Leaving medical school... (e.g. I should be studying)
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hey tough luck
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I am just frustrated that grad or professional schools (PT/ DDS/DMD/MD/DO/PharmD/OT/AuD/PA/OD) are taking advantage of the system and students.
Thanks for clarifying DermViser, the Duke program was always a mystery to me.
Yeah in that sense, I guess one could say they shortened pre-clinical years but kept program length about the same.
Now just out of curiosity, since it came up. If I understand your post correctly, and Duke does basic sciences year 1, clinicals year 2, and MPH and/or research year 3....is the 4th year just for electives/more research?
And is the 4th year optional for those who don't want to do more electives or continue their research? Or is it something they all must do?
I'm actually amazed they got basic sciences down to 1 year, my school just cut it down to 1.5 years for the MS1s and it was a bit chaotic. They shortened anatomy and biochem...but didn't change the amount of material or how it was taught, so many of the MS1s felt overwhelmed and rushed, kudos to Duke.
Yup, the 4th year is all electives so you would do audition electives (if you want) early on when the match cycle starts just like u would at any other school. I'm sure it is still hectic. You have to teach the same basic science material in 1 year (probably by removing redundancies and going even faster) while everyone else does it 1.5 - 2 years. 4th year is still mandatory at Duke: http://medschool.duke.edu/sites/medschool.duke.edu/files/pictures/Duke_Curriculum_7-29.pdf
I'm sure with Duke they've got it down cleanly to where things flow well in a year and all students going in know that they will be covering everything in 1 year. If your school just changed to a 1.5 yr. then there will be kinks still needing to be worked out. That being said, I could never do all of basic sciences in 1 year. That's just plain crazy bc the speed in a 1.5 - 2 year preclinical curriculum is already fast enough.
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not that i go to duke but i still feel clueless on a daily basis
I've heard the same thing with respect to their clerkship year and their function on the wards as an MS-2. It's not really surprising bc according to their curriculum plan, they take a “Clinical Skills Intensive” at the start of the second year which is supposed to lay the foundation for students’ clinical rotations and then they actually take the clinical skills course DURING their clinical clerkship year. I don't know anything about how all of their basic sciences in 1 year affect board scores. They can take USMLE Step 1 anytime during their "Scholarly Experience" year in MS-3 year.
That being said, I can't feel as sorry for them, bc all med students accepting Duke know that their school does all of basic sciences in a year. It would give me great pause as to whether I would be able to do so since every other medical school in the country does basic sciences in 1.5 or 2 years and there is good reason for that. From the standard 2 years, bringing it down to 1.5 years usually means redundancies have been removed (which can suck for some bc they like the repetition), bringing it down to 1 year means you removed redundancies and decided to go at even a faster pace. Way too much for me, and for almost no benefit.
I can't imagine doing the clinical years without a clinical skills course. I'm imaging much more standing around and doing nothing than usual. There has been much less hand holding than I expected and I'm really glad that I took time out during second year to go through UCSD's website for doing a history and physical
As if MS-3s clinical experience hasn't been watered down enough as it is -- now med students can't even write notes and have their resident/attending read their note, cosign, and maybe give them feedback. That's what is difficult for med students to understand early on. MS-3 isn't like the classroom at all in terms of learning and interns/residents definitely don't have time to reteach you something you should have learned and mastered in clinical skills like how to do an H&P, etc. Definitely no hand holding when it comes to the wards.
I agree - I absolutely loved that UCSD Physical Diagnosis website to make things very clear.
Wow they're really changing it up. I agree though, even with the kinks worked out, I'm trying to imagine covering all basic science in half the normal time and I can't get my head around it. They must have some very dedicated faculty to pull it off successfully like they're doing.
I think I'd prefer the standard curriculum my school does to this. Granted, I like that Duke is trying different things to see if they can make improvements to the standard medical curriculum. Maybe other schools can learn from the benefits and drawbacks of what Duke is doing and build on that.
