have picked the most difficult, most expensive possible way to find out what you don't want to do with your life. I am absolutely baffled by the expectation that people are supposed to have this figured out at 21.

Best of luck to you.

 

[tiedyeddog]

Everyone calm down. I'm kidding.

I prefer quesadillas.

lol

 

[tiedyeddog]

What about doctors who retire after only working 20-25 years? Way to kill society, guys.

Solution: Mandatory work age for all physicians until 95 years of age. Death doesn't preclude you from this.

On a side note, taxpayers pay for basketball arenas and football stadiums. Should we mandate prison for first round draft picks that flop? Ten years in jail for JaMarcus Russell for destroying societies morals? Anybody with me?

 

[operaman]

As a non-trad myself, let me add another practical consideration regarding how many years I'm going to practice. Those of us starting later will have to practice significantly longer in order for our retirement savings to reach a point where we can maintain some semblance of our working lifestyle. Sacrificing so many crucial years of compounding interest is brutal and likely entails working well past the age when most traditional med students will retire. As such, doesn't this render the whole point moot for all but the oldest non-trads?

I wish I had some study data to better flesh this out, but for now I'll have to rely on 8th grade math and a little assumption.

 

[colbgw02]

As a non-trad myself, let me add another practical consideration regarding how many years I'm going to practice. Those of us starting later will have to practice significantly longer in order for our retirement savings to reach a point where we can maintain some semblance of our working lifestyle. Sacrificing so many crucial years of compounding interest is brutal and likely entails working well past the age when most traditional med students will retire. As such, doesn't this render the whole point moot for all but the oldest non-trads?

I wish I had some study data to better flesh this out, but for now I'll have to rely on 8th grade math and a little assumption.

Ummm...but this only works if you didn't save anything during your first career. I won't run the numbers, but I'm guessing that X number of dollars invested at 24 (when traditional students have no savings, but non-trad students should at least have some) will probably work out better than 2X dollars invested at 32 (an age at which many traditional students will be practicing, but non-traditional students will still be in training). You know, time value of money and all.

 

[Dr Love]

The "physician shortage" is really a primary care shortage, and a geographic (rural) shortage. Go to the subspecialty boards and read the threads about job market saturaion in many specialties (gas, rads, etc). So rather than discriminate based on age, the "shortage" could be better addressed with programs that encourage students to go into primary care fields, and go to rural areas.

The "physician shortage" is really a myth with no evidence to back it up.

 

[jj6vcb]

I'm not even sure I disagree with the OP. Even though it would have eliminated me from contention for a medical school seat.

I just don't like the feel of the post. Kind of sneaky as if just an item for discussion. When it's clear s/he just doesn't think old people should be there.

They should state that forcefully and then for maximum effect compare our system to some other health education system.

I am fairly certain that the US is somewhat unique globally for opening it's doors to vast numbers of older students. If not unique. At least in a very small group. Should be plenty of data to prove this is bad from a "greater good" perspective. And I would probably agree.

But don't just hate. Because I was livin, gettin laid and blowin my mind in the world, while you were placing first in middle school science fair. And you think that's some kind of violation of nature.

Man up.

I don't know how to use multi quote so I'm going to respond to a few things here.

First of all, you even bringing this issue up in the same sentence as Brown v Board of Education (earlier post) hugely trivializes that case, which was for the greater good of our entire nation. Nasrudin, don't bother responding to this because there's no way I'm acknowledging a single post from you from this point on.

If there is in fact a correlation between age in medical school and the tendency to go into primary care/rural medicine, then that is great and these students are a great and important part of our country's healthcare system. I didn't know about that and am still not sure it's true, but it is a good enough example that I recognize there are probably more like it that have to do with older students' motivations for getting into medicine.

I never made any sweeping generalizations about older nontrads. I said the guys IN MY CLASS (2 specific people) seemed like they were just bored with their old lives and thought this would be interesting. Turns out they are both loaded (one sold his software company), they are not making some huge sacrifice by being here. Some people do make that sacrifice. Personally, I would have a hard time doing that if I had kids who depended on me for support.

