Policy Take Two Aspirin and Call Me by My Pronouns

[Lawpy]

Thoughts? @VA Hopeful Dr @sb247 @AnatomyGrey12 etc.

Here's the article: Opinion | Take Two Aspirin and Call Me by My Pronouns

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[deleted480308]

Thoughts? @VA Hopeful Dr @sb247 @AnatomyGrey12 etc.

Here's the article: Opinion | Take Two Aspirin and Call Me by My Pronouns

At ‘woke’ medical schools, curricula are increasingly focused on social justice rather than treating illness.

The American College of Physicians says its mission is to promote the "quality and effectiveness of health care," but it's stepped out of its lane recently with sweeping statements on gun control. And that isn't the only recent foray into politics by medical professionals. During my term as associate dean of curriculum at the University of Pennsylvania's medical school, I was chastised by a faculty member for not including a program on climate change in the course of study. As the Journal reported last month, such programs are spreading across medical schools nationwide.

Why have medical schools become a target for inculcating social policy when the stated purpose of medical education since Hippocrates has been to develop individuals who know how to cure patients?

A new wave of educational specialists is increasingly influencing medical education. They emphasize "social justice" that relates to health care only tangentially. This approach is the result of a progressive mind-set that abhors hierarchy of any kind and the social elitism associated with the medical profession in particular.

These educators focus on eliminating health disparities and ensuring that the next generation of physicians is well-equipped to deal with cultural diversity, which are worthwhile goals. But teaching these issues is coming at the expense of rigorous training in medical science. The prospect of this "new," politicized medical education should worry all Americans.

The traditional American model of medical training, which has been emulated around the world, emphasizes a scientific approach to treatment and subjects students to rigorous classroom instruction. Students didn't encounter patients until they had some fundamental knowledge of disease processes and knew how to interpret symptoms. They were expected to appreciate medical advances and be able to incorporate them into their eventual fields of practice. Medical education was demanding and occasionally led to student failure, but it produced a technically proficient and responsible physician corps for the U.S.

The traditional American model first came under attack by progressive sociologists of the 1960s and '70s, who condemned medicine as a failing enterprise because increased spending hadn't led to breakthroughs in cancer treatment and other fields. The influential critic Ivan Illich called the medical industry an instrument of "pain, sickness, and death," and sought to reorder the field toward an egalitarian social purpose. These ideas were long kept out of the mainstream of medical education, but the tide of recent political culture has brought them in.

As concerns about social justice have taken over undergraduate education, graduate schools have raced to develop curricula that will steep future educators in the same ideology. Today a master's degree in education is often what it takes to qualify for key administrative roles on medical-school faculties. The zeitgeist of sociology and social work have become the driving force in medical education. The goal of today's educators is to produce legions of primary care physicians who engage in what is termed "population health."

This fits perfectly with the current administrator-rich, policy-heavy, form-over-function approach at every level of American education. Theories of learning with virtually no experimental basis for their impact on society and professions now prevail. Students are taught in the tradition of educational theorist Etienne Wenger, who emphasized "communal learning" rather than individual mastery of crucial information.

Where will all this lead? Medical school bureaucracies have become bloated, as they have in every other sphere of education. Curricula will increasingly focus on climate change, social inequities, gun violence, bias and other progressive causes only tangentially related to treating illness. And so will many of your doctors in coming years.

Meanwhile, oncologists, cardiologists, surgeons and other medical specialists are in short supply. The specialists who are produced must master more crucial material even though less and less of their medical-school education is devoted to basic scientific knowledge. If this country needs more gun control and climate change activists, medical schools are not the right place to produce them.

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Dr. Goldfarb is a former associate dean of curriculum at the University of Pennsylvania's Perelman School of Medicine.

They should stick to medicine

 

[KeikoTanaka]

As a 2nd year now, I can say we've definitely touched on a lot of these things - but I've never once felt my hard-core sciences being put to the way side. In fact, when we learned about Climate Change, it had to do with Epidemiologic changes and what populations were now pre-disposed to various new infections and diseases.

I don't see how that's not important, especially since it's only going to get worse over the next 40 years while im in practice. And I go to a DO school. So I already have OMM taking up my time from my hard-core sciences haha. Yet, we make do, and still prepare for the USMLE, just like our MD counterparts.

My husband (we're gay) is in the curriculum committee at my school and is working on ways to incorporate LGBTQ health information into our curriculum.

For example, more case studies related to Transgender individuals: If an individual comes to your ED w/ an arrhythmia, and you learn from their family they are transitioning, this could be due to Spironolactone - a potassium sparing drug used for androgen / hormone control.

So I agree hard-science education should never fall to the way side for "social justice" - but most things can easily be brought back into the realm of hard science if done correctly.

 

[deleted480308]

As a 2nd year now, I can say we've definitely touched on a lot of these things - but I've never once felt my hard-core sciences being put to the way side. In fact, when we learned about Climate Change, it had to do with Epidemiologic changes and what populations were now pre-disposed to various new infections and diseases.

I don't see how that's not important, especially since it's only going to get worse over the next 40 years while im in practice. And I go to a DO school. So I already have OMM taking up my time from my hard-core sciences haha. Yet, we make do, and still prepare for the USMLE, just like our MD counterparts.

My husband (we're gay) is in the curriculum committee at my school and is working on ways to incorporate LGBTQ health information into our curriculum.

