Is it wrong for schools to take older nontrads?

[seelee]

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The entire question is insane. The OP doesn't like old people in his class and he is trying to justify his sentiments by making some appeal to "the greater good". It is a load of collectivist swill that has horrific implications. The whole notion that some board or committee is qualified enough to determine not only if someone would make a good doctor, but whether that person satisfies a nebulous "greater good" is ludicrous.

Adcoms can't even keep psychopaths out of medical school. Hows about we ask them to stop admitting the emotionally unstable, the incompetent, and the lazy first before we ask them to discriminate of the basis of age.

 

[sibitrum]

Even though I am a non-trad myself, I think it is an important question to consider. Please stop with the reductio ad absurdum arguments. From the voting age to social security, age and its implications have always had a unique spot in societal debates, apart from issues of genetics/race/sexual orientation/etc.

Whether you agree with it or not, schools already do take the initiative in trying to attain the "greater good." For example, look at policies aimed at recruiting disadvanaged or minority candidates. Generally, the ostensible purpose of this is so that areas that are underserved will get more medical providers. Another example is that the vast majority of adcoms have a non-specified requirement for applicants to acquire many hours of community service. Again, here they are trying to recruit future physicians who will be community-minded. Finally, I will bring up the point that adcoms already do have a bias against much older non-trads (e.g. 40s/50s).

Anyway, here are my thoughts (I'm sure I'm forgetting something) on how the cost-benefit analaysis breaks down for admitting non-trads who are 10-15 years out of school:

Pros:
-Bring unique work and life experiences to the medical school class and the field. I think this is especially valuable if they can contribute in a unique way to the field in a big way, such as through interdisciplinary research. In my opinion, when you get to the day-to-day operations of an attending after 7-10 years of medical education, any previous life experiences, while potentially useful, aren't really a huge differentiating factor between non-trads and the younger crowd.
-Potentially in it for "better" reasons and/or they have had more time/experience to think about it. This could lead to more collegiate personality types, a greater likelihood of going into underserved areas or academic medicine.

Cons:
-The major con, as has been noted, is that all else equal, nontrads will probably spend fewer years as a practicing attending.

Overall, I think the area requires more research so we can acquire more hard numbers on each of these topics.

 

[macgyver22]

Even though I am a non-trad myself, I think it is an important question to consider. Please stop with the reductio ad absurdum arguments. From the voting age to social security, age and its implications have always had a unique spot in societal debates, apart from issues of genetics/race/sexual orientation/etc.

Whether you agree with it or not, schools already do take the initiative in trying to attain the "greater good." For example, look at policies aimed at recruiting disadvanaged or minority candidates. Generally, the ostensible purpose of this is so that areas that are underserved will get more medical providers. Another example is that the vast majority of adcoms have a non-specified requirement for applicants to acquire many hours of community service. Again, here they are trying to recruit future physicians who will be community-minded. Finally, I will bring up the point that adcoms already do have a bias against much older non-trads (e.g. 40s/50s).

Anyway, here are my thoughts (I'm sure I'm forgetting something) on how the cost-benefit analaysis breaks down for admitting non-trads who are 10-15 years out of school:

Pros:
-Bring unique work and life experiences to the medical school class and the field. I think this is especially valuable if they can contribute in a unique way to the field in a big way, such as through interdisciplinary research. In my opinion, when you get to the day-to-day operations of an attending after 7-10 years of medical education, any previous life experiences, while potentially useful, aren't really a huge differentiating factor between non-trads and the younger crowd.
-Potentially in it for "better" reasons and/or they have had more time/experience to think about it. This could lead to more collegiate personality types, a greater likelihood of going into underserved areas or academic medicine.

Cons:
-The major con, as has been noted, is that all else equal, nontrads will probably spend fewer years as a practicing attending.

Overall, I think the area requires more research so we can acquire more hard numbers on each of these topics.

You conveniently ignore the many valid arguments brought up by others above. How can you justify targeting older students without also targeting women, students with disabilities or those who are determined not to go into primary care etc.

Those are not reductio ad absurdum arguments by any definition. To be fair you would have to consider all factors that would have a significant impact on the productivity of a medical school graduate. I would be so bold as to suggest that being female might cut the average career length and hours worked more than a 10-15 year age difference would. That comes from 21 years of experience. I've followed the career paths of a lot of the people I trained with. More than a handful of the women I was in med school or residency with are now working part time or not at all. I can't think of a single male I have come across who would fit into that category.

I'm not by any means suggesting that we discriminate against women, in fact just the opposite. Im simply suggesting that you cant discriminate against one group without applying the same methods to every subgroup if you're going to be fair. The only answer is to not discriminate against any of them.