As for being a young punk, I think this thread has shown that some of the older crowd is just as emotionally charged and at times irrational as people my age. Can't predict the future, but I wake up every day knowing I was born for science and medicine, and that wasn't apparent to me until I started med school. I'm not looking back any time soon.

The question I initially raised was more about health economics than philosophy or ageism. It was about having limited resources and doing what we can with what we have. It would be great if people could respond to that with ideas rather than rants and accusations... but hey it's the internet so if you want let's go crazy.

 

[jj6vcb]

The "physician shortage" is really a myth with no evidence to back it up.

Is that something you saw on this board and are just repeating?

http://content.healthaffairs.org/content/21/1/140.short

 

[Nasrudin]

It's possible that we all at some point may be determined economically not viable. Tell someone that, whether rationally or not. Don't expect grins and giggles.

As to your misunderstanding my syllogism. Or emotional rejection of your rap.

You could always...go F@ck yourself!

 

[macgyver22]

I want to bring this up in the context of the physician shortage that is supposedly looming. There are 2 guys in my class who are ~15-20 years older than the rest of us. Can't predict the future, but it is a reasonable expectation that these two will practice medicine for a shorter time than someone who graduates in their twenties.

Let's say each practices for 10 fewer years than a traditional med student. That's 20 work-years lost simply because these guys are older. If we assume similar rates of non-trads across the country at (conservatively) 100 schools, we're losing 2000 work-years from each graduating class because of this.

I'm not against people following their dreams and doing the work they think is right, but sometimes I feel like these guys just got bored with their old jobs and thought med school would be interesting, so their interest comes at a cost to society.

Why are you singling out older students? The same argument could be made for women since they tend to leave the profession in greater numbers then men or only work part time. Perhaps we should also discriminate against people with certain handicaps since they may or may not be less productive which in the end has the same effect as a physician who retires after only 15-20 years. You could even make a strong argument that schools should discriminate against students who want to pursue anything other than primary care since adding more specialist to the healthcare system raises healthcare costs for the system as a whole and doesn't provide for the needs of society.

It seems to me that despite your protests to the contrary you really do have something against older students and it has little to do with the fact that they may or may not have as long a career as a younger applicant for the same spot.

 

[colbgw02]

Okay. So we're all in agreement, right? Gattaca is the only solution.

 

[DrMidlife]

I wake up every day knowing I was born for science and medicine, and that wasn't apparent to me until I started med school. I'm not looking back any time soon.

Med school has nothing to do with how it's going to feel to practice medicine for a living, day in day out, year after year. That's the part I sincerely hope you find enjoyable enough to want to do it for the rest of your working life, without regret.

The question I initially raised was more about health economics than philosophy or ageism. It was about having limited resources and doing what we can with what we have.

The investment made in training a US physician is roughly a million public dollars. The most obvious piece is Medicare GME umbrella funding of $100k/yr per resident, and that's before you get into insurance or physical infrastructure or compliance or accreditation. No, student loans aren't included in that, but the oversight of those loans is.

So where's the contract that a med student signs, that says he or she will pay back that investment if he or she chooses to go into lucrative private practice? If you're not on a military or public health scholarship, or you're not at that Ohio DO school that makes you sign a 5 year contract, then you can do whatever you want with your MD. You don't ever have to practice at all. You don't have to stay with medicine after your loans are paid off. You don't have to give any kickbacks from your profits if you buy a Botox clinic, or if your medical blog starts getting enough ad revenue that you can quit practicing medicine after 8 years (ahem kevinmd ahem). Or you can do what you're supposed to, which is to care for patients, and suck it up when it sucks, for as long as you physically and mentally are able.

Mostly nobody ever talks about that ~$1 million as a debt to be repaid. We're blinded by our student loan totals. Right? I suggest that age has nothing to do with whether a med student has considered his or her personal commitment and responsibility in the wake of that ~$1 million. I have. Have you?

Best of luck to you.

