Should applicants like "Dr. House" be allowed into medical school?

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Kurk

Kurk

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Do you think House would've been able to get into med school in 2017 with his personality?

Is it ethical to deny someone who's so effective at diagnosing problems (moreso than their colleagues) just because of their personality?

I would 10/10 prefer House to be my personal physician over the "nice" person who's not as smart.

What do you think?
 
I honestly would want the best there is regardless of personality. When I come to the physician, I'm there to address an issue and get the best treatment possible. I'm not there to make friends and find a drinking buddy. Same thing with going to Olive Garden. I'm going there for the fine Italian food and while I would like my drinks to be refilled and food to come out correctly and appropriately, I am not there to make friends and do not care what the waiter is like as a person, how passionate they are about Italian food and the Olive Garden menu, or what they do in their free time.

But..............................

Medicine has become a patient satisfaction game. Plus, it's cool when you're not a jerk to people. Just follow the Golden Rule.
 
Kurk said:
I wonder how House got through the application process. Maybe he was really nice and turned into an ass due to stress/misery??
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When I was in medical school, I wondered how a lot of people got through the process. While I've met some cool down to earth people, I've met a lot of uptight jackasses. I guess it's a huge facade they put on.
 
Kurk said:
Do you think House would've been able to get into med school in 2017 with his personality?

Is it ethical to deny someone who's so effective at diagnosing problems (moreso than their colleagues) just because of their personality?

I would 10/10 prefer House to be my personal physician over the "nice" person who's not as smart.

What do you think?
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If I knew for a fact that I had a life-threatening 'zebra' disease, then yes, give me House. But for primary care? I couldn't imagine anything worse. Actually, I don't have to imagine, having met a few...
 
DokterMom said:
If I knew for a fact that I had a life-threatening 'zebra' disease, then yes, give me House. But for primary care? I couldn't imagine anything worse. Actually, I don't have to imagine, having met a few...
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^^ This. A close relative had a colectomy and subsequent J-pouch procedure. The surgeon was very rude, but they didn't care because he was a skilled department chair at the University of Chicago at the time and there were no complications after the procedure. He was incredibly grateful and couldn't care less about the surgeon's personality. If you're going to do a complex procedure or treat a rare illness that requires you to seek out a surgeon by name, then their personality would be at the bottom at the list of deciding factors, or it wouldn't be on it at all.
 
Planes2Doc said:
I honestly would want the best there is regardless of personality. When I come to the physician, I'm there to address an issue and get the best treatment possible. I'm not there to make friends and find a drinking buddy. Same thing with going to Olive Garden. I'm going there for the fine Italian food and while I would like my drinks to be refilled and food to come out correctly and appropriately, I am not there to make friends and do not care what the waiter is like as a person, how passionate they are about Italian food and the Olive Garden menu, or what they do in their free time.

But..............................

Medicine has become a patient satisfaction game. Plus, it's cool when you're not a jerk to people. Just follow the Golden Rule.
Click to expand...

You go to Olive Garden for fine Italian food?
 
Kurk said:
Do you think House would've been able to get into med school in 2017 with his personality?

Is it ethical to deny someone who's so effective at diagnosing problems (moreso than their colleagues) just because of their personality?

I would 10/10 prefer House to be my personal physician over the "nice" person who's not as smart.

What do you think?
Click to expand...
Have you seen how many of his patients he almost kills? I'll pass, thanks.
 
In my opinion, people as you describe in the OP- smart folks with awful personalities should NOT be allowed into medical school

The doctor-patient relationship is fundamentally based on a patient's ability to trust a physician enough to be comfortable telling them very personal things about their health. The doc being a jerk and making the patient feel like they can't share is fundamentally a very problematic thing. History is so critical to diagnosis and the incredibly intelligent "expert" doctor like House can't help a person if they aren't comfortable being forthcoming with their symptoms, social history, etc. People are perceptive and can smell meanies from a mile away.
 