I just think that MS-1/MS-2 is already stressful enough. The amount of information thrown at you and in such small time intervals is already bad enough and can cause such huge consequences on med students' mental health, with no benefit -- it's not like you can graduate 1 year earlier anyways. But instead of being introspective about it and taking that into consideration, Duke put the pedal to the metal and said let's make it even faster and do ALL of basic sciences in 1 year.
Duke does get to brag about how all their med students get to do 1 year of dedicated research in their specialty of choice, and more importantly, publish in journals, thus making Duke look good.
😆😆😆 --- so a med school version of "Show and Tell" from kindergarten.
I imagine the "I don't want to do research in my life" excuse from that applicant doesn't fly well when you went to a program that has this as an official part of its curriculum and you accepted that when you matriculated.
Oh, you raise a very good point. Though I mentioned it's good schools are trying new things for the sake of progress, I definitely agree the pedal to the metal attitude is harmful. Even at my school I saw a bit of it. They wanted to imitate the big name schools and jump on the bandwagon with added time consuming projects, PBLs, and condensed basic sciences. But, they did this without implementing the proper changes in the courses themselves and making the proper arrangements to fit these things in. The M1s definitely got overwhelmed, and in some cases might have hindered learning...and this is just on a 1.5 year curriculum.
So I absolutely agree, the 1 year thing sounds insane, and I don't think it's worth it for a "research" 4th year. I'd be curious to hear what a student in the Duke program has to say about their experience in it. I'm only speculating now, but it would be neat to hear how they feel about it.
Also, I hope I am wrong, and I'm not picking out any schools in particular, but in general I sometimes speculate that some schools do these curriculum changes more for their own benefit of "looking good to applicants" than the actual education and benefit of the students in the programs. Since both of us have experienced basic sciences, we know the reality. But to pre-meds applying, getting all the "boring" basic sciences done quickly and starting clinicals early sounds like a fantastic idea (I did too back when I applied), but once you're in it, you realize how impractical some of these changes can be.
I still think schools should try new things, but at a realistic and practical level. Otherwise, you're right, it can make a difficult time even harder.
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Oh, I completely agree. This is nothing more than a medical school arms race for getting the best applicants they can, esp. when they have to compete with top tier schools. Med schools aren't stupid. They know how to appeal to millenials and have done the admissions game for ages -- look at med schools now having Facebook pages, Twitter pages, putting their class shows on Youtube, etc. This isn't a coincidence. Same for recorded streaming video lectures, Pass/Fail grading, etc. you name it - these are to appeal to med students. The applicants that schools are fighting for and have a choice to go anywhere are the ones med schools are trying to convince with certain amenities. Having a full research year in MS-3 is one of those things.
A lot of the times you'll see what the admissions people value in students and what the actual med school faculty value in students are very different. There's a HUGE disconnect. Med schools themselves could care less and once you're in, you're relatively locked in. There's a reason med schools hate and put down SDN mainly bc it's pulling the curtain and revealing the true Wizard of Oz. 1.5 years is fine bc there are a lot of redundancies in a 2 year curriculum - which is fine if you like repetition. 1 year is ridiculous ESPECIALLY bc you don't get to graduate in 3 years.
OP - I have read some of what current med-students posted on your thread concerning your question. I didn't read it all. I won't give you a Kum-Ba-Yah approach to medicine. You have to love this job. You really have to love the bad positions you will be in with the opportunity to help people. The road toward attending sucks. It's not easy, or fun, and the job is difficult. It can be very rewarding - but those are pulsed doses.
I had a job prior to medical school also, a professional job working in the hospital laboratory. Most med-studs don't know that people working in the lab hold a 4-year degree and also need to pass a ridiculous test to get certified. I thought that test was way worse than Step II or III of the boards.
Anyway. There are definite areas of medicine which may appeal to you as an engineer and having an engineering brain. There is a great deal we don't know, and much of what is taught in medical school is anecdote and devoid of solid clinical data. If you desire concrete results based on certain treatment protocols with certain patient populations - we have specialties for that. We also have specialty areas with so much grey in them there is no concrete treatment for anything.
