Med School admissions is getting too competitive.

[Lucca]

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Loan forgiveness is in no way equivalent to a competitive salary. They need to actually be paid more, with actual cash, not expiring fringe benefits.

Sure, I'm not saying that there shouldnt be financial incentives for practicing in underserved areas. There definitely should be. I'm just not sure these will be enough to actually fix the problem. It might draw more people in but I still feel, ultimately, people will flock to the metropolitan, specialized positions they have been historically flocking to anyways in spite of existing or past incentives.

 

[Lucca]

Even if it paid equivalently wouldn't there still be a huge preference (for culture and family reasons) to practice in nice areas of cities, not ghettos or rural areas?

This is precisely what is observed. If we admit for factors that correlate strongly with social class (academics, testing) then were going to keep getting the same results. There should be mechanisms in place to attract and retain the people most likely to actually be a part of an underserved community. I'm not saying build separate medical schools were poor people train to take care of other poor people but perhaps a different, accelerated pathway with a commitment component that allows people passionate about this specific type of disparity (many students majoring in social work or anthropology across the nation, as an example) to actually be a part of the solution even though they might not be as academically inclined as their peers.

 

[Mad Jack]

The aca makes it harder because of all the extra service coordination and tracking docs are being pushed to do, they simply can't do it as a single doc shop in most cases.

The job of the nhsc is to get doctors to those places, it is not the job of medical schools to get doctors to those places. Medical school's role is to train the most competant doctor's possible before they go to residency. Where I end up living is none of my school's concern (note: I actually want to be rural)

It actually is of the school's concern. Many schools are given grants by the state they operate within, with the grant being provided in exchange for part of the school's mission to be selecting candidates that will serve the underserved within that state. Even those that do not get grants often have mission statements in regard to serving the underserved, and it is their right to select candidates that they feel will best meet the mission that the school believes to be its societal obligation.

 

[RustBeltOnc]

Even if it paid equivalently wouldn't there still be a huge preference (for culture and family reasons) to practice in nice areas of cities, not ghettos or rural areas?

Not necessarily. Furthermore, it's not "just about the money" with respect to recruiting a doc to an out of the way area. Breaks down like this:

1) Most docs want to be needed. Hence, there is inherent appeal to a bona fide under-served area.

2) However, if an out of the way area isn't truly under-served, the doc could be in a pickle: you could be twiddling your thumbs in an area without a lot of of other job opportunities for self/family.

3) As I stated above, patients in these areas aren't always clamoring for medical services, even if some stats demonstrate the area needs specialist X. Hustling for patients that don't want to be patients is painful.

Thus, the money needs to be good for docs to take a risk.

 

[Nietzschelover]

10 years of 65-80k vs the remaining 35 years of low 100s instead 350-400+ if you go for the high paying specialties...you do the math. With the average debt as an MD grad, you more than make up the difference as something like an ortho. If certainty of a high income throughout second half of your life is your primary motivation it's the clear winner

And how do you know a new grad starting at 70K 15-25 years later is only going to be in the low 100s?

 

[Lucca]

Not necessarily. Furthermore, it's not "just about the money" with respect to recruiting a doc to an out of the way area. Breaks down like this:

1) Most docs want to be needed. Hence, there is inherent appeal to a bona fide under-served area.

2) However, if an out of the way area isn't truly under-served, the doc could be in a pickle: you could be twiddling your thumbs in an area without a lot of of other job opportunities for self/family.

3) As I stated above, patients in these areas aren't always clamoring for medical services, even if some stats demonstrate the area needs specialist X. Hustling for patients that don't want to be patients is painful.

Thus, the money needs to be good for docs to take a risk.

I agree with the conclusion and 1 and 2 but I think I'll need some help being convinced of 3. I disagree with the premise. I think if people need care and aren't getting it they either A) don't have access to the care B) dont understand why they need the care or C) dont like or have the ability to use existing services because of non-geographic access barriers. I dont think people just sit around thinking "I just want to keep being sick"

 

[Mad Jack]

10 years of 65-80k vs the remaining 35 years of low 100s instead 350-400+ if you go for the high paying specialties...you do the math. With the average debt as an MD grad, you more than make up the difference as something like an ortho. If certainty of a high income throughout second half of your life is your primary motivation it's the clear winner

The majority of residents do not end up in high paying specialties. If you're coming out of a top school, that's one thing, but mid-tier and lower, there's a good chance you'll float in the 200-250k range.

 

[mw18]

I'm not sure I understand the logic in OP's arguments.