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Mad Jack said:
Have you seen how many of his patients he almost kills? I'll pass, thanks.
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I don't recall.



If Gallop held a poll where the good majority of people stated that they would prefer House over a nice but less competent physician would medical schools change their criteria for acceptance?
 
In terms of a colleague, I would take someone with a better personality than someone who has better scores. No one cares how smart you are if you're a ****ing dingus. Someone already in medicine is already "smart enough" and any medical knowledge deficiency can always be gained down the line but someone with a piss poor attitude will always have that attitude and never change no matter how smart he is.
 
Kurk said:
Is it ethical to deny someone who's so effective at diagnosing problems (moreso than their colleagues) just because of their personality?
Click to expand...

Being an effective physician in the real world means having good relationships with both patients and colleagues. Sure, there are jerks out there who are good at what they do, but they have succeeded in spite of their flaws, not because of them.

I need to start a list of classic SDN questions. This would certainly be one of them.
 
Kurk said:
Do you think House would've been able to get into med school in 2017 with his personality?

Is it ethical to deny someone who's so effective at diagnosing problems (moreso than their colleagues) just because of their personality?

I would 10/10 prefer House to be my personal physician over the "nice" person who's not as smart.

What do you think?
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Nope. I'd reject him outright at interview.

You also have to remember that impaired people aren't as nice or as good at what they do in TV-land.

There's a reason why humanistic domains outnumber those for knowledge/smarts among requirements for both medical schools and residencies. Americans don't like smart doctors who lack the human touch.

BTW, according to our wise attending and resident colleagues on SDN, do you know what they look for in new residents? The ability to get along with people for the next 3-5 years. They already know that they're smart. So, even if House were to make it through medical school, he'd probably go unmatched.
 
I think in the current world where people get offended easily, having someone like House = lawsuit material.

Personally I wouldn’t mind being treated by a highly intelligent doctor w/ poor bedside manners as long as the doc cures me so I dont have to see them again.
 
"So your arm only hurts after you sleep on it. Have you tried...oh I don't know...not doing that?"

or
Patient: "Thank you so much! I have to get you a gift or something"

House: "Sometimes the best gift is the gift of never seeing you again"

or

Doc: "He swallowed a magnet; we got to cut it out."

House: "How old are you?"

Kid: "8"

House: "He swallowed something stuck to a fridge. Darwin says let him die."


OMG but LOL
 
Lucca said:
Breaking into patients homes, obtaining consent for nothing, actively denying consent, having people do procedures they can’t possibly be trained to do, etc.
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House is actually a secret agent and this all falls under eminent domain 😉
 
I wish professors were held to the same standards in terms of "people skills -- not being a jerk" (most fine, some not).

I think they mostly get hired due to the research money they can bring to the school, with their competency (intelligence, etc.) being important too.

I think people skills just goes by the wayside.

Although, with their less than idea paychecks, you can only ask for so much.
 
All of this business about being nice and adding psychobabble to the MCAT is terribly troubling to me. Medical school admissions is a zero sum game. Science is getting denigrated in this process. I don't care if a physician has good bedside manners. I want correct answers.

I had a good pal in law school with low back pain and he went to physicians, physical therapists, etc for a year and they couldn't tell him what was causing the pain. He read an article in Penthouse magazine about testicular cancer and concluded that he should be tested for that. It turns out he did have cancer but it was too late to save him. He died a miserable death and his widow never had children. I'm sure everybody was nice to him but who cares?

It's true that iconoclastic, sarcastic personalities can be a pain in the butt to work with. Some people just can't suffer fools. However, I will guarantee you that when you have a sick kid and a physician with a gentile personality can't figure out what the hell is going on, you are going to pray to God that a Dr. House walks in and figures it out.
 