Engineers tend to be particular in their specialty selection, but if you are really unhappy in MS1 - get out. Pursue something else. Again, this isn't an easy job and so much depends on art with talking with patients, developing treatments etc. Unfortunately, we can't get a clear linear relationship with most disease processes - and so I could see that truth being very unsatisfying for a person who expects a mathematical calculation to always yield a constant result.
One can always volunteer, learn CPR, be a first responder, be a volunteer fireman, etc. If you dislike MS1, you are an MS1. If you question your place as an MS1, you need to clearly evaluate why you are there. Know yourself. How about seeing as many patients on the ward in a single day as you can? You have a med student badge. Go do H&P's on 20 patients. See what that brings out in you, see what you want to do with what they tell you.
People struggle with changing careers all the time. In medicine, saying you can't do it, then later trying to re-apply with a change in mind is usually not successful. MS have a low attrition rate for a reason. Get in or get out - don't short an alternative career if that's what you want! If you want medicine, go get it - but it will be hard, you will work for a long time at it, and you will never have an absolute answer. Do what's right for you and your family - but don't feel obligated.
This is a job. This job is hard. This job is mentally, physically difficult for physicians who do the right thing an care for their patients. YOU need to make the right choice for yourself and your patients in the future.
I had a job prior to medical school also, a professional job working in the hospital laboratory. Most med-studs don't know that people working in the lab hold a 4-year degree and also need to pass a ridiculous test to get certified. I thought that test was way worse than Step II or III of the boards.
Anyway. There are definite areas of medicine which may appeal to you as an engineer and having an engineering brain. There is a great deal we don't know, and much of what is taught in medical school is anecdote and devoid of solid clinical data. If you desire concrete results based on certain treatment protocols with certain patient populations - we have specialties for that. We also have specialty areas with so much grey in them there is no concrete treatment for anything.
Engineers tend to be particular in their specialty selection, but if you are really unhappy in MS1 - get out. Pursue something else. Again, this isn't an easy job and so much depends on art with talking with patients, developing treatments etc. Unfortunately, we can't get a clear linear relationship with most disease processes - and so I could see that truth being very unsatisfying for a person who expects a mathematical calculation to always yield a constant result.
One can always volunteer, learn CPR, be a first responder, be a volunteer fireman, etc. If you dislike MS1, you are an MS1. If you question your place as an MS1, you need to clearly evaluate why you are there. Know yourself. How about seeing as many patients on the ward in a single day as you can? You have a med student badge. Go do H&P's on 20 patients. See what that brings out in you, see what you want to do with what they tell you.
People struggle with changing careers all the time. In medicine, saying you can't do it, then later trying to re-apply with a change in mind is usually not successful. MS have a low attrition rate for a reason. Get in or get out - don't short an alternative career if that's what you want! If you want medicine, go get it - but it will be hard, you will work for a long time at it, and you will never have an absolute answer. Do what's right for you and your family - but don't feel obligated.
This is a job. This job is hard. This job is mentally, physically difficult for physicians who do the right thing an care for their patients. YOU need to make the right choice for yourself and your patients in the future.
Very true...and you're absolutely right about the disconnect between faculty and admissions. Most of our professors seem very unhappy with the changes that were made, I don't blame them either. A few courses were already taught very well and these changes got in the way of that to a degree, and it definitely made more work for the faculty, even though quality of teaching probably didn't improve much.
And for sure, for someone like me who has no intention of doing research, going through basic sciences at that pace and having the added stress just doesn't seem worth it for an extra year of research. Better route would probably be to make what Duke is doing, an optional track for students who choose they want an academic research career and know what they're getting into. But, let other students do 1.5 year curriculum.
It's a shame med schools are having to resort to these things, but at the end of the day I guess it comes down to applicants and money.
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Pistolpete.
It took me a long time to get to where I am today.
The hurdles are numerous and keep coming...moc...etc...
However, the flexibility and things you can do as an MD are awesome. You may like biomedical engineering/ ortho. You may be a med director at a large research institute to help gather more evidence for medicine. Heck, you may become a psychiatrist for medical students!