It was easier 50 years ago. It was also easier to become President 230 years ago, too, but nobody owes me the presidency. The issue with medical school admissions is that the schools aren't creating a floor for admissions, the market is. It's without reason to say the standards are impossible, when your peers are the one's creating the standards. If med schools said it takes a 4.0/42+ equivalent, and they each took one or two students a year, they would owe society, not anyone individually, to be more inclusive. But, as it stands, they owe society to take the people that they feel will make the best doctors. They way they've gone about that is with the admissions system the way it is. It's not perfect, but they're accepting who they think is the best of the pool. Along with children and grandchildren of big donors, I would imagine.

I will agree that the system doesn't do enough to incorporate those of different backgrounds and socioeconomic status before they get to the application stage (and probably even after).

 

[RustBeltOnc]

I agree with the conclusion and 1 and 2 but I think I'll need some help being convinced of 3. I disagree with the premise. I think if people need care and aren't getting it they either A) don't have access to the care B) dont understand why they need the care or C) dont like or have the ability to use existing services because of non-geographic access barriers. I dont think people just sit around thinking "I just want to keep being sick"

All true. And yet, as a doc you are limited in what you can do about B) and C).

 

[Mad Jack]

Even if it paid equivalently wouldn't there still be a huge preference (for culture and family reasons) to practice in nice areas of cities, not ghettos or rural areas?

I prefer rural myself, and I'd even take a pay cut to do so. I grew up in a rural county. It's not hard to find candidates willing to work in these areas, just select for people that aren't into the big city life.

 

[Lucca]

All true. And yet, as a doc you are limited in what you can do about B) and C).

Sure, but I think it's unfair to say that people dont want to be patients. It might be a problem doctors are not able or equipped to address but I think saying things like that runs the risk of leading people to empathize too much with the physician and not enough with the patient.

 

[RustBeltOnc]

I'm not sure I understand the logic in OP's arguments.

It was easier 50 years ago. It was also easier to become President 230 years ago, too, but nobody owes me the presidency. The issue with medical school admissions is that the schools aren't creating a floor for admissions, the market is. .

Truth.
But, OP can look on the bright side: there are more medical schools.

And a good coping mechanism is to pretend you are actually competing for the Rhodes. 🙂

 

[Nietzschelover]

200K in rural WV or KY might beat 600K in Philly, NYC, or Boston.

 

[RustBeltOnc]

I prefer rural myself, and I'd even take a pay cut to do so. I grew up in a rural county. It's not hard to find candidates willing to work in these areas, just select for people that aren't into the big city life.

There are many people like that. Includes me. But you don't agree to less pay unless you know for certain there is awesome job security and real, rewarding work.

 

[RustBeltOnc]

200K in rural WV or KY might beat 600K in Philly, NYC, or Boston.

No! No, no, no. And this is "rustbeltonc".

The rural wv or ky job has you super vulnerable to the vicissitudes of a handful of wack admins.

 

[RustBeltOnc]

Sure, but I think it's unfair to say that people dont want to be patients. It might be a problem doctors are not able or equipped to address but I think saying things like that runs the risk of leading people to empathize too much with the physician and not enough with the patient.

Trust me, no one wants to be an oncologist's patient.

 

[Nietzschelover]

I'm not sure I understand the logic in OP's arguments.

It was easier 50 years ago. It was also easier to become President 230 years ago, too, but nobody owes me the presidency. The issue with medical school admissions is that the schools aren't creating a floor for admissions, the market is. It's without reason to say the standards are impossible, when your peers are the one's creating the standards. If med schools said it takes a 4.0/42+ equivalent, and they each took one or two students a year, they would owe society, not anyone individually, to be more inclusive. But, as it stands, they owe society to take the people that they feel will make the best doctors. They way they've gone about that is with the admissions system the way it is. It's not perfect, but they're accepting who they think is the best of the pool. Along with children and grandchildren of big donors, I would imagine.

I will agree that the system doesn't do enough to incorporate those of different backgrounds and socioeconomic status before they get to the application stage (and probably even after).

Put "fairness" aside. A question is whether med schools (and society at large) are missing out on some portion of candidates who would be better physicians by demanding more accomplishment (more box-checking?) across multiple dimensions and thereby ironically creating (and getting) even more tunnel-vision and one-dimensional acceptees. Perhaps this happens hardly at all, which would be good. But I wouldn't be surprised if some of ultra-applicants with who have hit all of the targets (GPA, MCAT, ECs)... and especially if they have wildly exceeded the targets...are in fact not necessarily the ones who will make for the best physicians in real life.