For example, more case studies related to Transgender individuals: If an individual comes to your ED w/ an arrhythmia, and you learn from their family they are transitioning, this could be due to Spironolactone - a potassium sparing drug used for androgen / hormone control.

So I agree hard-science education should never fall to the way side for "social justice" - but most things can easily be brought back into the realm of hard science if done correctly.

climate change shouldn't be a med school curriculum

 

[Mad Jack]

climate change shouldn't be a med school curriculum

The epidemiological effects of a warming climate were covered in my medical school in exactly one brief lecture, because it's important to be aware that certain diseases are creeping further and further north, thus we have to understand what populations are now at risk for diseases they previously were not. Not being aware that the ranges of certain vectors of diseases are changing is doing a disservice to your patients

 

[deleted480308]

The epidemiological effects of a warming climate were covered in my medical school in exactly one brief lecture, because it's important to be aware that certain diseases are creeping further and further north, thus we have to understand what populations are now at risk for diseases they previously were not. Not being aware that the ranges of certain vectors of diseases are changing is doing a disservice to your patients

and I might agree with you if someone was just mentioning that a disease is moving geographically. But we all know it rarely stops there and drifts into assigning cause that isn't established well and then into "what we need to do to stop it" which isn't medicine

If they just stick to medicine, I'm fine

 

[Mad Jack]

and I might agree with you if someone was just mentioning that a disease is moving geographically. But we all know it rarely stops there and drifts into assigning cause that isn't established well and then into "what we need to do to stop it" which isn't medicine

If they just stick to medicine, I'm fine

"Isn't established well?"

It's pretty clearly established that our insect range issues in the northeast are the result of less frost days and warmer average temperatures allowing species that could not previously survive this far north to do so, and our tick populations have exploded due to a lack of persistent cold periods several years running in ways that are historically unprecedented.

Whether physicians should get involved in the gun control debate is another one where I obviously think yes. If we see hundreds of people coming in with lungs obliterated by vaping we're allowed to speak up, as we would with any other threat to public health. Guns are a public health issue, because they kill and wound a lot of people. We have to piece together and deal with the aftermath of these shootings, and we shouldn't do it in silence. If anything else was killing thousands of people every year and we didn't speak up we would be considered negligent at best or conspirators at worst, why are guns so different?

 

[deleted480308]

"Isn't established well?"

It's pretty clearly established that our insect range issues in the northeast are the result of less frost days and warmer average temperatures allowing species that could not previously survive this far north to do so, and our tick populations have exploded due to a lack of persistent cold periods several years running in ways that are historically unprecedented.

Whether physicians should get involved in the gun control debate is another one where I obviously think yes. If we see hundreds of people coming in with lungs obliterated by vaping we're allowed to speak up, as we would with any other threat to public health. Guns are a public health issue, because they kill and wound a lot of people. We have to piece together and deal with the aftermath of these shootings, and we shouldn't do it in silence. If anything else was killing thousands of people every year and we didn't speak up we would be considered negligent at best or conspirators at worst, why are guns so different?

I should have been more clear. I meant the notion that this warming cycle is definitely caused by humans and that we can definitely "change it back" or stop it.

For guns? I'm all for people talking about safe storage around kids and mental health in areas of suicide/homicide. But the notion that the govt shouldn't allow people to have firearms because some folks use them improperly being a "health issue" that doctors should be in? Nope. We shouldn't be pushing to ban guns any more than we should push to ban soda, tobacco, french fries, candy, not using seatbelts, motorcycles, not exercising, being fat, etc. Overarching control of a patient's life is not our jurisdiction.

 

[Mad Jack]

I should have been more clear. I meant the notion that this warming cycle is definitely caused by humans and that we can definitely "change it back" or stop it.

For guns? I'm all for people talking about safe storage around kids and mental health in areas of suicide/homicide. But the notion that the govt shouldn't allow people to have firearms because some folks use them improperly being a "health issue" that doctors should be in? Nope. We shouldn't be pushing to ban guns any more than we should push to ban soda, tobacco, french fries, candy, not using seatbelts, motorcycles, not exercising, being fat, etc. Overarching control of a patient's life is not our jurisdiction.

Given that >99% of scientists are in agreement, I think the science is pretty settled. Even if you don't buy warming, the acidification of the oceans is proof enough that our CO2 has done a great deal of damage to the ecosystem. And it's an easy problem to solve, we just need to decide to do so.

As to guns, it's usually not a lifestyle choice for the person being shot. That's the difference between it and all the other things you name- it largely (although certainly not exclusively as suicide statistics in Australia post-ban show) affects those who aren't the owner of the firearm. We very well should be lobbying for tougher laws with regard to drunk driving, safety standards for vehicles, bans on vaping products that show demonstrable harm to pulmonary tissue, and I'm all about tighter controls on who gets to own a firearm. And the frequent talking point of chalking it up to mental illness is nonsense, as is shown by both the research and my own anecdotal experience. The potential mass shooters that have come into our ER were exclusively individuals that were not mentally ill. They were angry over personal disputes and wanted some revenge. Being a murderer isn't a mental illness, it's usually just someone that is furious and has the means to act on that fury.

I don't personally push for gun control. Hell, I'm looking to buy a few. But I think it is well within the right of any physician to argue that they should be more strictly regulated, as they clearly have a public health impact.

