Med school entrance

[deleted158872]

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I learned a bit about healthcare policy in class; afaik, the AMA is in control of the # of students entering med schools, and I think this is the reason why med school admissions is the toughest compared to other professions/careers out there. However, I doubt that this "gate keeping" is to ensure the quality of doctors that schools produce, because there are many programs out there that recruit students from high school or sophomore year of college, often without MCAT, and some don't even require >3.4 GPA... and the doctors they produce are fine and competent. So I think that given the chance, many of rejected applicants would otherwise perform well in med school.
I wonder: 1/ Is AMA 'gate keeping' necessary? 2/ What keeps schools from admitting more applicants and then dismiss students who have actually failed first year of med school, rather than keep a "bottleneck" of admissions and try very hard to retain students (by giving them multiple chances before dismissing them)?

 

[GomersGoToGround]

Schools DO try very hard to retain students.

Admitting way more students while keeping the number of residency slots positions the same would create an even bigger bottleneck effect.

Larger amount of outstanding applicants than seats allows schools to snipe for candidates.

 

[Goro]

You might want to ask for your tuition money back for that class.

First of all, it's LCME that sets these policies, not the AMA. Ditto COCA for DO schools, not AOA.

Secondly, there are vastly more programs that don't use the BS/MD route, and I have heard musings on the latter being in decline. I will leave it to my clinical colleagues to chime in on this.

I learned a bit about healthcare policy in class; afaik, the AMA is in control of the # of students entering med schools, and I think this is the reason why med school admissions is the toughest compared to other professions/careers out there.

There are over 100,000 candidates for 25000 med school seats. Where would you start? It's a seller's market, and so one has to start somewhere, like with, you know, proven indicators of success in med school?
However, I doubt that this "gate keeping" is to ensure the quality of doctors that schools produce, because there are many programs out there that recruit students from high school or sophomore year of college, often without MCAT, and some don't even require >3.4 GPA... and the doctors they produce are fine and competent.

But will they make good doctors? We have to take that consideration as well. A career in Medicine is not a reward for merely being smart. And there's a finite number of 18 years olds who any conception of what a career in medicine is like. Most 18 year old I've met barely know they're alive. See @DermViser 's recent sage posts in the Allo forum on this.
So I think that given the chance, many of rejected applicants would otherwise perform well in med school.

It would make them look like the didn't know what they were doing and lead to a bidding war for applicants. We're not the airlines. We take attrition rates seriously.
2/ What keeps schools from admitting more applicants and then dismiss students who have actually failed first year of med school, rather than keep a "bottleneck" of admissions and try very hard to retain students (by giving them multiple chances before dismissing them?

 

[DermViser]

I learned a bit about healthcare policy in class; afaik, the AMA is in control of the # of students entering med schools, and I think this is the reason why med school admissions is the toughest compared to other professions/careers out there. However, I doubt that this "gate keeping" is to ensure the quality of doctors that schools produce, because there are many programs out there that recruit students from high school or sophomore year of college, often without MCAT, and some don't even require >3.4 GPA... and the doctors they produce are fine and competent. So I think that given the chance, many of rejected applicants would otherwise perform well in med school.
I wonder: 1/ Is AMA 'gate keeping' necessary? 2/ What keeps schools from admitting more applicants and then dismiss students who have actually failed first year of med school, rather than keep a "bottleneck" of admissions and try very hard to retain students (by giving them multiple chances before dismissing them)?

The AMA isn't the gatekeeper. The LCME is and probably the AAMC as well and that's a good thing, unlike Caribbean schools who take in hordes of people and bilking them out of their money. A school has to have enough resources to provide for the number of students they accept. This is even more important bc of the set number of residency program positions that are available based on funding by the federal govt. The LCME oversees this to make sure this is the case and med schools are being honest.

The programs that you are referring to are BS/MD and Early Assurance programs that also fall under the LCME and AAMC bc they are at US Medical schools as well and they also fall under the cap of total students for that school. Every medical school has the choice to decide how to best select its applicants that attend their medical school. They can choose to take a whole class without doing any of the premed requirements and MCAT if they so choose. I don't see how this proves your point.

