Yes over reaching.
There is ALOT more to be a doctor than memorize a bunch of mnemonics. First, the memorization alone is a problem - as most medical students satisfy themselves with that. They memorize but really don't understand why etc. So they really can't think about things - education and smarts are vastly different. Many educated people cannot think - problem solve or be creative. Memorizing an answer helps you solve specific problems you have memorized the answer to, understanding helps you find more ways to deal with things, custom fit solutions instead of simply putting all of your patients in a cookie-cutter treatment routine. There is an old NIGHT GALLERY TV show in Youtube called the black bag, about a time in the far future when medicine is reduced to a simple algorhythm because all education has been dumbed down - medicine becomes a simple cookbook if A = B healing method.
Second, doctors really should have some personality, some bedside manner. I know many of you think of medicine in terms of pushing buttons and this cure for that disease matching, but making patients feel better is much more. Even if we speak of placebo, it has been shown to result in patients getting better about 35% of the time. A doctor with a strong healing personality has the power of placebo on his side.
Most MD's could not survive on the health care playing field without the sloped advantage they have from insurance. If healthcare went to a pure cash basis (such as is the case with most acupuncturists, naturopaths, massage therapists etc) the vast majority of MD's would be out of business ....NOW. 2 studies have showed that more money is spent on "holistic" health care each year, even though it is almost exclusively paid for out of pocket. Say what you might about evidence based, proof etc - where people put their own hard earned money shows what people really value. People put their money on massage, acupuncture etc to a large extent over medicine. Much of that is personality driven - people believe it, and they feel better afterwards. I myself hate going to my doctor, and pretty much all previous doctors, but love going to my acupuncturist, massage therapist etc. If my insurance did not pay I would perhaps never go to my MD.
CS in part tests how you interact with patients - personality deficits in medicine are compensated for by the fact that someone else (insurance) is paying for the care much of the time, lack of healing attitude, lack of ability to build rapport with a patient is hidden by 3rd party pay. Level the health care field by letting everyone pay for their care (like it was just a few decades ago) and you would see an attrition in medicine that would shock Hippocrates himself. CS is an opportunity to see if you can interact appropriately with people
Also, cutting corners with things like quickie inadequate exams like a "real practice" is part of the crap that everyone hates in medicine.
I was supposed to have shoulder surgery (full thickeness tear of supraspinatus, partial tear of subscapularis, torn labrum, spurs) a few weeks ago. I went in for my clearance exam by my PCP. I had a 103 degree temp, and upper respiratory symptoms. They cleared me for surgery in 2 weeks but said "call back if you aren't better". I called back 3 times, and could not get an appointment or get the MD to call me back. I showed up for the surgery at the outpatient surgery center - I was coughing up a cup of so of dark thick green sputum daily. I had crackles so loud that if the room was kind of quiet, I had people at work say "what the hell is that?" - they could hear the snap crackle and pop of my lungs as I breathed. The pre-op nurse took my O2 sats with a pulse ox, and the reading was 93 - she said "that can't be right" and wrote a higher number. I was febrile and she wrote a normal temp. I complained. I was told it was probably allergies causing it. I was minutes away from surgery and I lied and said I had a latex allergy which brought it to a griding halt. I was not about to let those fudging, incompetent boobs operate on me. I still can't get into my PCP until May 1st. So I went to the pet store and bought antibiotics and treated myself. Why - because everyone was doing brief exams and cutting corners, taking the easy way. Take CS - let someone evaluate if you know how to treat a patient adequately. Memorization, although a lower form of learning - does you no good if you are doing things sloppily, too quickly, without adequate thoroughness - what good is any knowledge if you aren't using, by gaining enough facts from a decent exam.
They want to to see you do a decent adequate exam on CS because that is how it should be done in "real practice", not lying, cutting corners, fudging on results etc.
http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Here is what patients want - many doctors do not measure up. Doctors hurry , cut corners, have hostile relationships with other health care personell, do not demonstrate caring.
Big deal you can memorize a bunch of junk and pass step 1 and step 2. Some people can memorize all sorts of baseball rules, but not play a decent game of baseball either. If you want a health care role in which you deal with patients with a bunch of flow charts, and memorized data and algorhythms - then do phone medicine (they have a link sometimes up above of being a doctor on call, and answering questions over the phone) or do IME's (independant medical exams) for insurance companies, or research. Don't go in and cut corners with patients, fake your way through a day, reduce patient care to a series of memorized equations and cookie cutter routines. Dealing with patients cannot be learned in books.
What they expect in CS is a minimum. If you can't do it, medicine is over reaching.
Like I said, "dumb" answer. That was just me trying to offer some words of "wisdom" from what I know...