 

[docB]

I think that dismissing the whole discussion and one that shouldn't even happen is short sighted. As I mentioned this is an old issue that keeps coming up again and again. Many here advocate increased governmental subsidy for medical education to reduce the debt load for various reasons. If subsidies increase there will certainly be even more discussion about who should get those resources. This isn't going away.

 

[macgyver22]

I think that dismissing the whole discussion and one that shouldn't even happen is short sighted. As I mentioned this is an old issue that keeps coming up again and again. Many here advocate increased governmental subsidy for medical education to reduce the debt load for various reasons. If subsidies increase there will certainly be even more discussion about who should get those resources. This isn't going away.

Fine but are you then willing to address all the other groups. Are we going to limit medical education to a select group of "supermen" who are young and fit both physically and mentally and sign a covenant to work long hours for some minimum number of decades so that we can ensure we get the most from our investment?

Anything short of that is just a dishonest attempt to use the "greater good" as an excuse to target a single group when there are many other groups that truly pose the same hazard to our "investment"

There is a price to be paid if such an attempt is made. As more groups are considered "undesireable" the medical education process and physicians themselves will be viewed with suspicion by people who feel that they have ben marginalized. This is a dangerous path to pursue

 

[tiedyeddog]

Fine but are you then willing to address all the other groups. Are we going to limit medical education to a select group of "supermen" who are young and fit both physically and mentally and sign a covenant to work long hours for some minimum number of decades so that we can ensure we get the most from our investment?

Anything short of that is just a dishonest attempt to use the "greater good" as an excuse to target a single group when there are many other groups that truly pose the same hazard to our "investment"

There is a price to be paid if such an attempt is made. As more groups are considered "undesireable" the medical education process and physicians themselves will be viewed with suspicion by people who feel that they have ben marginalized. This is a dangerous path to pursue

I couldn't agree more with this. If you're going to limit the entry of one group based purely on the length of work-years they provide, you have to do it to all groups. Then we are going right back to the "old boy" club that medicine used to be.

 

[Bigz]

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 stop at age? what about Obese medical students? Perhaps this is why you need us over 30's to let you know that discrimination of any kind is wrong and most importantly against the law. I was truly astonished during a debate in an ethics class about Insurance with people who have never had to worry about getting insurance for a family.

 

[Dr Love]

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

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

Oh, well, if it's on the internet, it must be true.

 

[Wilf]

I'm worried that there are going to be too many doctors in the near future. I am always glad to see when med schools take older students.

 

[KeyzerSoze]

the entire question is insane. The op doesn't like old people in his class and he is trying to justify his sentiments by making some appeal to "the greater good". It is a load of collectivist swill that has horrific implications. The whole notion that some board or committee is qualified enough to determine not only if someone would make a good doctor, but whether that person satisfies a nebulous "greater good" is ludicrous.

Adcoms can't even keep psychopaths out of medical school. Hows about we ask them to stop admitting the emotionally unstable, the incompetent, and the lazy first before we ask them to discriminate of the basis of age.

+100000.

My favorite parts are "load of collectivist swill" and "nebulous 'greater good'".

 

[EagerToBeMD]

This debate reminds me of a radical Christian who argues against gay marriage because he says "marriage should only be for reproductive purposes" and then conveniently ignores the question "should we then outlaw marriage for fertile couples as well?"

Hate to break it to you youngins, but as a 25-year-old med student, I thank God for the older students. They have a work ethic a 1000 times stronger than any of the kids (including me). They're more responsible, more willing to do what it takes to get the job done without whining and complaining every 10 seconds, and they often have more energy than the whiners who can't stand to work a 12-hour shift without complaining to the other students about slave labor. There's something to be said about having been out in the real world with a real job before med school. I think med schools should go the way of PA schools (and other graduate programs) in requiring applicants to have a few years of work experience before attending.

 

[45408]

This debate reminds me of a radical Christian who argues against gay marriage because he says "marriage should only be for reproductive purposes" and then conveniently ignores the question "should we then outlaw marriage for fertile couples as well?"

😕 what's wrong with fertile couples?

 

[Starlightembers]

😕 what's wrong with fertile couples?

I believe EagerToBeMD meant to type infertile.

 

[Lbgem]

This debate reminds me of a radical Christian who argues against gay marriage because he says "marriage should only be for reproductive purposes" and then conveniently ignores the question "should we then outlaw marriage for fertile couples as well?"