BS/MD programs were initially started in the 1960s/1970s when going to medical school wasn't popular and most high achieving students went into fields such as Engineering that were booming at the time. This is no longer the case where medical schools are in a seller's market and most medical schools are getting just as good if not better applicants thru the normal process. Many of these programs have stayed on purely due to the tradition of having the program regardless of what the data on board scores, medical school performance, etc. may show (see the NY Times article on the Mt. Sinai HuMed program).

 

[MMADoc]

There appears to be a general belief that medical schools are somehow being protected from applicants who are "unqualified". I believe the truth of the matter is more like protecting "unqualified" applicants from medical school. Medical school will eat you up and spit you out if you cant handle it.

 

[LizzyM]

IIRC, LCME is the child of the AMA and the AAMC. Both contribute to the membership which then reviews and accredits (and re-accredits) medical schools.

What has been said earlier is correct: medical schools can not matriculate more students than they can serve. It isn't just about building more classrooms and more labs but also having enough clinical slots and supervising faculty physicians to give students the necessary opportunities and supervision during the clinical rotations. That is the bottleneck in medical school. At the other end, is the bottleneck of residency. You can have an MD but not be licensed to practice unless you complete at least one year of residency (more often one does 3 years before practicing independently). If schools were to expand their clerkships and their class size without an increase in the number of residency slots, we'd have med school graduates who would be severely under-employed while waiting and hoping for a residency position. Currently there are hundreds (if not thousands) of foreign medical graduates who volunteer in clinical research settings and/or work in low level tech jobs and do all sorts of things in the hope of catching the eye of a residency director and getting a coveted residency slot in the US.

Would you like to pay $30-50K or more for a year of med school and then flunk out? How would you fund that year and if you flunked out, how would you pay back the loan? Better to take only those we believe will "make it" and nurture them like hot house orchids than to make the first year of medical school a cut-throat, Survivor academic experience.

 

[deleted158872]

Thanks for correcting me on LCME.

A point that's being said by responders to my opening post is that 'if we admit too many students then it will result in more intense competition for residency spot'. It's the same as, 'if we admit more students then of course more students will be able to succeed in med school and compete for residency spots'. So I don't think the medical organization is "protecting unqualified applicants from med school"; it's more like protecting the profession from saturation.

The difference between US and Caribbean med schools is the quality of the curricula. If students fail at a Caribbean school, likely it is the sub-par quality of the school to blame. [ A 2008 study in the journal Academic Medicine found that the first-time pass rate on the exam at Caribbean schools ranged from 19% to 84% ]. US medical curriculum is standardized and goes through careful review. If I failed in a US med school, most likely I only had myself to blame.
Paying $30-50k while having uncertainty in job prospects is the reality of most careers. Medicine is one of the very few exceptions where graduates are guaranteed a job because Medicine has a politically powerful organization to limit the # of people entering the profession.

Currently there are hundreds (if not thousands) of foreign medical graduates who volunteer in clinical research settings and/or work in low level tech jobs and do all sorts of things in the hope of catching the eye of a residency director and getting a coveted residency slot in the US.

If they fail to the licensing exam in the US, they can redo 4 years of med school in the US then enter residency like the rest of the US med students. Why don't these IMGs choose this route?

 

[baxt1412]

Thanks for correcting me on LCME.



If they fail to the licensing exam in the US, they can redo 4 years of med school in the US then enter residency like the rest of the US med students. Why don't these IMGs choose this route?

why would they want another 4 years of incredibly tough schooling over things they have already learned?

 

[Mad Jack]

I learned a bit about healthcare policy in class; afaik, the AMA is in control of the # of students entering med schools, and I think this is the reason why med school admissions is the toughest compared to other professions/careers out there. However, I doubt that this "gate keeping" is to ensure the quality of doctors that schools produce, because there are many programs out there that recruit students from high school or sophomore year of college, often without MCAT, and some don't even require >3.4 GPA... and the doctors they produce are fine and competent. So I think that given the chance, many of rejected applicants would otherwise perform well in med school.
I wonder: 1/ Is AMA 'gate keeping' necessary? 2/ What keeps schools from admitting more applicants and then dismiss students who have actually failed first year of med school, rather than keep a "bottleneck" of admissions and try very hard to retain students (by giving them multiple chances before dismissing them)?

That's a great thought but you have no idea what you're talking about for reasons that have already been explained by other posters