 

[jj6vcb]

Why are you singling out older students? The same argument could be made for women since they tend to leave the profession in greater numbers then men or only work part time. Perhaps we should also discriminate against people with certain handicaps since they may or may not be less productive which in the end has the same effect as a physician who retires after only 15-20 years. You could even make a strong argument that schools should discriminate against students who want to pursue anything other than primary care since adding more specialist to the healthcare system raises healthcare costs for the system as a whole and doesn't provide for the needs of society.

It seems to me that despite your protests to the contrary you really do have something against older students and it has little to do with the fact that they may or may not have as long a career as a younger applicant for the same spot.

I really don't. I'm friends with an older student in my class. It's just something I think about. How could it have anything to do with anything besides the issue I brought up? You think I just generally dislike people who are older than I am? I don't think that's reasonable for you to infer from my post. It seems to me that the crazies have all come out and instead of having a reasonable discussion we've all decided to declare a thought I had about possible ways to increase the supply of doctors in this country immoral.

 

[Untraditional]

I'm in ur medschool. Takin' ur spot.

And I'm gonna be in ur residency takin' ur spot again, lol!!!

U mad? Don't be ageist.

 

[macgyver22]

I really don't. I'm friends with an older student in my class. It's just something I think about. How could it have anything to do with anything besides the issue I brought up? You think I just generally dislike people who are older than I am? I don't think that's reasonable for you to infer from my post. It seems to me that the crazies have all come out and instead of having a reasonable discussion we've all decided to declare a thought I had about possible ways to increase the supply of doctors in this country immoral.

Perhaps it was unfair to question your motives but, I'm just wondering why you are singling out the older students but yet you have no concerns about any of the other categories i mentioned since the same argument could be applied to all of them

 

[theseeker4]

A lot more than the "ageism" question, I find it interesting that people actually think someone who can get into medical school is obliged beyond any legal contracts they may sign to be a slave to society in any way, shape or form. I hope everyone who is becoming a doctor is at least somewhat motivated by a desire to help others, but when did becoming a doctor turn into a sentence to indentured servitude? I have every intention to work a full career in medicine, but if I decide after my training to do something else, as long as I pay my loans, it is none of anyone's business what I do or why. If you want to be a slave to your own personal sense of what is owed by doctors to society, feel free, but don't presume to require anyone else to live by your standards. No one "owes" society a certain number of years of their lives simply by deciding to pursue medicine. If you really think they do, maybe you should consider what that means for you personally; do you really want someone else dictating how long you have to work, where you have to work, what specialty you must choose, etc?

 

[learss]

I really don't. I'm friends with an older student in my class. It's just something I think about. How could it have anything to do with anything besides the issue I brought up? You think I just generally dislike people who are older than I am? I don't think that's reasonable for you to infer from my post. It seems to me that the crazies have all come out and instead of having a reasonable discussion we've all decided to declare a thought I had about possible ways to increase the supply of doctors in this country immoral.

Seriously?
This could never be a discussion, because what you are suggesting is that medical school admission directors start practicing age discrimination, which is illegal. Why stop at older students? You can apply the same argument to women.

 

[Law2Doc]

...

Let's say each practices for 10 fewer years than a traditional med student. That's 20 work-years lost simply because these guys are older. If we assume similar rates of non-trads across the country at (conservatively) 100 schools, we're losing 2000 work-years from each graduating class...

I think that may be a faulty assumption. The person starting medicine late has no intention of ever retiring, he's more likely planning to die on the job. The person starting at age 21 probably anticipates a phasing out of his career in favor of golf and fishing in his golden years.

Also health is much more important than age in terms of determining career longevity. A healthy person in his mid 30s probably outlives a heavy smoker in his 20s on most actuarial tables, or a young person with diabetes, or even a younger person with a strong family history of heart disease. Obviously we can't discriminate on these bases, which are even more significant than a few years.

Finally the rate of attrition and rate of opting to not use your medical license in medicine is higher with the younger crowd than the older sect. If you know what the alternatives are, you dont have a lot of those "grass is greener" moments. If you look at who ditches med school, or decides to go work for McKinsie, it's not going to be the 40 year old in your class. that person is more clear on their path, having already tried their hands at something else. The 21 year old is the one who suffers the "is it worth it" angst in med school.