The answer I got in response to asking that was - they were TRYING to procreate. That there was still a possibility they could have kids. And that the purpose of marriage was to raise a family (i.e. kids). I asked okay what about people that didn't want kids and got married? Then the response to that was they may change their mind in the future, but the possibility of having kids was still there...

Some of the my more moderate Christian friends while against gay marriage said civil unions were fine, but the term/institution of marriage belonged to religion. Therefore religion should be the one to define its participants (i.e. man + woman).

 

[Duotone]

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.

1. Assuming every younger doctor outlives an older one.
2. Assuming your graduating class has absolutely nothing to gain from the older non-trads that isn't measured in work-years.
3. Assuming these older non-trads do not belong to this society that so magnanimously and graciously ends up bearing the cost of their interest.

I guess you would rather they be your patients and not your colleagues.

 

[SouthSideSteve]

So what about women? They get knocked up, spit out kids, and some eventually never return to practice. Should adcoms only consider 22 year old males for admission?

 

[EagerToBeMD]

I believe EagerToBeMD meant to type infertile.

Thank you. The Prowler knew that as well.

The answer I got in response to asking that was - they were TRYING to procreate. That there was still a possibility they could have kids. And that the purpose of marriage was to raise a family (i.e. kids). I asked okay what about people that didn't want kids and got married? Then the response to that was they may change their mind in the future, but the possibility of having kids was still there...

Then perhaps they'd advocate marriage having an age limit. Once a woman is over the age of 45-50, she can no longer get married. Wonder what they're bigoted response to that would be. They haven't learned yet that God Hates Bigots.

Some of the my more moderate Christian friends while against gay marriage said civil unions were fine, but the term/institution of marriage belonged to religion. Therefore religion should be the one to define its participants (i.e. man + woman).

Except, the government recognizes marriage as well. It's not entirely a religious issue. It's a LEGAL one. No one is saying that every Catholic Church in the nation needs to marry gay couples. But what people are saying, rightly so is that gay couples should not be discriminated against by the very government that's supposed to represent them.

 

[docB]

Fine but are you then willing to address all the other groups. Are we going to limit medical education to a select group of "supermen" who are young and fit both physically and mentally and sign a covenant to work long hours for some minimum number of decades so that we can ensure we get the most from our investment?

Anything short of that is just a dishonest attempt to use the "greater good" as an excuse to target a single group when there are many other groups that truly pose the same hazard to our "investment"

There is a price to be paid if such an attempt is made. As more groups are considered "undesireable" the medical education process and physicians themselves will be viewed with suspicion by people who feel that they have ben marginalized. This is a dangerous path to pursue

Agreed. The lower productivity argument could be used to argue for exclusion of other groups as well however, as I mentioned before, the discussion always ends with a conclusion that the lower productivity is amply surpassed by other benefits from training these cohorts.

My point is not that it is a good idea. It was that it is a recurring discussion and the immediate shouting down of the discussion does not allow those bringing it up to learn why it is a bad idea. You'll notice that no one has ever once advocated that we help end racism by never ever discussing racism.

I couldn't agree more with this. If you're going to limit the entry of one group based purely on the length of work-years they provide, you have to do it to all groups. Then we are going right back to the "old boy" club that medicine used to be.

So to rephrase this in a way that fosters the discussion "Excluding groups would hurt the medical profession because it has benefited from increasing diversity."

Why stop at age? what about Obese medical students? Perhaps this is why you need us over 30's to let you know that discrimination of any kind is wrong and most importantly against the law. I was truly astonished during a debate in an ethics class about Insurance with people who have never had to worry about getting insurance for a family.

Again this discussion has been had repeatedly. Here's an example. It's not just reductio ad absurdum. It's a real train of thought for many.

 

[macgyver22]

Agreed. The lower productivity argument could be used to argue for exclusion of other groups as well however, as I mentioned before, the discussion always ends with a conclusion that the lower productivity is amply surpassed by other benefits from training these cohorts.

My point is not that it is a good idea. It was that it is a recurring discussion and the immediate shouting down of the discussion does not allow those bringing it up to learn why it is a bad idea. You'll notice that no one has ever once advocated that we help end racism by never ever discussing racism.

OK . Good point

 

[Dral]

I was an older nontrad. I always had the intention of going to med school since undergrad, but I spent a number of years on a PhD before starting med school.

It is surely wrong to assume a nontrad just got bored with their career. However, objectively, we do contribute fewer years. Some people go through med school and never even practice medicine, but that can't be predicted usually...while accepting an older person is a predictable loss in practice years.

However, as someone pointed out, this isn't the real problem.