 

[deleted480308]

Given that >99% of scientists are in agreement, I think the science is pretty settled. Even if you don't buy warming, the acidification of the oceans is proof enough that our CO2 has done a great deal of damage to the ecosystem. And it's an easy problem to solve, we just need to decide to do so.

As to guns, it's usually not a lifestyle choice for the person being shot. That's the difference between it and all the other things you name- it largely (although certainly not exclusively as suicide statistics in Australia post-ban show) affects those who aren't the owner of the firearm. We very well should be lobbying for tougher laws with regard to drunk driving, safety standards for vehicles, bans on vaping products that show demonstrable harm to pulmonary tissue, and I'm all about tighter controls on who gets to own a firearm. And the frequent talking point of chalking it up to mental illness is nonsense, as is shown by both the research and my own anecdotal experience. The potential mass shooters that have come into our ER were exclusively individuals that were not mentally ill. They were angry over personal disputes and wanted some revenge. Being a murderer isn't a mental illness, it's usually just someone that is furious and has the means to act on that fury.

I don't personally push for gun control. Hell, I'm looking to buy a few. But I think it is well within the right of any physician to argue that they should be more strictly regulated, as they clearly have a public health impact.

we're just going to keep disagreeing on just about all of that, that's fine.

I do agree with you that mental illness isn't necessarily the main cause of firearms deaths (I think most of that is as-holishness). I only mentioned mental health is it's actually a health problem.

 

[jdh71]

The cynic in me wonders if this is more about physicians (especially those evil cis heterosexual male variety) who tend to lean right in their politics. More indoctrination on left leaning to farther left political topics may help remedy this situation? Gotta get them formative before they can really start making up their own minds?

Though it’s probably nothing quite that organized. If I wear my foil hat, I can see the plot in the novel on just this topic!

Seems like there can or should be a way to incorporate the impact of these global and social issues on medicine as a whole and on our patients in the specific without needing to bend or advocate outright in the specific to a particular partisan (which seems often left) political position or policy on the issues themselves.

 

[KeikoTanaka]

I think what Mad Jack stated should be re-iterated: It was a single lecture. In no way has talking about climate change affected or taken away from my hard sciences. I think just because the criteria / curriculum changes to include things doesn't mean its actually stressed. We never spoke about guns in our school. We all know that if you want to be an advocate, that's what clubs and writing to your local officials are for. But, for most things, literally mentioning it for ~20 minutes is sufficient. We're med students, we don't need to ponder for hours about the effects of climate change, we get it, we move on.

 

[Crayola227]

I mean, we spoke about guns, but it was about screening for those at risk of suicide in psych, or basic home safety check stuff in peds, or in the context of patients where there was concern for abuse by someone in the household. I think that's relevant, and the sort of common-sense stuff that we cover in patients because it is part of our job.

I saw a kid whose very young little sibling accidentally blew their limb off with a rifle the parent left out. Obviously there was a discussion about how they should consider storing their guns in the future. We frequently try to address a lack of common sense in our patients all the time.

I recently had a personal scare with an Iraq War vet with PTSD who was toting his gun around.

Telling patients to consider how to make their homes safer from gun injury is hardly political in my view. Sure, docs could be motivated that way or lobby in that sphere. I think it should be treated as two separate issues.

I'm actually pro-guns in a lot of ways. I'm less so in certain situations, and no matter how pro-gun I am, I have to reconcile that with the fact that statistically, some of the above groups may not be safer with guns in the home, and it's my duty to say as much, however for guns I might be. I try not to let my pro-gun views keep me from suggesting that some patients should consider not owning guns, or having them in the home, or having them very secured. Just as I would not like to see my anti-gun colleagues try to push their views on patients, I try not to let being pro-gun keep me from making those recommendations to patients. Not all patients are safer owning guns.

One thing that annoyed me in the article as well, was the supposition that we are to learn to cure patients. Hardly. That's the easy part. The truth is that more and more we spend our time managing chronic conditions.

In any case, it's a very limited view this guy is taking, and that he also describes in those he's criticizing. Of course we should be applying population-based health, the average primary care doc has a patient population of about 10,000 people, and about 2,500 on their actual panel.

The fact is that the climate has changed. It can be argued that this change was inevitable and part of the natural order of things on a longitudinal scale of the Earth's history, or that it's not clear how the rise in CO2 affects these things, if at all. OK. The point is, we can accept that change is happening, and how it will affect health, and what to do about that, without actually having to consider *how* climate change is coming about and what that otherwise means for what humans should do to address it.

The point is, the legitimacy of talking about these topics and what they mean for patient health is completely relevant.

What is more concerning to me, is how it is coming about. Of course it should be scientifically based. Of course we should try to remain as politically neutral as we can be in coming to some kind of consensus on best practices. That's easier said than done. I think it's concerning if this is politically motivated, or if you're getting bloat and those that aren't medically qualified to direct medical education.

The dudes from the 70s are not wrong, that at some point we have to consider societal and cultural effects on patient health. That we need to treat the whole patient in that context as well. I can believe that the forest is getting lost for the trees in some ways, and that it's possible things have swung too much to being partisan or less rigorous.

 

[VA Hopeful Dr]

The cynic in me wonders if this is more about physicians (especially those evil cis heterosexual male variety) who tend to lean right in their politics. More indoctrination on left leaning to farther left political topics may help remedy this situation? Gotta get them formative before they can really start making up their own minds?