There's quite alot that an MD opens up for you.
Only you can make this decision.
It took me a long time to get to where I am today.
The hurdles are numerous and keep coming...moc...etc...
However, the flexibility and things you can do as an MD are awesome. You may like biomedical engineering/ ortho. You may be a med director at a large research institute to help gather more evidence for medicine. Heck, you may become a psychiatrist for medical students!
There's quite alot that an MD opens up for you.
Only you can make this decision.
D
deleted390966
How does NYU do it? Do they eliminate unnecessary rotations or what?
I'd prefer decreasing undergraduate years to 2 because med school teaches you all you need to know anyway. I feel that the stuff learned in undergrad is useless.
I think you miss the respect/admiration that you had when you were a working engineer. Now you are in medical school, working your ass off and are back at square one, toadying and fawning to professors and doctors.
Well, the good news is you don't have to give up being an engineer, you can bring that with you. Those that leave very technical fields like engineering or computer science often go into radiology because they like computing and evaluating on a screen. There is some overlap. The first two years are also those textbook years so they are the most challenging. Good luck.
Well, the good news is you don't have to give up being an engineer, you can bring that with you. Those that leave very technical fields like engineering or computer science often go into radiology because they like computing and evaluating on a screen. There is some overlap. The first two years are also those textbook years so they are the most challenging. Good luck.
Honestly, you can condense the first 2 years into a single year. The problem is that Step 1 tests you on so much useless garbage that cutting out that garbage puts your students at a massive disadvantage. However, for the practice of medicine, so much of what we learn in the first 2 years is worthless.
Biochem -> worthless. The only thing clinically relevant from biochem are the inborn errors of metabolism (which are caught on newborn screening anyways and can be learned in like 30 minutes). No one cares that you know sickle cell disease is a G->V mutation that results in hemoglobin aggregration when O2 tension is low. No one cares that you know that in beta-thalessemia, the mutation is in the promoter region, resulting in decreased expression of the beta-globulin gene. These concepts are more important for a scientist researcher, not a clinician.
Microbiology -> Most everything here could be condensed into "know your gram negatives, gram positives, what antibiotics cover what and the most likely organisms of infection for various conditions". For the vast majority of viruses, all you need to know is that we can do symptomatic support except for the few rare cases in which there is actual pharmacology intervention. Other than that, there'll never be a point where patient care will be influenced by the fact that RSV is an enveloped, negative sense ssRNA virus in the paramyxoviridae family. Once you nail this question on Step 1, no one other than a research virologist will care about this factoid.
Immunology -> same deal. Recognizing when immunodeficiency is a likely diagnosis is way more important than memorizing the stupid minute details about CDs on T/B cells or the steps in which antibody switching take place. There is far too much emphasis on memorization and not enough on understanding. For example, any idiot medical student can spout off "HOT T BONE STEAK". Less than 5% will actually be able to link that mnemonic to anemia of chronic disease. Immunology is a subject where you can get into the nitty gritty details and end up dumber for it.
Pathology -> Let me sum up pathology in a simple statement. Pathophysiology >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> pathology. Unless you plan on becoming a pathologist, the vast majority of pathology is just wasted space in your brain. Knowing how all the various nephrotic/nephritic diseases look under the electron microscope is worthless; I doubt this is even done in a pathologist's report. I had probably 10 questions on Step 1 that dealt with this though. Knowing the sequela and complications of diseases is extremely important but these details get lost in the minutia of pathology and everyone suffers as a result.
Pharm -> this is probably the 2nd most important class in the first 2 years. My only real gripe is that we spend too much time on drugs that haven't been used in 20 years.
If we cut out all the minutia/garbage, concentrated on actually developing clinical reasoning and understanding clinical management, we would train far better doctors in less time. There is so much mental masturbation disguised as important clinical pearls when in reality, it's mostly PhDs trying to stay remotely relevant in the healthcare education industry. No one wants to reexamine medical education because somehow designing a more efficient, more focused curriculum is "watering down medical education" when the truth of the matter is that medical education is a bloated mess at the moment with 90-9% of pre-clinical knowledge being useless in the practice of medicine and extremely important, relevant clinical knowledge being left out.