 

[miz]

Statistics break down at the individual level... your 38yo may work more hours over a total career than a 22yo; your male med student may drop out to raise the family while his wife works. You punish individuals when you judge by the overall trend.
as a statistical anomaly myself I prefer to advocate for admissions tolerance :]

 

[Law2Doc]

...Some people go through med school and never even practice medicine, but that can't be predicted usually...while accepting an older person is a predictable loss in practice years...

if you really want to go down this road, actuarial science for the insurance industry is built around predictions similar to this. They will tell you that a 35 year old workout enthusiast is, in general, likely going to outlive a 20 year old smoker. That an obese 18 year old with a family history of heart disease is more likely to die before the slim 30 year old with no family history. That the average length of life for a male is 75, but if you reach 50 in good health, you are likely going to significantly surpass that average. And so on. As you can see, age isn't always the most important determinator. Baseline health is. So do we want med schools to not accept people who aren't fit or have bad genes or dangerous habits because their productive lives are shorter? We already can predict this. The insurance industry makes money precisely because they can comfortably predict this and adjust the premiums accordingly. So basically anyone a few pounds heavy or with a few bad habits or a few sick relatives had better rally round the nontrads on this one, because if it comes down to a question of who is going to objectively practice longer, I hate to break it to you but there are a lot more generally healthy doctors in their 80s practicing out there than obese smoking doctors with family histories in their 60s.

 

[Darwinism]

I don't see why you people think medicine is such a "stand alone" field.
Should we just not let older people go to college for anything period?
If you think so, you're a communist...

 

[epsilonprodigy]

I am guessing OP's supposedly "innocuous" question stems from his/her feelings of inadequacy next to non-trad classmates who know the intricacies of professional behavior and have had highly relevent life experiences. When I was in undergrad, I was one of the few "kids" in a sea of non-trads (economy crash= lots of career changers= lots of older folks entering nursing, which is what my u-grad degree was in.) I often felt grossly inadequate next to those who had been in the military, the peace corps, successfully raised children, and so on.

The difference: instead of hating on them, I shut my mouth and tried to learn something from them.

 

[Dartmouth2005]

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.

^^^This.^^^

 

[BEN52]

Your very post proves why non-trads are a good thing and bring balance to the medical field.

It seems to me you believe that you believe you are entitled to something. Something you believe you will good at and will do for a long time but have nothing to quantify that beyond your belief you were "born" for this. Exactly how do you know you were "born" for this. Exactly what do you know about health care? What do you know about your ability to work 100 plus hour work weeks with a limited and varying sleep schedule? You are making an assumption. Obviously the assumption holds true more often than not as the bulk of physicians in this country are not non-trads and graduate and become good doctors.

A non-trad brings perspective to the table which you clearly lack.

 

[bamtuba]

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.

I was *only* 29 when I matriculated and did what you described, but yeah, pretty much did it just for kicks.

😉

 

[mfrizzo3]

Yes, I hear they smell like mothballs and peppermint. /Thread.

 

[scarshapedstar]

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.

Because there certainly aren't any overachieving 22-year-olds who go into medicine for the wrong reasons or burn out or anything like that. No cost to society by letting them in.

Where do you draw the line, anyway? I'm starting at 27, mostly because I made the mistake of trying to be an engineer. Am I worthless because of that?

 

[docB]

Your very post proves why non-trads are a good thing and bring balance to the medical field.

It seems to me you believe that you believe you are entitled to something. Something you believe you will good at and will do for a long time but have nothing to quantify that beyond your belief you were "born" for this. Exactly how do you know you were "born" for this. Exactly what do you know about health care? What do you know about your ability to work 100 plus hour work weeks with a limited and varying sleep schedule? You are making an assumption. Obviously the assumption holds true more often than not as the bulk of physicians in this country are not non-trads and graduate and become good doctors.

A non-trad brings perspective to the table which you clearly lack.

You realize you are making just as glaring of a generalization as you think the OP made?

 

[deleted192690]

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?

+1

 

[Untraditional]

Where do you draw the line, anyway? I'm starting at 27, mostly because I made the mistake of trying to be an engineer. Am I worthless because of that?

Another recovering research engineer here. We need to start a support group. 😛

 

[startoverat40]

I'm sure glad the admission committee didn't think it would be wrong to accept me! WOOOHOOO 😍

 

[ToldYouSo]

Wow, really interesting viewpoints. I feel that if advances in medical/biotech keep happening the differences in terms of age between a 20 & 40 yo have more to do with lifestyle than anything else. Regardless, the field benefits from people in all walks of life; besides aren't the older non-trads the best kind? (panda bear) XDD