Though it’s probably nothing quite that organized. If I wear my foil hat, I can see the plot in the novel on just this topic!

Seems like there can or should be a way to incorporate the impact of these global and social issues on medicine as a whole and on our patients in the specific without needing to bend or advocate outright in the specific to a particular partisan (which seems often left) political position or policy on the issues themselves.

And I suspect most schools do just that. I remember a lecture of LGBT specific health issues. It was 2 hours, apolitical, and really just hit the areas that matter. Stuff like: yes lesbians still need pap smears, find out details about the surgery your transgendered patients have had if they had it, MtF transgender patients on hormones do need mammograms... You get the idea.

 

[VA Hopeful Dr]

"Isn't established well?"

It's pretty clearly established that our insect range issues in the northeast are the result of less frost days and warmer average temperatures allowing species that could not previously survive this far north to do so, and our tick populations have exploded due to a lack of persistent cold periods several years running in ways that are historically unprecedented.

Whether physicians should get involved in the gun control debate is another one where I obviously think yes. If we see hundreds of people coming in with lungs obliterated by vaping we're allowed to speak up, as we would with any other threat to public health. Guns are a public health issue, because they kill and wound a lot of people. We have to piece together and deal with the aftermath of these shootings, and we shouldn't do it in silence. If anything else was killing thousands of people every year and we didn't speak up we would be considered negligent at best or conspirators at worst, why are guns so different?

****, so chronic Lyme is going to get worse?

 

[jdh71]

****, so chronic Lyme is going to get worse?

Has been. Clearly mutating resistance to any and all abx. Diluadid seems to help tho.

 

[Mad Jack]

Has been. Clearly mutating resistance to any and all abx. Diluadid seems to help tho.

It resists everything except one trick your doctor doesn't want you to know about

 

[Little Green Mensch]

Regarding guns: I would hope encouraging patients to learn safe storage and handling techniques is pretty uncontroversial. There are some patients, often psych patients, who should not have access to firearms, because their risk of self-harm or suicide by gun is much higher than John Q. Public's. I don't see that being terribly controversial, either.

Where I take issue with physicians opining in favor of gun control "as a public health issue" is that many of them are horrendously dishonest about the actual scope and nature of the issue. Two-thirds of gun deaths in the U.S. are suicides, and there is little evidence that sharply curtailing access to guns, waiting periods, etc. will reduce deaths in the population most likely to commit suicide by gun (men use more lethal means on average, and are a majority of completed suicides). The overwhelming majority of the gun homicides in the U.S. are committed using handguns, and people already legally barred from gun ownership (i.e. those with criminal records) are profoundly over-represented among both the perpetrators and victims of homicide by firearm.

Despite these facts, the majority of physicians who weigh in on this issue focus in on spree killings with semi-automatic rifles, which comprise less than 2% of deaths by gun in the U.S. (C.f The Assault Weapon Myth, and Thousands Of Americans Are Gunned Down Each Year, But Few Die By Assault-Style Rifle) A true "public health approach" to gun deaths would focus on suicide prevention, better enforcement of extant gun laws, and theft prevention (many guns used in crimes are stolen); of course, that wouldn't get you plaudits from the chattering classes.

 

[wamcp]

I graduated with my MD five years ago now. Has curricula been changed to this point that a former upenn dean has to write a WSJ editorial?
——-
Take Two Aspirin and Call Me by My Pronouns

At ‘woke’ medical schools, curricula are increasingly focused on social justice rather than treating illness.

By Stanley Goldfarb
Sept. 12, 2019 5:54 pm ET

Dr. Goldfarb is a former associate dean of curriculum at the University of Pennsylvania’s Perelman School of Medicine.

The American College of Physicians says its mission is to promote the “quality and effectiveness of health care,” but it’s stepped out of its lane recently with sweeping statements on gun control. And that isn’t the only recent foray into politics by medical professionals. During my term as associate dean of curriculum at the University of Pennsylvania’s medical school, I was chastised by a faculty member for not including a program on climate change in the course of study. As the Journal reportedlast month, such programs are spreading across medical schools nationwide.
Why have medical schools become a target for inculcating social policy when the stated purpose of medical education since Hippocrates has been to develop individuals who know how to cure patients?
A new wave of educational specialists is increasingly influencing medical education. They emphasize “social justice” that relates to health care only tangentially. This approach is the result of a progressive mind-set that abhors hierarchy of any kind and the social elitism associated with the medical profession in particular.
These educators focus on eliminating health disparities and ensuring that the next generation of physicians is well-equipped to deal with cultural diversity, which are worthwhile goals. But teaching these issues is coming at the expense of rigorous training in medical science. The prospect of this “new,” politicized medical education should worry all Americans.