 

[RustBeltOnc]

Put "fairness" aside. A question is whether med schools (and society at large) are missing out on some portion of candidates who would be better physicians by demanding more accomplishment (more box-checking?) across multiple dimensions and thereby ironically creating (and getting) even more tunnel-vision and one-dimensional acceptees. Perhaps this happens hardly at all, which would be good. But I wouldn't be surprised if some of ultra-applicants with who have hit all of the targets (GPA, MCAT, ECs)... and especially if they have wildly exceeded the targets...are in fact not necessarily the ones who will make for the best physicians in real life.

Nietzschelover --

As stated above, my coping mechanism was to pretend it was the Rhodes I sought. That was decades ago. Others in my UG employed a similar strategy.

All are high-functioning, job-satisfied (not always happy people).

 

[Nietzschelover]

No! No, no, no. And this is "rustbeltonc".

The rural wv or ky job has you super vulnerable to the vicissitudes of a handful of wack admins.

Are you saying they can't make 200K.....and have a 5 bedroom, 3.5 baths home for 250-300K that would cost 5 million + in those cities?

 

[mw18]

Put "fairness" aside. A question is whether med schools (and society at large) are missing out on some portion of candidates who would be better physicians by demanding more accomplishment (more box-checking?) across multiple dimensions and thereby ironically creating (and getting) even more tunnel-vision and one-dimensional acceptees. Perhaps this happens hardly at all, which would be good. But I wouldn't be surprised if some of ultra-applicants with who have hit all of the targets (GPA, MCAT, ECs)... and especially if they have wildly exceeded the targets...are in fact not necessarily the ones who will make for the best physicians in real life.

Oh, no, I absolutely think that there is a very good chance some very good potential doctors slip through the cracks. My argument is that it's not the schools, necessarily, but the volume of candidates who make the process so competitive. Could and should the system be tweaked? If it can for the better, then it should. But with any system there will be those that sneak through the cracks.

But, if you agree that an aptitude for the sciences is a requirement, and a level of intelligence (mcat is an iq test that you have to have a ton of knowledge and strategy to even take on the right plane), then the rest of the requirements should be about willingness to work hard. You can get solid EC's if you're willing to put the time in and have the discipline to want to differentiate yourself. IF we're putting SES and fairness aside.

 

[Nietzschelover]

Nietzschelover --

As stated above, my coping mechanism was to pretend it was the Rhodes I sought. That was decades ago. Others in my UG employed a similar strategy.

All are high-functioning, job-satisfied (not always happy people).

So you're saying that even then you used what might be termed a very linear approach? And now an even more intense linear-oriented approach is required? How does that make for a truly well-rounded candidate as opposed to a resume-***** kind of candidate?

And did you get the Rhodes?!

 

[RustBeltOnc]

Are you saying they can't make 200K.....and have a 5 bedroom, 3.5 baths home for 250-300K that would cost 5 million + in those cities?

My concern is, you are in a remote area with only one hospital system and subject to all sort of shenanigans by admins, and aren't able to easily change jobs. 200K a year isnt enough to sell that vulnerability to spouses, family, etc.

 

[RustBeltOnc]

So you're saying that even then you used what might be termed a very linear approach? And now an even more intense linear-oriented approach is required? How does that make for a truly well-rounded candidate as opposed to a resume-***** kind of candidate?

And did you get the Rhodes?!

So, medical school admissions merely mirror life. Not losing sleep over that one!

I didn't apply. MD applications were enough. I didn't have enough spiritual / emotional energy left.

 

[Nietzschelover]

Oh, no, I absolutely think that there is a very good chance some very good potential doctors slip through the cracks. My argument is that it's not the schools, necessarily, but the volume of candidates who make the process so competitive. Could and should the system be tweaked? If it can for the better, then it should. But with any system there will be those that sneak through the cracks.

But, if you agree that an aptitude for the sciences is a requirement, and a level of intelligence (mcat is an iq test that you have to have a ton of knowledge and strategy to even take on the right plane), then the rest of the requirements should be about willingness to work hard. You can get solid EC's if you're willing to put the time in and have the discipline to want to differentiate yourself. IF we're putting SES and fairness aside.

I guess my point is that if the necessary targets keep moving up and up, there are superlative human beings in the 3.7 to 3.75 category who are going to be on the outside looking in. Perhaps they approached college the way I think most should approach college (my bias) and from day one didn't gun for the 3.95 and living life solely for the purpose of developing the "best" med school app on paper.

