New England Journal Med: Are We in a Medical Education Bubble Market?

[Lucca]

I recently interviewed Dr. Asch and I thought you guys might find his replies interesting, especially regarding his article on the bubble market in NEJM that we've been discussing.
The rest of the words here are not for reproduction and are directly from Dr. Asch.

DR. ASCH: "There is already tremendous change. At times I would like to start from scratch, because I am impatient. However, there already is interdisciplinary entrepreneurship and I have found physicians to be among the most entrepreneurial people I know. But it is also complicated and inefficient and I will give you that point. There are stakeholders and there are high stakes—both clinically and economically. And most of the stakeholders have some power. Change is hard under those circumstances. Maybe doctors need to understand political science as much as they need to understand business. Put that on your training list.


A liberal arts education may in fact be the best preparation for a career in Medicine or related fields"

...

ME: The New England Journal of Medicine recently published an article of yours warning of a medical education bubble in the near future; the author cites the rise of tuition costs, a predicted shortage in physicians, and likely cuts to physician compensation as evidence. We can see a bubble quickly forming in dentistry and veterinary medicine, are medical schools next? Might there come a time when blazing passion for science and service for others will simply not be enough to justify the cost of a medical education?


DR. ASCH: "Let me be clear: I don’t think we are in a medical education bubble. But I do think it costs way too much to train doctors the way we do and we’d all be better off if, while we are busy making health care better, cheaper, and more accessible, we did the same thing for medical education. I think that is possible. In fact, I’m optimistic we can do it."

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[TheRobin]

Somewhat related, but does anyone know why Texas (public) medical schools have ridiculously low tuition rates? My state schools average around $32,000 per year in tuition and fees. One Texas school that I looked at on a whim was half of that, i.e. roughly $16,000 per year. What gives?

 

[LizzyM]

I highly suspect that if you dug into the budgets in TX you would find that the taxpayers are picking up the tab for some of the cost of operating the medical schools in TX.

 

[notbobtrustme]

Medicine is the worst career choice except for all other careers. Medicine looks like a bad deal, but you know what else is a bad deal? Just about every other field. Something like 70% of all jobs created since 2008 have been for 30k or less. The US is a fundamentally different place than it was 20 years ago or 40 years ago. The careers that were the backbone of the economy have basically evaporated. Even if it costs 300k to get an MD, it's a hell of a lot better than selling suits at the Men's Warehouse or some other ****ty job that most pre-meds will end up doing. Sure, there'll always be some superhot that ends up founding a biotech in his garage. He's/She's the exception to the rule, just like that kid who went DO and matched to ACGME Dermatology (but everyone loves harping his story!). It won't be you. If you look at the averages, anyone graduated since 2005 is basically screwed.

 

[GandalfTheWhite]

Somewhat related, but does anyone know why Texas (public) medical schools have ridiculously low tuition rates? My state schools average around $32,000 per year in tuition and fees. One Texas school that I looked at on a whim was half of that, i.e. roughly $16,000 per year. What gives?

Almost all of the Texas schools are public schools and, as such, receive endowments from the state to provide great medical education to its residents. In return, Texas schools must accept 90% of its applicants from within the state. That way, Texas doesn't waste it's endowment on out of state students.

 

[NickNaylor]

Somewhat related, but does anyone know why Texas (public) medical schools have ridiculously low tuition rates? My state schools average around $32,000 per year in tuition and fees. One Texas school that I looked at on a whim was half of that, i.e. roughly $16,000 per year. What gives?

Most people that are accepted to Texas state schools are Texas residents, likely grew up in Texas, and likely intend to practice in Texas. I think the average Texas resident is more likely to remain in Texas compared to other states. I'd compare it to the way California residents tend to be about staying in California. As mentioned above, subsidizing training for Texas residents will in theory lead to more incentives to practice in lower paying specialties and provide better access to Texas citizens.

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[notbobtrustme]

****ing socialism Texas.

 

[circulus vitios]

Medicine is the worst career choice except for all other careers. Medicine looks like a bad deal, but you know what else is a bad deal? Just about every other field. Something like 70% of all jobs created since 2008 have been for 30k or less. The US is a fundamentally different place than it was 20 years ago or 40 years ago. The careers that were the backbone of the economy have basically evaporated. Even if it costs 300k to get an MD, it's a hell of a lot better than selling suits at the Men's Warehouse or some other ****ty job that most pre-meds will end up doing. Sure, there'll always be some superhot that ends up founding a biotech in his garage. He's/She's the exception to the rule, just like that kid who went DO and matched to ACGME Dermatology (but everyone loves harping his story!). It won't be you. If you look at the averages, anyone graduated since 2005 is basically screwed.

B-b-but software programmer biglaw investment banking 'entrepreneurship'! I could make millions in any other field!