The traditional American model of medical training, which has been emulated around the world, emphasizes a scientific approach to treatment and subjects students to rigorous classroom instruction. Students didn’t encounter patients until they had some fundamental knowledge of disease processes and knew how to interpret symptoms. They were expected to appreciate medical advances and be able to incorporate them into their eventual fields of practice. Medical education was demanding and occasionally led to student failure, but it produced a technically proficient and responsible physician corps for the U.S.
The traditional American model first came under attack by progressive sociologists of the 1960s and ’70s, who condemned medicine as a failing enterprise because increased spending hadn’t led to breakthroughs in cancer treatment and other fields. The influential critic Ivan Illich called the medical industry an instrument of “pain, sickness, and death,” and sought to reorder the field toward an egalitarian social purpose. These ideas were long kept out of the mainstream of medical education, but the tide of recent political culture has brought them in.
As concerns about social justice have taken over undergraduate education, graduate schools have raced to develop curricula that will steep future educators in the same ideology. Today a master’s degree in education is often what it takes to qualify for key administrative roles on medical-school faculties. The zeitgeist of sociology and social work have become the driving force in medical education. The goal of today’s educators is to produce legions of primary care physicians who engage in what is termed “population health.”
This fits perfectly with the current administrator-rich, policy-heavy, form-over-function approach at every level of American education. Theories of learning with virtually no experimental basis for their impact on society and professions now prevail. Students are taught in the tradition of educational theorist Étienne Wenger, who emphasized “communal learning” rather than individual mastery of crucial information.
Where will all this lead? Medical school bureaucracies have become bloated, as they have in every other sphere of education. Curricula will increasingly focus on climate change, social inequities, gun violence, bias and other progressive causes only tangentially related to treating illness. And so will many of your doctors in coming years.
Meanwhile, oncologists, cardiologists, surgeons and other medical specialists are in short supply. The specialists who are produced must master more crucial material even though less and less of their medical-school education is devoted to basic scientific knowledge. If this country needs more gun control and climate change activists, medical schools are not the right place to produce them.

 

[wamcp]

Corrupting Medical Education

The reaction to Dr. Goldfarb’s op-ed proves his point.

By The Editorial Board
Sept. 15, 2019 4:09 pm ET

Left-wing medical Twitter —yes, there is such a thing—piled on with virtue signaling that distorted Dr. Goldfarb’s argument. He didn’t write that doctors shouldn’t have opinions about political issues. He wrote that those issues shouldn’t interfere with the scientific and clinical training essential to producing doctors who can serve patients.
The most disappointing response came from Penn medical school, which sprinted for political cover. Dean J. Larry Jameson and Senior Vice Dean Suzanne Rose sent a letter to students and faculty that is a case study in progressive correctness:
“Please know that the views expressed by Dr. Goldfarb in this column reflect his personal opinions and do not reflect the values of the Perelman School of Medicine,” the letter said. “We deeply value inclusion and diversity as fundamental to effective health care delivery, creativity, discovery, and life-long learning. We are committed to ensuring a rigorous and comprehensive medical education that includes examination of the many social and cultural issues that influence health, from violence within communities to changes in the environment around us.”
Maybe we should begin to wonder about the quality of the doctors who graduate from Penn. Patients want an accurate diagnosis, not a lecture on social justice or climate change. Thanks to Dr. Goldfarb for having the courage to call out the politicization of medical education that should worry all Americans.

 

[radsisrad]

I graduated with my MD five years ago now. Has curricula been changed to this point that a former upenn dean has to write a WSJ editorial?

It was pretty bad back then, too. Speaking from experience.

 

[Dro133]

Complete and utter bull****.

First of all, curriculum changes are not coming at the expense of a rigorous scientific and clinical education. Getting a residency spot is more competitive than ever. Scores for the most objective measure of pure "knowledge" that we have, USMLE Step 1, are at their highest point ever and continue to rise. To say that producing more "woke" doctors means producing worse doctors is completely disingenuous and reeks of an old guard, "they don't make 'em like they used to" type of mindset.

This guy is arguing that we should ignore social inequities which are a huge driver of our country having worse overall health outcomes than most developed nations? That we should be satisfied with patching people up and sending them back out into a world which is set up for them to fail and end up back in the hospital? If our job as doctors is to care for the sick and improve the health of our patients, then there is little we could do that would be more effective at improving public health than addressing social inequities, and that requires being aware of social determinants of health.

This author is part of an old guard that believes that treating the sick is more important than preventing poor health in the first place. It's no wonder that we have the most expensive healthcare in the world and some of the worst outcomes amongst developed countries.

Edit: had to add more because I read the comment by the editorial board again and became even more infuriated. Who the **** is the Wall Street Journal's editorial board to comment on the quality of medical student that comes out of UPenn? They have no credibility in that realm whatsoever. "The politicization of medical education that should worry all Americans" -- are you kidding me? This is such an irresponsible take. I don't understand how they can call themselves respectable journalists with this piece of irresponsible fear-mongering.

 

[Chibucks15]

Idk there’s quite a lot of “woke” BS out there that’s incorporated. Idk maybe my classmates are a little more vocal than most

 

[DO2015CA]

Just like everything in medical school, funnel out the white noise your school pushes down your throat

 

[VA Hopeful Dr]

Complete and utter bull****.

First of all, curriculum changes are not coming at the expense of a rigorous scientific and clinical education. Getting a residency spot is more competitive than ever. Scores for the most objective measure of pure "knowledge" that we have, USMLE Step 1, are at their highest point ever and continue to rise. To say that producing more "woke" doctors means producing worse doctors is completely disingenuous and reeks of an old guard, "they don't make 'em like they used to" type of mindset.

This part seems pretty disingenuous given that this forum has at least a monthly thread about how lectures are useless and the key to success is the myriad of Step 1 study resources.