We leave medical school with two things...
1. A rudimentary understanding of medicine
2. A long list of doctors to avoid (this is a bonus)
 
An interviewer literally asked me this as a follow up to an MMI question


Sent from my iPhone using Tapatalk
 
I bet Dr. House wouldn't be accepted today... He'd get to the interview stage, sure, but then his attitude would be a huge turn-off. I once witnessed three different students send in complaints about an applicant because he was cocky and sarcastic at the supposedly "low key" interview meals and student panels... Doubt we'll be seeing him next year.
 
Kurk said:
I wonder how House got through the application process. Maybe he was really nice and turned into an ass due to stress/misery??
Click to expand...
He wasn’t always that way - apparently he was much nicer (perhaps even human?) when he was dating Stacy, so I can only imagine that he’s just gotten “worse” over time. If that’s the case, I don’t think it’s an unrealistic situation; I can’t tell you how many doctors I’ve been to that actively encourage people not to go into the field. Nonetheless, I love House; it’s my favorite show (and always will be because I somewhat identified with the character). With all that being said, I can see someone like House being accepted when they were nicer. I doubt that he was ever a saint or anything, but I see no reason why he shouldn’t be accepted in such a case. As someone else said, he probably hide his opinions and personality during the admissions process. The only reason he doesn’t hide it during the show is because he admits that he simply doesn’t care - he has a job (even if Cuddy always threatened to take it away) and has no reason to “hide” any longer.

House is brilliant the same way Sean is (from The Good Doctor). In most situations, I’d rather have a brilliant doctor than a nice one who has no idea what’s wrong with me. The only situation I probably would not want him as my doctor were if he were a surgeon, because I’ve already experienced similar situations. My neurosurgeon is very smart as well, but if I’d known how he’d end up acting before my surgery, I sure as heck wouldn’t have let him touch me. Honestly, I most likely would’ve “settled” for a less experienced surgeon.
 
cj_cregg said:
God help me if I see this logical fallacy one more time in this thread
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You are arguing the opposite extreme-that there are enough brilliant doctors who are also sociable. But that is neither accurate nor gets at the heart of the question.
 
cj_cregg said:
God help me if I see this logical fallacy one more time in this thread
Click to expand...
You do realize that you’re putting words in people’s mouth, which is also a logical fallacy - you know, strawman and all? It’s pretty ironic but most of the time someone points out someone else’s logical fallacy, they end up committing one as well.

No one here has said that all brilliant doctors have terrible personalities and all “dumb doctors” (whatever the heck that even means) have good personalities. However, there is a such thing as having an incredibly brilliant doctor with a nasty personality versus a totally clueless one who is an angel. If you are blessed enough to have never been in that situation, good for you, but if not, then you really can’t comment on it since you don’t seem to understand the difference between the two situations.
 
cj_cregg said:
I disagree that there aren't enough people in the world who are smart enough and empathetic enough to practice good medicine, particularly since both critical thinking and empathy can be taught to some extent. Every doctor in the world doesn't need to be Einstein. Not saying doctors should be of average/below average intelligence by any means - you have to be pretty smart, but you don't have to be an absolute genius to be a good doctor in 90% of circumstances. Nor does every doctor have to be a perfect angel every second of every patient encounter. I'm not arguing an "extreme."

As to your argument about "the heart of the question," I'm also arguing that doctors who are not empathetic, good listeners, etc. (it's not just being "sociable") will struggle to practice good medicine under many circumstances. If you're a surgeon, sure, maybe you could get away with not getting a good history or not helping a patient adhere to a treatment plan. But the bulk of physicians need to have these skills to appropriately diagnose and treat their patient population, and I have seen physicians without these skills fail at this in the clinic.


Seems like you took this a little more personally than I intended it. Sorry if I was short with you - it wasn't my intention.

I didn't put words in anyone's mouth. I literally quoted your post (and others') that directly compared nice dumb doctors to smart mean ones. That is a false dichotomy and not a logical argument in any way. For most people, those aren't the only two choices. Or are you saying that's not what you intended to do when you said "I’d rather have a brilliant doctor than a nice one who has no idea what’s wrong with me."? If that's the case, I apologize for misunderstanding your statement.