 

[mw18]

I guess my point is that if the necessary targets keep moving up and up, there are superlative human beings in the 3.7 to 3.75 category who are going to be on the outside looking in. Perhaps they approached college the way I think most should approach college (my bias) and from day one didn't gun for the 3.95 and living life solely for the purpose of developing the "best" med school app on paper.

Yeah, if the schools are really blind to that fact. I think it definitely can happen, and I'm not the rule here; but I have a 3.75 and there were undoubtedly 118 students that applied to Hopkins with a 4.0. Probably several thousand with a gpa higher than mine. That being said, there were, without question, truly better applicants who applied there and didn't get in. There is some randomness involved, but also other factors being considered.

 

[FindMeOnTheLinks]

So you're saying that even then you used what might be termed a very linear approach? And now an even more intense linear-oriented approach is required? How does that make for a truly well-rounded candidate as opposed to a resume-***** kind of candidate?

And did you get the Rhodes?!

You might see these candidates who have an "intense linear protected approach" but that doesn't mean they are the norm. I would argue they are the outlier. In my experience, most of my classmates and many applicants I met on the interview trail seemed to be extremely well-rounded. Furthermore some schools prefer to have a well-rounded class as a whole rather than having an entire class made up of well-rounded individuals. This promotes diversity - everyone is different and pursues their own passions (while at the same time engaging in other activities that most consider essential for admissions). I would argue that expecting applicants to engage in a wider variety of activities to make them more "well-rounded" would actually be a regressive approach. Prospective physicians should be passionate and should pursue their passions deeply rather than spreading out their initiative over a variety of arbitrary activities.

 

[efle]

And how do you know a new grad starting at 70K 15-25 years later is only going to be in the low 100s?

Going by the data. Even a smart, hardworking individual could not absolutely bank on doing better than low 100s with their bachelors without some good luck/timing/connections involved.

The majority of residents do not end up in high paying specialties. If you're coming out of a top school, that's one thing, but mid-tier and lower, there's a good chance you'll float in the 200-250k range.

for these type of discussions (premed vs engineer, or comparing specialties etc) you have to assume people are capable of whatever can be guaranteed through ability and hard work. If we want to be realistic, any high schooler asking these sorts of questions would have to be told they likely wouldn't make it into med school at all

 

[Psai]

there is no doctor shortage

 

[deleted480308]

It actually is of the school's concern. Many schools are given grants by the state they operate within, with the grant being provided in exchange for part of the school's mission to be selecting candidates that will serve the underserved within that state. Even those that do not get grants often have mission statements in regard to serving the underserved, and it is their right to select candidates that they feel will best meet the mission that the school believes to be its societal obligation.

I'm not saying they can't legally. I'm saying they shouldn't

 

[RustBeltOnc]

there is no doctor shortage

more truth.

 

[Mad Jack]

Going by the data. Even a smart, hardworking individual could not absolutely bank on doing better than low 100s with their bachelors without some good luck/timing/connections involved.


for these type of discussions (premed vs engineer, or comparing specialties etc) you have to assume people are capable of whatever can be guaranteed through ability and hard work. If we want to be realistic, any high schooler asking these sorts of questions would have to be told they likely wouldn't make it into med school at all

I prefer to use profession averages myself. The average medical student versus the average engineer in a given field. The average petroleum engineer makes $132,320, the average chemical engineer makes $94,350, the average electrical engineer makes $91,410, the average aerospace engineer makes $103,720, the average computer engineer makes $100,920, etc, etc. The average engineer is basically pulling low six figures. The average non-specialist clocks in at around 200k. Sure, the top 10% of petroleum engineers earn just shy of $190,000, on average, and the highest compensated specialists outside of niche fields like neurosurgery (orthopedic surgeons) in medicine make an average of $420,000 a year, but the vast majority of people will end up somewhere in the average range of the bell curve. 90 times out of 100, you're not special within your field, because everyone around you is often equally (or more) talented as you are, hence the sudden shock many medical students feel of suddenly being average or below average when they hit medical school. Plan for the worst, hope for the best, and you'll never be disappointed. If you plan for the best, hope for the best, and oversell your abilities, the vast majority of the time it will result in failure. Cautious optimism is my personal way of looking at things.

 

[WingedOx]

If he dropped out as an M1 though doesn't that indicate problems with the academics more than being unfulfilled by patients?