 

[Ho0v-man]

Don’t think there’s anything wrong with informing students of the difficulties that lower SES patients face when they leave the hospital. Let’s be honest here, the majority of medical students never considered the challenges of living below a six figure income prior to medical school. There’s definitely a place for this info. I personally question the utility of it being delivered by administrative non-physicians who’ve likely never had first or even second hand experience with poverty, but that’s a whole other issue.

Climate change? Gun control? Pfft! No idea where that’s coming from. I’m sure some of my faculty have strong opinions and I guess I could see them going on a tangent in lecture or something on a random day, but this stuff would never be an actual part of the curriculum.

But this article is pure trash. It’s not like any school has cancelled heme/onc and replaced it with a month-long course on not assuming someone’s gender. GTFOH. This honestly reads like some right winger got upset that medical students came into a clinical rotation with their own opinions on political issues.

 

[deleted407021]

Old man yells at could, etc. , etc.

 

[Dro133]

This part seems pretty disingenuous given that this forum has at least a monthly thread about how lectures are useless and the key to success is the myriad of Step 1 study resources.

I'm not sure why this matters. My point is, students are leaving their pre-clinical years with more basic science knowledge than ever as evidenced by higher Step 1 scores, so I don't see how the author can say that "wokeness" is being taught at the expense of basic science knowledge.

Also, I'm not sure about how other schools operate, but all of our "woke" lectures were required small group sessions, so they were in addition to, not in lieu of, our regular lectures.

 

[bananafish94]

Meanwhile, oncologists, cardiologists, surgeons and other medical specialists are in short supply. The specialists who are produced must master more crucial material even though less and less of their medical-school education is devoted to basic scientific knowledge.

There's no shortage of old men yelling at clouds. I like how the author assumes that students are mastering less basic science material despite students becoming more competitive and scoring higher on standardized exams every single year. And somehow connects this to mastering a sub-specialty? Yeah, I bet that cardiology fellowship is overshadowed by the handful of social justice lectures that we have each year during pre-clinical years. Maybe they should add another year of training to make up for all the lost time! In all seriousness, I think the author is probably just a part of the "old guard" and wants things to stay the way they used to be.

 

[VA Hopeful Dr]

I'm not sure why this matters. My point is, students are leaving their pre-clinical years with more basic science knowledge than ever as evidenced by higher Step 1 scores, so I don't see how the author can say that "wokeness" is being taught at the expense of basic science knowledge.

Also, I'm not sure about how other schools operate, but all of our "woke" lectures were required small group sessions, so they were in addition to, not in lieu of, our regular lectures.

Because its evidence that what the schools are doing have less impact than previously. So even if they were teaching stuff like climate change at the expense of heme-onc it wouldn't likely really show up.

For what its worth, I don't agree with the author of the article in general.

 

[jdh71]

Because its evidence that what the schools are doing have less impact than previously. So even if they were teaching stuff like climate change at the expense of heme-onc it wouldn't likely really show up.

For what its worth, I don't agree with the author of the article in general.

The higher test scores also aren't necessarily an indicator of better basic science knowledge and how to integrate it (if at all) into clinical practice, just an indicator of better step 1 prep. It's an industry now, is it not? Hell I remember back in the days of walking up hill both ways in the winter to medical school lectures all we had was First Aid and USMLE World. The kids these days needing to stay off my lawn aren't "smarter" - better prepared for the test because of better prep materials and length of time? Yes. More clever and tech savvy? Seems like it.

We discussed this some over in the policy thread. Students needs to know about the health outcomes of things like climate change, guns, lower socioeconomic status, being a member of a minority, etc. I think it's all of the political and policy agitation that goes along with it that becomes tiring and tedious. A few extra hours for some lectures for medical students is something they can handle.

 

[KeikoTanaka]

There's no shortage of old men yelling at clouds. I like how the author assumes that students are mastering less basic science material despite students becoming more competitive and scoring higher on standardized exams every single year. And somehow connects this to mastering a sub-specialty? Yeah, I bet that cardiology fellowship is overshadowed by the handful of social justice lectures that we have each year during pre-clinical years. Maybe they should add another year of training to make up for all the lost time! In all seriousness, I think the author is probably just a part of the "old guard" and wants things to stay the way they used to be.

Maybe the shortage in Oncology/Cardiology/Surgical Subspecialties has more to do with the fact that these people are expected to work 60+ hours a week for the rest of their lives meanwhile my generation (millennials) is perfectly willing to sacrifice 150,000$/year more in salary for 20 hrs a week more of freedom. Also, we're told incessantly "They're so competitive" - So people probably don't even bother thinking of it as an option while in school unless you're already in the top 10% of your class with tons of research and publications under your belt. Yet here they are, in "high demand" yet everyone is so defeated by the daunting med school process they think they don't have a chance, perhaps until it's too late, and you already chose/matched into a specialty outside of IM out of fear of not getting into a Fellowship and being relegated to a life as a GIM/Hospitalist.

 

[VA Hopeful Dr]

The higher test scores also aren't necessarily an indicator of better basic science knowledge and how to integrate it (if at all) into clinical practice, just an indicator of better step 1 prep. It's an industry now, is it not? Hell I remember back in the days of walking up hill both ways in the winter to medical school lectures all we had was First Aid and USMLE World. The kids these days needing to stay off my lawn aren't "smarter" - better prepared for the test because of better prep materials and length of time? Yes. More clever and tech savvy? Seems like it.