Thanks, but I'm not blessed enough to have avoided the situation you describe. My favorite doctors on my care team, whether primary care or specialists, have been ones that are smart and nice. Of the dozens of doctors I've watched work with hundreds of patients on clinical rotations, the best ones are smart and nice. Yes, there are some doctors out there who have poor clinical knowledge/skills but are nice people, and some who are knowledgeable and skilled but have no people skills at all. But I would argue that this is a minority of practicing physicians, particularly among young physicians/medical students as many schools make the shift towards emphasizing things like community service and people skills in addition to stats that are indicative of success in medical school and beyond.
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You can’t ascertain someone’s opinion from one situation and assume that it applies to another situation in which there are more options. That’s why it’s a strawman; you’re putting words in people’s mouth because you’re completely missresprenting an argument that was never even made in the first place. (That argument being that “smart but bad personality” and “nice but less knowlegable” are the only types of physicians that exist in this world.) Not only that, but you lumped multiple people’s post with one as if you assumed each person had the same opinion. For example, I didn’t use the word “dumb” and neither did other people, so why are you trying to equate one person’s post with other peoples’? That makes no sense and it’s also an unfair assumption.

The reason people are saying “smart but bad personality” versus “less knowledgeable but good personality” is because it’s a realistic situation that often happens (not to mention that it is the situation depicted on the actual show). Clearly if we were all given a choice we’d chosen a physician who is both knowledgeble and courteous, but that doesn’t always happen. In fact, many would argue the exact opposite of what you said - that the “smart but bad personality” doctor situation doesn’t occur often. If it didn’t, then you wouldn’t have multiple people imagining such a situation when replying to the thread.

By the way, you didn’t offend me; part of my post was poorly worded, and I admit that it could come across rude. My apologies.
 
To me, what matters the most is whether the person gets good patient outcomes. I hope that anyone with real clinical experience will correct me if I'm wrong, but I believe social and emotional intelligence are necessary to achieve good patient outcomes in many cases. For instance, reassuring and motivating a patient to comply with a treatment plan that they feel uncertain about requires a great deal of empathy and communication skills.

JAMA had an interesting editorial recently on a related topic about the Iatrogenic Potential of Physician's Words.
 
cj_cregg said:
And anyway, OP was asking more about admissions...so like you said, the ideal is that everyone could have a physician who is both knowledgeable and courteous. That starts with the admissions process. I guess what I'm trying to get at is that the original question of the thread, whether someone with a bad personality (again, simplifying the terminology here) should be admitted to medical school just because they're super smart is more of a hypothetical thought experiment. In the real world there's no need to make that choice because there are plenty of applicants who are smart enough and nice enough to be good doctors. I'm talking more about the real world vs. the TV show, I suppose.
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First off, I appreciate you explaining what you were trying to say.

Unless I’m misunderstanding the OP I don’t think that the question was if he should be admitted just because he’s smart, but rather should his personality prevent his admission (even though he’s a good diagnostician and presumably was a good student). You’re right that it’s a thought experiment, but since we’re discussing a character, I figure the point is for it to somewhat unrealistic anyway. I mean, theoretically, he could be a great diagnostician but have been a terrible student and a similar question could be posed: should he be admitted because of good diagnostic skills even with a poor academic record (assuming it was a consistently poor record with no signs of improvement)?

On the other hand, I think the question is being posed because this is a situation that is encountered in real life (although, as you said, not usually during the admissions process). From my perspective at least, what it comes down to is the fact that there are doctors with such terrible people skills that they make you wonder how they got admitted to medical school in the first place. So maybe it’s not really a thought experiment after all, but trying to figure out how someone can be in the medical profession but come across as not wanting to actually help people. It’s as if we’re trying to figure out what happened to the person to make them the way the are (and of course most people do wonder this about House).
 