Biochem -> worthless. The only thing clinically relevant from biochem are the inborn errors of metabolism (which are caught on newborn screening anyways and can be learned in like 30 minutes). No one cares that you know sickle cell disease is a G->V mutation that results in hemoglobin aggregration when O2 tension is low. No one cares that you know that in beta-thalessemia, the mutation is in the promoter region, resulting in decreased expression of the beta-globulin gene. These concepts are more important for a scientist researcher, not a clinician.
Microbiology -> Most everything here could be condensed into "know your gram negatives, gram positives, what antibiotics cover what and the most likely organisms of infection for various conditions". For the vast majority of viruses, all you need to know is that we can do symptomatic support except for the few rare cases in which there is actual pharmacology intervention. Other than that, there'll never be a point where patient care will be influenced by the fact that RSV is an enveloped, negative sense ssRNA virus in the paramyxoviridae family. Once you nail this question on Step 1, no one other than a research virologist will care about this factoid.
Immunology -> same deal. Recognizing when immunodeficiency is a likely diagnosis is way more important than memorizing the stupid minute details about CDs on T/B cells or the steps in which antibody switching take place. There is far too much emphasis on memorization and not enough on understanding. For example, any idiot medical student can spout off "HOT T BONE STEAK". Less than 5% will actually be able to link that mnemonic to anemia of chronic disease. Immunology is a subject where you can get into the nitty gritty details and end up dumber for it.
Pathology -> Let me sum up pathology in a simple statement. Pathophysiology >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> pathology. Unless you plan on becoming a pathologist, the vast majority of pathology is just wasted space in your brain. Knowing how all the various nephrotic/nephritic diseases look under the electron microscope is worthless; I doubt this is even done in a pathologist's report. I had probably 10 questions on Step 1 that dealt with this though. Knowing the sequela and complications of diseases is extremely important but these details get lost in the minutia of pathology and everyone suffers as a result.
Pharm -> this is probably the 2nd most important class in the first 2 years. My only real gripe is that we spend too much time on drugs that haven't been used in 20 years.
If we cut out all the minutia/garbage, concentrated on actually developing clinical reasoning and understanding clinical management, we would train far better doctors in less time. There is so much mental masturbation disguised as important clinical pearls when in reality, it's mostly PhDs trying to stay remotely relevant in the healthcare education industry. No one wants to reexamine medical education because somehow designing a more efficient, more focused curriculum is "watering down medical education" when the truth of the matter is that medical education is a bloated mess at the moment with 90-9% of pre-clinical knowledge being useless in the practice of medicine and extremely important, relevant clinical knowledge being left out.
Preach
The way medical school should be: Teach disease. Presentation, how to ask the history, how to focus your exam and have people who can actually show you how to do the exam properly and what findings to look for, which tests to order for what indications (I've had a PA order a ct ab/pelvis on a guy with abdominal pain who was stable and had normal imaging the day before. Not surprisingly, test was negative). How to actually order tests. How to read and interpret cbcs, cmps, etc. Learn anatomy by looking at x-rays, cts, mris, ultrasounds instead of dead bodies that we splay open. Besides surgery, I've never looked at an open body. Normal levels of everything and when to get worried about a number. When to actually work things up and when to leave them be. How to monitor things like electrolytes and proper repletion to restore homeostasis
Most important: How to create a differential diagnosis by making a algorithm and use it effectively to narrow a diagnosis.