We discussed this some over in the policy thread. Students needs to know about the health outcomes of things like climate change, guns, lower socioeconomic status, being a member of a minority, etc. I think it's all of the political and policy agitation that goes along with it that becomes tiring and tedious. A few extra hours for some lectures for medical students is something they can handle.

No argument on any of this

 

[jdh71]

Maybe the shortage in Oncology/Cardiology/Surgical Subspecialties has more to do with the fact that these people are expected to work 60+ hours a week for the rest of their lives meanwhile my generation (millennials) is perfectly willing to sacrifice 150,000$/year more in salary for 20 hrs a week more of freedom. Also, we're told incessantly "They're so competitive" - So people probably don't even bother thinking of it as an option while in school unless you're already in the top 10% of your class with tons of research and publications under your belt. Yet here they are, in "high demand" yet everyone is so defeated by the daunting med school process they think they don't have a chance, perhaps until it's too late, and you already chose/matched into a specialty outside of IM out of fear of not getting into a Fellowship and being relegated to a life as a GIM/Hospitalist.

Wow. You sound like a victim.

 

[VA Hopeful Dr]

Maybe the shortage in Oncology/Cardiology/Surgical Subspecialties has more to do with the fact that these people are expected to work 60+ hours a week for the rest of their lives meanwhile my generation (millennials) is perfectly willing to sacrifice 150,000$/year more in salary for 20 hrs a week more of freedom. Also, we're told incessantly "They're so competitive" - So people probably don't even bother thinking of it as an option while in school unless you're already in the top 10% of your class with tons of research and publications under your belt. Yet here they are, in "high demand" yet everyone is so defeated by the daunting med school process they think they don't have a chance, perhaps until it's too late, and you already chose/matched into a specialty outside of IM out of fear of not getting into a Fellowship and being relegated to a life as a GIM/Hospitalist.

Seriously?

The match rate for heme-onc was 99%, cardiology was 99.3%, colon/rectal and oncology both matched at 100%, peds surgery was 95%, as was thoracic.

If there are people "daunted" by the idea, well I think medicine will survive.

 

[jdh71]

Seriously?

The match rate for heme-onc was 99%, cardiology was 99.3%, colon/rectal and oncology both matched at 100%, peds surgery was 95%, as was thoracic.

If there are people "daunted" by the idea, well I think medicine will survive.

Hell. I also don’t want people daunted by the hours on many of those jobs. I mean you don’t get to have it both ways. It’s like a marine complaining about having to carry a rifle and a heavy pack. They go together. Patients need us when they need us.

 

[deleted962973]

Seriously?

The match rate for heme-onc was 99%, cardiology was 99.3%, colon/rectal and oncology both matched at 100%, peds surgery was 95%, as was thoracic.

If there are people "daunted" by the idea, well I think medicine will survive.

So then the shortage of doctors in these specialities has nothing to do with this generation of “woke” medical students not applying to them (as the author insinuated) and everything to do with there not being enough training spots.

 

[Dro133]

The higher test scores also aren't necessarily an indicator of better basic science knowledge and how to integrate it (if at all) into clinical practice, just an indicator of better step 1 prep. It's an industry now, is it not? Hell I remember back in the days of walking up hill both ways in the winter to medical school lectures all we had was First Aid and USMLE World. The kids these days needing to stay off my lawn aren't "smarter" - better prepared for the test because of better prep materials and length of time? Yes. More clever and tech savvy? Seems like it.

We discussed this some over in the policy thread. Students needs to know about the health outcomes of things like climate change, guns, lower socioeconomic status, being a member of a minority, etc. I think it's all of the political and policy agitation that goes along with it that becomes tiring and tedious. A few extra hours for some lectures for medical students is something they can handle.

Sure, I agree that there's no guarantee that higher test scores are an indicator of being a better clinician, but I brought that up to demonstrate how ridiculous the assertion is that medical schools are graduating students who are going to become worse doctors with less knowledge. There's no evidence to suggest that teaching social determinants of health makes for worse clinicians. To me, it seems as if the author never considered the possibility that today's graduates may be just as strong clinically as their predecessors while simultaneously being, on average, more attuned to social determinants (thanks in part to changes in medical school curricula).

 

[jdh71]

Sure, I agree that there's no guarantee that higher test scores are an indicator of being a better clinician, but I brought that up to demonstrate how ridiculous the assertion is that medical schools are graduating students who are going to become worse doctors with less knowledge. There's no evidence to suggest that teaching social determinants of health makes for worse clinicians. To me, it seems as if the author never considered the possibility that today's graduates may be just as strong clinically as their predecessors while simultaneously being, on average, more attuned to social determinants (thanks in part to changes in medical school curricula).

I don’t remember arguing that students sitting through woke lectures would be worse physicians.

Did I miss that part of my post??? I am old. Perhaps senile?

 

[Dro133]

I don’t remember arguing that students sitting through woke lectures would be worse physicians.

Did I miss that part of my post??? I am old. Perhaps senile?

No, you did not. I was addressing the author's assertion.