TV physicians are just that- TV physicians.

I mean, does anyone seriously think that Dr. Murphy from "The Good Doctor" would actually make it past the interview stage?
 
Dr. Scribe said:
I mean, does anyone seriously think that Dr. Murphy from "The Good Doctor" would actually make it past the interview stage?
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I've been watching that show and this is something I've been wondering too. I bet Dr. Glassman (hospital president, surrogate dad guy) got him into med school and convinced the adcoms to overlook his poor interviewing skills, but how did he survive clinical rotations in 3rd/4th year but still come out so clueless as an intern? At least he seems to be improving slightly in recent episodes. Apart from the thing that happened in the midseason cliffhanger, but I'm not gonna spoil anyone 😛
 
narla_hotep said:
I've been watching that show and this is something I've been wondering too. I bet Dr. Glassman (hospital president, surrogate dad guy) got him into med school and convinced the adcoms to overlook his poor interviewing skills, but how did he survive clinical rotations in 3rd/4th year but still come out so clueless as an intern? At least he seems to be improving slightly in recent episodes. Apart from the thing that happened in the midseason cliffhanger, but I'm not gonna spoil anyone 😛
Click to expand...

I think it’s possible with a lot of coaching; he is, after all “high functioning.” I have ASD as well (although it’s not as obvious as his is) and I’m aware that I’ll need special “preparation” for interviews that other people don’t need. The other thing is that ASD symptoms can fluctuate depending on the circumstances; since he’s pretty obviously impaired, I would imagine he would have needed some type of accommodations throughout medical school (although I have no idea how that would work as far as interacting with patients).

With that being said, I’m like 3 episodes behind right now, so maybe my opinion will change after I see this cliffhanger. 😱
 
psychgirl95 said:
I think it’s possible with a lot of coaching
Click to expand...

Exactly lol. But in the show he struggles with the idea of getting therapy or having a person to help him with daily living, which makes me wonder if he's ever had any professional help for his social issues or communication difficulties. His real parents were abusive so probably no early intervention therapy, but I wonder if he ever saw someone as a teenager.
 
Obnoxious Dad said:
All of this business about being nice and adding psychobabble to the MCAT is terribly troubling to me. Medical school admissions is a zero sum game. Science is getting denigrated in this process. I don't care if a physician has good bedside manners. I want correct answers.

I had a good pal in law school with low back pain and he went to physicians, physical therapists, etc for a year and they couldn't tell him what was causing the pain. He read an article in Penthouse magazine about testicular cancer and concluded that he should be tested for that. It turns out he did have cancer but it was too late to save him. He died a miserable death and his widow never had children. I'm sure everybody was nice to him but who cares?

It's true that iconoclastic, sarcastic personalities can be a pain in the butt to work with. Some people just can't suffer fools. However, I will guarantee you that when you have a sick kid and a physician with a gentile personality can't figure out what the hell is going on, you are going to pray to God that a Dr. House walks in and figures it out.
Click to expand...

There’s a reason why medicine is an art. If you ONLY want correct answers, go to scientists.
 
cj_cregg said:
And anyway, OP was asking more about admissions...so like you said, the ideal is that everyone could have a physician who is both knowledgeable and courteous. That starts with the admissions process. I guess what I'm trying to get at is that the original question of the thread, whether someone with a bad personality (again, simplifying the terminology here) should be admitted to medical school just because they're super smart is more of a hypothetical thought experiment. In the real world there's no need to make that choice because there are plenty of applicants who are smart enough and nice enough to be good doctors. I'm talking more about the real world vs. the TV show, I suppose.
Click to expand...
I agree with you that there are probably enough candidates that are nice enough and smart enough to only admit those. But I think the real question isn't nice/dumb vs. smart/mean vs. smart/nice but smart/nice versus extremely smart/not sociable. As in should a person who is clear and away better scientist (for lack of a better word, as I feel clinician is a bit more encompassing into people skills and diagnostician too narrow) be admitted to handle that 10% of cases you referred to earlier.
 