Dermviser's old signature comes to mind, the quote talking about how everyone comes in ready to change the world and sacrifice, and then ends up resenting patients and praying for the lifestyle specialty match

There's a reason why MS4s going into Derm always seem dead on the inside.

 

[WingedOx]

The only answer is to pay them more. They will not move there en masse without it

That or other "forced" incentives. IE, "you'll have to pay this scholarship back if you don't work 5 years in designated underserved areas".

I have lots of thoughts on what can derisively be called "rural affirmative action" but alas, I'll save that for later if this thread is still around. Time to run errands!

edit: though it seems like you've covered a decent amount on that.

 

[Mad Jack]

I'm not saying they can't legally. I'm saying they shouldn't

Medicine isn't merely a throwaway service to be provided, it's a necessity for survival. Schools have an obligation to do their best to ensure that that service is available to as many people as possible, as medicine is, at its core, a noble profession with great responsibilities to society that come along with the great rights we are given. Hence, schools must select people that will maintain those responsibilities and the nobility of the profession.

Once medicine becomes truly "just a job," it is basically screwed, as happened in Russia, where being a physician is viewed as not only just a job, but a lowly endeavor that is completely without nobility or prestige.

 

[Nietzschelover]

You might see these candidates who have an "intense linear protected approach" but that doesn't mean they are the norm. I would argue they are the outlier. In my experience, most of my classmates and many applicants I met on the interview trail seemed to be extremely well-rounded. Furthermore some schools prefer to have a well-rounded class as a whole rather than having an entire class made up of well-rounded individuals. This promotes diversity - everyone is different and pursues their own passions (while at the same time engaging in other activities that most consider essential for admissions). I would argue that expecting applicants to engage in a wider variety of activities to make them more "well-rounded" would actually be a regressive approach. Prospective physicians should be passionate and should pursue their passions deeply rather than spreading out their initiative over a variety of arbitrary activities.

I would agree, but I think that is exactly what candidates are being expected to do.

 

[WingedOx]

Medicine isn't merely a throwaway service to be provided, it's a necessity for survival. Schools have an obligation to do their best to ensure that that service is available to as many people as possible, as medicine is, at its core, a noble profession with great responsibilities to society that come along with the great rights we are given. Hence, schools must select people that will maintain those responsibilities and the nobility of the profession.

Once medicine becomes truly "just a job," it is basically screwed, as happened in Russia, where being a physician is viewed as not only just a job, but a lowly endeavor that is completely without nobility or prestige.

Yup. Consider a school like Michigan State, which has had a rural focus for years. I had a lot of Michigan-based classmates at my undergrad and the ones who got interviews there and the ones who didn't were almost totally random in regard to MCAT and GPA. However, it was pretty obvious the people getting looks were the ones whose ECs etc showed a focus on rural service. Today most of them are working in primary care settings in the state

Like it or not, not having available medical services has inherent costs to the state as well. (Penny wise and pound stupid decisions about mental health in Chicago is a wonderful example of this lately, sadly).

 

[WingedOx]

I would agree, but I think that is exactly what candidates are being expected to do.

I'd like you to prove you have a life outside of medicine. It's a sign of reasonable mental health. A burnt out physician isn't doing anyone any good.

 

[Psai]

There's a reason why MS4s going into Derm always seem dead on the inside.

i dunno man, a lot of them seem to be pretty, stylish women

 

[Doudline]

there is no doctor shortage

Yes there is.

Supply < demand. That's the sole definition of a shortage. The motivations of physicians NOT to work has nothing to do with it.

 

[efle]

Yes there is.

Supply > demand. That's the sole definition of a shortage. The motivations of physicians NOT to work has nothing to do with it.

That's the definition of a surplus...

 

[Doudline]

That's the definition of a surplus...

Oops yes that was a typo. Corrected.

 

[efle]

Oops yes that was a typo. Corrected.

I think what they're criticising is the blanket terminology "doctor shortage" which implies something very different than "few doctors are seeking the low paying / remote / bad area jobs where there is great need of them". That's the shortage.

 

[Doudline]

I think what they're criticising is the blanket terminology "doctor shortage" which implies something very different than "few doctors are seeking the low paying / remote / bad area jobs where there is great need of them". That's the shortage.

Sure. But they're often sweeping the problem under the rug simultaneously, as if it were going to fix itself. If physicians do not want to live/practice in remote areas, they won't either in 10 years or 30 years.

We have to either: A. force them; b. incentivize them; c. bring more physicians in, hoping that the increased competition will drive down salaries and employment in big areas and produce an exodus.