I also agree with Twinsfan above. The nontrad leaving a successful career is not doing it for the money, or the prestige, or to make his parents proud, or all the stupid reasons some subset of the younger crowd goes into medicine. He's often time making this move despite a financial loss. Doesn't mean he'll be a better doctor, but will certainly be more dedicated and will complain about things a heck of a lot less. A profession does better with this kind of person in their ranks than they do with the kid who became a doctor for the Bentley he thinks he can make in derm.

 

[poke73]

Or Logan's Run!

 

[wholeheartedly]

I think that may be a faulty assumption. The person starting medicine late has no intention of ever retiring, he's more likely planning to die on the job. The person starting at age 21 probably anticipates a phasing out of his career in favor of golf and fishing in his golden years.

Also health is much more important than age in terms of determining career longevity. A healthy person in his mid 30s probably outlives a heavy smoker in his 20s on most actuarial tables, or a young person with diabetes, or even a younger person with a strong family history of heart disease. Obviously we can't discriminate on these bases, which are even more significant than a few years.

Finally the rate of attrition and rate of opting to not use your medical license in medicine is higher with the younger crowd than the older sect. If you know what the alternatives are, you dont have a lot of those "grass is greener" moments. If you look at who ditches med school, or decides to go work for McKinsie, it's not going to be the 40 year old in your class. that person is more clear on their path, having already tried their hands at something else. The 21 year old is the one who suffers the "is it worth it" angst in med school.

I also agree with Twinsfan above. The nontrad leaving a successful career is not doing it for the money, or the prestige, or to make his parents proud, or all the stupid reasons some subset of the younger crowd goes into medicine. He's often time making this move despite a financial loss. Doesn't mean he'll be a better doctor, but will certainly be more dedicated and will complain about things a heck of a lot less. A profession does better with this kind of person in their ranks than they do with the kid who became a doctor for the Bentley he thinks he can make in derm.

This.

A lot of this debate, and the one about women practicing fewer hours or either gender part-time physicians rest on the assumption that quantity of care (i.e. hours/years practiced) is the best indicator of the value of a physician. What about quality or care? We all have worked with people or been around people that get twice as much accomplished in the same time as everyone else, or people who have a more intuitive read on patients and might be able to provide better care, or people who are just in general better doctors and can make more of an impact in 40 hrs than the avg doc can in 50.

When you factor in all the unpredictability of who does what specialty, when they retire, how long they stay, who goes into research or industry, who jumps ship and leaves medicine altogether, who does fewer hours but provides better quality care, and all the other factors brought up here there isn't an accurate way to say this group or that group isn't as valuable and shouldn't practice.

 

[gman33]

Schools aren't really too concerned with what you do with your education.
They want to know that you will finish and pay 4 years of tuition.

Ideally they'd like you all to go into primary care and practice for 50 years.

What you actually do is your own business.
You paid for a service and they provided it.

There are bigger problems than being concerned if someone may practice a few less years because they are older.

I started med school a dozen years later than most of my classmates.
I probably will practice a few years less than most of them.

Hopefully I'll be a good doc for the time I do practice.

I do get the idea that a younger person may provide more years of a needed service.
Maybe some of my life experience will help make me a better doc sooner as some of the young-ins still need to learn life lessons that will make that possible.

I'm not saying that's really the case, but it might turn out to be a wash.

 

[michaelrack]

You could even make a strong argument that schools should discriminate against students who want to pursue anything other than primary .

some schools do this

 

[Ortho Guy]

You could even make a strong argument that schools should discriminate against students who want to pursue anything other than primary care ortho.

Agreed.

 

[ZagDoc]

I used to think that way too. But after being in classes with them for 2 years, I'd say they're much more balanced and sane people, while 75% the 21/22 year olds coming straight out of college are a bunch of idiots who aren't prepared to take care of a cactus much less a patient.

True story - I had a cactus in medical school that died.

 

[Ortho Guy]

True story - I had a cactus in medical school that died.

Taking care of those little bastards is much harder than you'd think.

 

[Cooperd0g]

Ideally they'd like you all to go into primary care and practice for 50 years.