I had a lecture on hypokalemia recently by a nephrologist and I came into it thinking, hey hypokalemia just replete, ask about diuretics, family history of kidney disease, get a bmp with mg to look at ca and mg, check for addisons with a acth stim test if necessary. This guy went through a huge algorithm talking about the emergencies of hypokalemia and then broke down the rest of the differential with what he was thinking at each step and dividing it based on things like blood pressure, exam findings, etc. I was amazed at how much I just didn't know. There were so many things I knew and couldn't even begin to start working up
How medical school is actually taught - Ph.D.s that never saw a single patient in their life pontificate about the importance of elongation factor 2 in diphtheria. Once in a while, an MD will come by drop some useful clinical knowledge that you don't remember by the time it comes up again in one of your patients. This style of teaching is good for making stupid questions about little facts for multiple choice tests but horrible for actually seeing and working up patients. There's no wonder you need to do residency, a new medical student on the wards is completely useless in pretty much every single way. There's no one there to hold your hand because everyone is busy filling the EMR with crappy notes that no one is going to read.
The way medical school should be: Teach disease. Presentation, how to ask the history, how to focus your exam and have people who can actually show you how to do the exam properly and what findings to look for, which tests to order for what indications (I've had a PA order a ct ab/pelvis on a guy with abdominal pain who was stable and had normal imaging the day before. Not surprisingly, test was negative). How to actually order tests. How to read and interpret cbcs, cmps, etc. Learn anatomy by looking at x-rays, cts, mris, ultrasounds instead of dead bodies that we splay open. Besides surgery, I've never looked at an open body. Normal levels of everything and when to get worried about a number. When to actually work things up and when to leave them be. How to monitor things like electrolytes and proper repletion to restore homeostasis
Most important: How to create a differential diagnosis by making a algorithm and use it effectively to narrow a diagnosis.
I had a lecture on hypokalemia recently by a nephrologist and I came into it thinking, hey hypokalemia just replete, ask about diuretics, family history of kidney disease, get a bmp with mg to look at ca and mg, check for addisons with a acth stim test if necessary. This guy went through a huge algorithm talking about the emergencies of hypokalemia and then broke down the rest of the differential with what he was thinking at each step and dividing it based on things like blood pressure, exam findings, etc. I was amazed at how much I just didn't know. There were so many things I knew and couldn't even begin to start working up
How medical school is actually taught - Ph.D.s that never saw a single patient in their life pontificate about the importance of elongation factor 2 in diphtheria. Once in a while, an MD will come by drop some useful clinical knowledge that you don't remember by the time it comes up again in one of your patients. This style of teaching is good for making stupid questions about little facts for multiple choice tests but horrible for actually seeing and working up patients. There's no wonder you need to do residency, a new medical student on the wards is completely useless in pretty much every single way. There's no one there to hold your hand because everyone is busy filling the EMR with crappy notes that no one is going to read.
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How does NYU do it? Do they eliminate unnecessary rotations or what?
I'd prefer decreasing undergraduate years to 2 because med school teaches you all you need to know anyway. I feel that the stuff learned in undergrad is useless.
Funny you should say this:
http://jama.jamanetwork.com/article.aspx?articleid=1853148 (he was a recent 4th year who had recently matched into Derm, so obviously he could get this off his chest now) but it was in response to this: http://jama.jamanetwork.com/article.aspx?articleid=1787417
The NBME's response: http://jama.jamanetwork.com/article.aspx?articleid=1853154
Thanks for all the replies. The statement about feeling out of place/questioning the career vs simple frustration as a med student really hit home. Still not sure about the decision making process, but it will be good to have a break in a few weeks.
I also think med school neglect classes that I think are important for physician.. For instance, a class like biostats is not supposed to be taught in 8 hours. That is what my school did; they cover biostats in 8 hours and they gave us a weekend to study and then they said come back on monday to take the exam. Someone like me who never took a stats class just crammed and passed the damn thing without even processing what I was learning...
Biostats is a class that my school probably said: 'Let's get it out of the way'
Biostats is a class that my school probably said: 'Let's get it out of the way'
You always pick such sad and lonely avatars. Why?
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Because they're hilarious.
I guess you are correct since my anatomy class is a 3-month class...
To the OP, I hope you can find some peace either staying in medicine or going a different route. It's hard for anyone to say what the right move is for you. Medical school is different than practice, and both seem to be changing a lot right now. It's like trying to hit a moving target. When I finally decided to do this med school thing I dived in head first and committed to see it through.