doctorcocter said:
The Good Doctor looks like Dougie Houser but the writers made him have autism for that “different” factor. It also makes for a much more sympathetic protagonist. Basically, to me it seems like pandering and the show’s trailor didn’t really interest me.
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Yeah, I watched the first few episodes and couldn't get into it, although reviews have said that Season 2 is a lot better so I might come back to it and try to push through. I disliked "Prayer for Owen Meany" when I first started but someone whose taste I respect loved it, so I picked it up later and ended up loving it too.

As for House MD: loved the show. Seems like there will always be House-esque doctors in real life and a context in which their House-ness doesn't matter. If I'm suffering from a condition that no one else can pin down, then give me House no matter how offensive he is. If I'm going for an annual well-woman exam, no.
 
Obnoxious Dad said:
I had a good pal in law school with low back pain and he went to physicians, physical therapists, etc for a year and they couldn't tell him what was causing the pain. He read an article in Penthouse magazine about testicular cancer and concluded that he should be tested for that. It turns out he did have cancer but it was too late to save him. He died a miserable death and his widow never had children. I'm sure everybody was nice to him but who cares?
Click to expand...

Was it testicular cancer? Did he have a palpable scrotal mass?
 
Med Ed said:
Was it testicular cancer? Did he have a palpable scrotal mass?
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*disclaimer: not a physician*

Lower back pain can account for a ridiculous amount of health issues. In fact, isn't lower back pain (and chest pains) among the top 3 people ask physicians about at check-ups?

Testicular cancer probably wouldn't be the first choice, and I'm shocked if lower back pain was the main overbearing symptom. I would imagine heaviness of scrotum or enlarged bumps on the testicles would have also "most likely" been present?
 
Obnoxious Dad said:
It was testicular cancer but I do not know if he had a palpable scrotal mass.
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What you have shared raises a lot of questions. Perhaps he had one or two undescended testes, which itself is a risk factor for testicular cancers. The neoplasm we typically associate with the term "testicular cancer" (seminoma) has a 95% survival rate at 5 years. Metastasis to bone, of the sort that would result in back pain, is highly unusual even in higher stage disease. Solitary bone metastasis is case report-worthy.

I actually have a colleague who recently died of widely metastatic carcinoma, with the initial presentation being lower back pain. Imaging studies showed the tumors fairly easily.

Either way, the notion of the singularly brilliant doctor, who can see what no one else does, makes for good television but doesn't reflect real life very accurately. We've all had those rare "ah ha!" cases in our careers, but the boring truth is that most diagnostic delays are due to communication breakdowns, not inadequacies of cognition and/or deductive reasoning.
 
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^This reminds me of the story of the Challenger explosion. The human tendency is to think that such a significant disaster must have had a proportionally significant cause, and maybe an exceptionally brilliant House-like engineer could have prevented it. But the truth is that the engineers knew the faulty part might fail and that it needed to be redesigned months before the launch. The problem was that management refused to listen to them (a mundane communication breakdown).
 
Prometheus123 said:
^This reminds me of the story of the Challenger explosion. The human tendency is to think that such a significant disaster must have had a proportionally significant cause, and maybe an exceptionally brilliant House-like engineer could have prevented it. But the truth is that the engineers knew the faulty part might fail and that it needed to be redesigned months before the launch. The problem was that management refused to listen to them (a mundane communication breakdown).
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I heard that it was one engineer who knew about it, expressed their concerns to the other engineers to no avail, and we all know what happened after that. They were victims to group think. I hate working in groups because of this. You can know something that others don't, have the know-how to fix it, but lack the autonomy/power to make it happen. Thinking that you can have a group of people who are all equally as intelligent, sociable, emotionally mature is like Marx thinking that Communism could actually work. It's idealism created by academics who lack practical intelligence
 
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