Unfortunately I think most med schools would prefer that you make zillions and endow their school.

I don't have set numbers about non-trads. I was making six figures in a job that most people think is very cool. But they also don't know what the job is actually like. It also was no longer as gratifying as I matured. My priorities changed. It isn't that I was bored, it was that I wanted to have a greater impact with my community. Couple that with my desire to live in a relatively rural area because I'm totally over cities and crowds, it makes perfect sense to me. Though I admit a few other specialties do appeal to me, but in a way that I could still serve a rural environment. I read an article last year that rural specialties are even more scarce than primary care. There are only three member retina surgeons in all of Wyoming, according to the American Ophthalmological Society. Patients drove for several hours to the clinic where I worked last year (part time at $15 per hour - quite the cut from six figures). As a pilot, I can run clinics in several locations to reduce that burden on patients and have fun doing it.

And once I have the life I really want, why the heck would I retire? I might wind down the hours, but if I quit entirely I would get bored out of my mind. I don't like golf anyway - too boring.

 

[tiedyeddog]

I just don't understand how you can logically say "let's keep people above, say, 30 thirty years of age out of medical school." due to "potentially giving less to society" and the not extend that same idea to other groups. You could then extend it to women; they will need maternity leave. Then, you could extend it to people from poor families; they will have a tougher time getting through medical school, due to financial problems. They might fail out before starting residency. What about genetic testing? Those predisposed to certain hereditary factors might die earlier, that would allow less time to practice.

I believe the reality is people of varying backgrounds bring different, unique things to the table. With age comes different viewpoints not gained through following the "norm"; premed-medical school-residency. This helps society as a whole as patients are unique and come from wide spectrum of experiences and cultures.

 

[CATrtb]

Ummm...but this only works if you didn't save anything during your first career. I won't run the numbers, but I'm guessing that X number of dollars invested at 24 (when traditional students have no savings, but non-trad students should at least have some) will probably work out better than 2X dollars invested at 32 (an age at which many traditional students will be practicing, but non-traditional students will still be in training). You know, time value of money and all.

32 year-old non-trad here. I plan on working longer in order to retire with the same amount that a 22 year old would. I spent all my retirement from working ages 20-32 on medical school. I doubt most non-trads in their thirties have any retirement left by the time they hit residency. Anyway I will have to work enough in order to pay off my enormous loans, pay back my lost retirement, and build up my own average "physician's retirement". So that will be at least ten years longer than your traditional student.

 

[keithslc]

It has been my experience that the medical community benefits greatly from people who have had carreers outside of medicine. The egos that physicians and nurses have in medicine are ridiculous. Many act as if there is no other profession that requires very capable people.
I would love to see a move away from the snobby rich kid mentality that prevails today. It may be hard to grasp for those with a homogenous career that ,there is alot to be said for the diverse skills brought from people who have mechanical, technical, agricultural, etc... backgrounds that can be applied to medicine.

 

[OneTyme]

true story - i had a cactus in medical school that died.

lmfao

 

[docB]

I think the OP is being treated more harshly than he deserves. This is a question that comes up and discussing it really makes people think about where medical education and medicine as a career falls in society.

Many have noted that if ageism were practiced it could lead to other groups such as women being excluded as well. That discussion also happens frequently but for some reason it usually is applied to residency and attending jobs. Do some searches about it and read the threads.

The usual conclusion to the discussion is a consensus that while various groups may have different work patterns their overall value and contributions outweigh those disturbances.

 

[On the Loose]

I just don't understand how you can logically say "let's keep people above, say, 30 thirty years of age out of medical school." due to "potentially giving less to society" and the not extend that same idea to other groups. You could then extend it to women; they will need maternity leave. Then, you could extend it to people from poor families; they will have a tougher time getting through medical school, due to financial problems. They might fail out before starting residency. What about genetic testing? Those predisposed to certain hereditary factors might die earlier, that would allow less time to practice.

Yup! And anyone with a family history of heart disease should be excluded. Let's also exclude anyone who's overweight because they may die earlier. The truth is, a healthy 22-year-old could die tomorrow and a healthy 32-year-old could live to be 100. We don't know.