On a separate note, how many of you would voluntarily attend a program where you didn't have an M1 or M2 year? Instead you studied on your own for step 1, took the test, if you did well then you could attend an intense month course on the physical exam, and if you passed then you'd be eligible for clinical years. Bold? Yes. Crazy? Yes. Shorter and cheaper? Yes.
On a separate note, how many of you would voluntarily attend a program where you didn't have an M1 or M2 year? Instead you studied on your own for step 1, took the test, if you did well then you could attend an intense month course on the physical exam, and if you passed then you'd be eligible for clinical years. Bold? Yes. Crazy? Yes. Shorter and cheaper? Yes.
It would probably be best to reach a decision before you take out loans for the spring semester, just saying.
It's not an issue TBH, but my problem is that even med students in SDN fall into the trap of thinking like med school administrators -- i.e saying in subtle way if it's been like that for many years, maybe it's the way it's supposed to be done. I know the system produces good physicians, but no one will convince me that the system is efficient the way it is and you can not educate a PCP in 8 years (2-year prereqs, 3-year med and 3-year residency) and have the same result...
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It's clear that the process can be done more efficiently. However, we have a completely screwed up market where the standard forces of supply/demand and consumer/producer relationships are all out of whack. LCME, the AMA, current Physicians, and all of us (assuming we get MD's) are highly incentivized to keep the system the way it is.
Eventually we will have to move away from the current system, but it will take a lot of time. Right now it generates a ton of money for a lot people and the root consumers (trainees/us and patients/sick people) cannot decide when or how to consume the service.
If you want to be a doctor you have to take Step 1, which means the schools have to teach you a certain way and you have to go to a standard med school. They have no incentive to adjust their practices given the hordes of people trying to get in. So even though Med Students are paying huge sums of money for a service (the MD), the system can continue treating them poorly without compromising demand. Same deal with patients. The free market is a powerful system, but only when it works.
My guess is the change will only come when us graduates (who are handing future earnings potential to schools/federal government via debt) reach a barrier with earnings. Eventually the ~6M lifetime earnings of a physician will approach the lifetime debt payback for low earning specialties. Then the system will have to change (cut a year to be more efficient most likely).
Eventually we will have to move away from the current system, but it will take a lot of time. Right now it generates a ton of money for a lot people and the root consumers (trainees/us and patients/sick people) cannot decide when or how to consume the service.
If you want to be a doctor you have to take Step 1, which means the schools have to teach you a certain way and you have to go to a standard med school. They have no incentive to adjust their practices given the hordes of people trying to get in. So even though Med Students are paying huge sums of money for a service (the MD), the system can continue treating them poorly without compromising demand. Same deal with patients. The free market is a powerful system, but only when it works.
My guess is the change will only come when us graduates (who are handing future earnings potential to schools/federal government via debt) reach a barrier with earnings. Eventually the ~6M lifetime earnings of a physician will approach the lifetime debt payback for low earning specialties. Then the system will have to change (cut a year to be more efficient most likely).
Maybe the op needs some 420 to chillax
Not sure if OP still follows this, but I've come to the realization that the alternatives are not as good, even in Engineering. The likelihood your salary will go down or you be replaced by H1B visas or automation are much higher in other sectors like Engineering, finance and accounting then in healthcare. Finishing medical school and becoming a physician is still a great decision if you can see yourself enjoying it at least half the time.
OP is out. Had another thread in which he stated he's done.
The same could be said of physicians and midlevels in the near future. We're rapidly being viewed as superfluous expenses that are far too overqualified for what we do. Don't go into medicine because it's a secure job. Go into it because you enjoy it, it you will hate every moment of the rest of your career.
+1. One example, if you stop by the Kaiser Permenante hospital in San Jose/Santa Teresa, you'll notice a lot of physicians (particularly IM and FM) are Chinese/South Indian immigrant physicians. I am in no way to question whether they do a good work on their job but the large number of immigrant physicians shows that hospitals are willing to take foreign physicians.