A can't happen. B we've tried with money -lots of it- and it hasn't worked, not under the current form anyway.

What choice do we have then? Throw even more incentive money, or open the doors to more physicians.
This second option might prove to be cheaper than the first.

 

[Spector1]

We should just do it like they do in Asia (S. Korea, Taiwan etc) where students just go to medical school out of high school instead of having to go through pointless undergrad. It would be way more efficient and we could train more docs

Source: http://askakorean.blogspot.com/2015/03/so-how-do-you-become-doctor-in-korea-if.html

 

[Goro]

Yup! Nothing like gold old Millennial entitlement in the AM.

How does you having it harder mean they owe you anything? Times were different and things change. They don't owe you the exact world they were educated in lol.

 

[medic86]

We should just do it like they do in Asia (S. Korea, Taiwan etc) where students just go to medical school out of high school instead of having to go through pointless undergrad. It would be way more efficient and we could train more docs

Source: http://askakorean.blogspot.com/2015/03/so-how-do-you-become-doctor-in-korea-if.html

This one was enlightening:

http://askakorean.blogspot.com/2015/02/youre-not-going-to-be-doctor-in-korea.html

Having to score perfectly on an exam like that? Ew.

 

[Pacna]

We should just do it like they do in Asia (S. Korea, Taiwan etc) where students just go to medical school out of high school instead of having to go through pointless undergrad. It would be way more efficient and we could train more docs

Source: http://askakorean.blogspot.com/2015/03/so-how-do-you-become-doctor-in-korea-if.html

Agreed.

Unfortunately, the US government is enabling universities to require 4-year degrees by funding undergrad degrees. As many (most?) medical schools are associated with universities, taking applications from people who used free, online resources to meet pre-reqs would remove much of the incentive to attend college for our crowd and thus deny universities revenue. It's tough to get people to act against their own self-interest. (The AMA promoting a fictional doctor shortage is one example.)

Perhaps we could make the transition by implementing policies like you suggest which don't reduce the overall cost to the student at first.

Also, it's just a drastic change, and the US isn't good at that. We still haven't switched to the metric system FFS!

 

[RustBeltOnc]

Sure. But they're often sweeping the problem under the rug simultaneously, as if it were going to fix itself. If physicians do not want to live/practice in remote areas, they won't either in 10 years or 30 years.

A can't happen. B we've tried with money -lots of it- and it hasn't worked, not under the current form anyway.

When you start your job search you will see the bolded above isn't true.

As stated above, MD reluctance to go to rural areas is in fact multi factorial. One thing that could help: some sort of efficient, evidence-based estimate of the real need for health care services, made independent of administrators. Also, if you are in a remote area with one hospital system, you need to know the admins aren't wack.

 

[Pacna]

When you start your job search you will see the bolded above isn't true.

As stated above, MD reluctance to go to rural areas is in fact multi factorial. One thing that could help: some sort of efficient, evidence-based estimate of the real need for health care services, made independent of administrators. Also, if you are in a remote area with one hospital system, you need to know the admins aren't wack.

Could you please publicly propose a "wack score" for hospital administration?

 

[Lucca]

We should just do it like they do in Asia (S. Korea, Taiwan etc) where students just go to medical school out of high school instead of having to go through pointless undergrad. It would be way more efficient and we could train more docs

Source: http://askakorean.blogspot.com/2015/03/so-how-do-you-become-doctor-in-korea-if.html

I would prefer a system that utilized multiple pipelines into medicine rather than pretending that a single one is right for every student. The UK schools offer the MBBS as a 6 (or 7 I forget) year program starting after high school and as a four year program for people who have already graduated university. As long as the programs straight out of high school had requirements outside of medicine and the basic sciences I would absolutely be for that system. I also think that medical school graduates should have to complete some kind of rural rotation following intern year as a member of a primary care team in an underserved area or at the very least given the choice to do so.

They do this in my home country in SA and I think it's a really good thing to have. I think many people would be willing to put in some time as a primary care provider to pay back loans (NHSC style) if they also werent locked into a few key specialties once they make that decision. There is no reason a student who wants to be a vascular surgeon can't offer primary care services to people that need it after proper training as either an extension of their duty as physicians or as a way to repay society for their training.

I can totally understand people who dont want to commit themselves to the financial, personal, and professional hazards of performing primary care in an underserved setting for life but I think most people going into medicine genuinely want to help people and would be willing to put in 2-3 years if given the opportunity (and an incentive) to do so that didn't also tie their hands behind their back (per specialty selection).