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So... just b/c someone is an immigrant physician if they are working here they did a residency here and are probably completely qualified to practice.
I went on rounds with my PI last week and the ortho attending leading rounds was foreign.
Also, it is very offensive to put down Chinese/South Indian physicians like you did in your comment. Chinese/South Indian are definitely over represented in medicine in terms of minorities but that has no relevance to a person's ability to practice.
I'm curious to know where did I put down Chinese/South Indian physicians in my post. I used the Kaiser hospital example because there are a lot of Chinese/South Indian physicians there, not that I have a problem with it.
fyi, I'm South Asian. I know a lot of Indian physicians who are good at their job.
I suppose I can comment now on what it’s been like so far to have left medical school. Enlightening, it has been — yes, it has. I will say only a few things here, the first of which is that most of what has happened to me has been absolutely appalling.
I also must say that I am an extremely intelligent human being. It is an absurdity that because I have chosen to leave medical school as it is known in this beautiful country of ours (with the sights and the stars) that I am apparently now a total and utter vagabond.
I am willing to work and to continue exceeding boundaries but I am still unemployed, being offered opportunities that have been somewhat insulting to my intelligence. I am not meaning to insult any other profession, but I am worthy of more than a $25,000/year salary.
That said, I have never been physically healthier. My hair is growing back, after having fallen out in some sort of eflluvium post-dropout, and the severe nodulocystic acne that I was experiencing seems to have come to a screeching halt. Knock-on-wood.
I have ceased all prescribed pharmaceuticals aside from Escitalopram 20mg daily, which gives an additional benefit of helping to keep my OCD (and likely PTSD) at bay. I am still seeing my psychiatrist twice a month to ensure that I am in reality, and I finally got the chance to handle a worsening high-grade HPV situation that I had developing in my cervix along with the biopsy of a suspicious mole that had been growing for years. Ironic, that I would have had to leave the medical profession to fully ascertain the security of these vital issues. My OBGYN explained that had I not undergone the LEEP procedure (which I had no time to even consider during medical school), that I would have had cervical carcinoma in 10 years from now — and I pictured myself in my white coat, wheeling myself into chemo before my shift at the hospital.
So yes, I am unemployed. But I am healthy, again, and I will stay alive.
I also must say that I am an extremely intelligent human being. It is an absurdity that because I have chosen to leave medical school as it is known in this beautiful country of ours (with the sights and the stars) that I am apparently now a total and utter vagabond.
I am willing to work and to continue exceeding boundaries but I am still unemployed, being offered opportunities that have been somewhat insulting to my intelligence. I am not meaning to insult any other profession, but I am worthy of more than a $25,000/year salary.
That said, I have never been physically healthier. My hair is growing back, after having fallen out in some sort of eflluvium post-dropout, and the severe nodulocystic acne that I was experiencing seems to have come to a screeching halt. Knock-on-wood.
I have ceased all prescribed pharmaceuticals aside from Escitalopram 20mg daily, which gives an additional benefit of helping to keep my OCD (and likely PTSD) at bay. I am still seeing my psychiatrist twice a month to ensure that I am in reality, and I finally got the chance to handle a worsening high-grade HPV situation that I had developing in my cervix along with the biopsy of a suspicious mole that had been growing for years. Ironic, that I would have had to leave the medical profession to fully ascertain the security of these vital issues. My OBGYN explained that had I not undergone the LEEP procedure (which I had no time to even consider during medical school), that I would have had cervical carcinoma in 10 years from now — and I pictured myself in my white coat, wheeling myself into chemo before my shift at the hospital.
So yes, I am unemployed. But I am healthy, again, and I will stay alive.
I'm not sure that zero is more than 25,000
You're way too early in your career to be jaded. You should seriously reconsider before taking out another loan. I just finished residency in my early 30s and have landed a salary >400K and am still occasionally questioning if this was the right career move. Mind you I have one of the few jobs in medicine that's 8-5, M-F and is incredibly competitive to get into (ie radonc).