 

[Aerus]

Why are more resources automatically not equal to better basic science knowledge? People are forgetting that Anki and other flashcard programs are also a large reason why we are seeing higher test scores and flash cards are a great way to increase basic science knowledge when there's so much minutiae to memorize. I can't imagine the old generation of med school graduates having a better basic science knowledge background with just First Aid and hard copy textbooks if they didn't have flash card programs like we do. Sure they could have made their own hard copy flash cards by hand, but I doubt doing that was as prolific as using Anki is nowadays. Anki is definitely more efficient than making hard copy flashcards for sure.

 

[VA Hopeful Dr]

So then the shortage of doctors in these specialities has nothing to do with this generation of “woke” medical students not applying to them (as the author insinuated) and everything to do with there not being enough training spots.

That or a maldistribution

 

[KeikoTanaka]

Wow. You sound like a victim.

No, I have no idea what I want to do, just relaying things I've heard from others. I'm impartial lol

 

[Select All That Apply]

This thread pretty much encapsulates why medical education could tangibly be forced to incorporate issues about gun control and climate change. Dro's written response of disgust to reading the OP is likely apropro to the sentiment of those with an agenda within the education domain who feel that it is the best medium in which they can facilitate humans to consider issues of social justice. Meanwhile everyone else is simply echoing the sentiment that medical education itself is already flawed to varying degrees and filled with empty noise, so adding on more noise shouldn't change an individual student's outlook on what they need to extrapolate in order to succeed.

However, postsecondary education has drastically changed within the past decade. The cases involving both Oberlin College and Evergreen State College within the past year have shown that inoculating and exposing students primarily to social conflict theory and then subsequently to frameworks of feminism and racial-conflict have resulted in students that primarily see their circumstances as being a product of feminism and racial discrimination. When these students act out on these ideological principles, the university claims no responsibility for being a vehicle of influence in these matters (Gibson's Bakery v. Oberlin College). Being more inclusive and adding in more public health, social justice, and environmental science classes on a benign level is at best tolerable with the possible negative outcome of it being analogous to its effect on undergraduate students.

 

[deleted407021]

This thread pretty much encapsulates why medical education could tangibly be forced to incorporate issues about gun control and climate change. Dro's written response of disgust to reading the OP is likely apropro to the sentiment of those with an agenda within the education domain who feel that it is the best medium in which they can facilitate humans to consider issues of social justice. Meanwhile everyone else is simply echoing the sentiment that medical education itself is already flawed to varying degrees and filled with empty noise, so adding on more noise shouldn't change an individual student's outlook on what they need to extrapolate in order to succeed.

However, postsecondary education has drastically changed within the past decade. The cases involving both Oberlin College and Evergreen State College within the past year have shown that inoculating and exposing students primarily to social conflict theory and then subsequently to frameworks of feminism and racial-conflict have resulted in students that primarily see their circumstances as being a product of feminism and racial discrimination. When these students act out on these ideological principles, the university claims no responsibility for being a vehicle of influence in these matters (Gibson's Bakery v. Oberlin College). Being more inclusive and adding in more public health, social justice, and environmental science classes on a benign level is at best tolerable with the possible negative outcome of it being analogous to its effect on undergraduate students.

woah

 

[7331poas]

Complete and utter bull****.

First of all, curriculum changes are not coming at the expense of a rigorous scientific and clinical education. Getting a residency spot is more competitive than ever. Scores for the most objective measure of pure "knowledge" that we have, USMLE Step 1, are at their highest point ever and continue to rise. To say that producing more "woke" doctors means producing worse doctors is completely disingenuous and reeks of an old guard, "they don't make 'em like they used to" type of mindset.

This guy is arguing that we should ignore social inequities which are a huge driver of our country having worse overall health outcomes than most developed nations? That we should be satisfied with patching people up and sending them back out into a world which is set up for them to fail and end up back in the hospital? If our job as doctors is to care for the sick and improve the health of our patients, then there is little we could do that would be more effective at improving public health than addressing social inequities, and that requires being aware of social determinants of health.

This author is part of an old guard that believes that treating the sick is more important than preventing poor health in the first place. It's no wonder that we have the most expensive healthcare in the world and some of the worst outcomes amongst developed countries.

Edit: had to add more because I read the comment by the editorial board again and became even more infuriated. Who the **** is the Wall Street Journal's editorial board to comment on the quality of medical student that comes out of UPenn? They have no credibility in that realm whatsoever. "The politicization of medical education that should worry all Americans" -- are you kidding me? This is such an irresponsible take. I don't understand how they can call themselves respectable journalists with this piece of irresponsible fear-mongering.

Sounds like you are one of my "woke" classmates that cause everyone to sit through mandatory BS

 

[Dro133]

Meanwhile everyone else is simply echoing the sentiment that medical education itself is already flawed to varying degrees and filled with empty noise, so adding on more noise shouldn't change an individual student's outlook on what they need to extrapolate in order to succeed.

Issues of social justice and inequality are not "empty noise" when it comes to health outcomes. This isn't some pie-in-the-sky, millenial hipster take about what is moral or "right" (although striving for social equality are both of those things); we're talking about cold, hard healthcare outcomes here.

All-cause mortality. Heart disease. Stroke. Cancer. Diabetes. Homicide. Infant mortality. Prenatal care. Infectious disease. Blacks have worse health outcomes across the board when compared to whites. This is a result of structural inequality, and it's why the social justice movement is important. It's why our country's overall health outcomes are amongst the worst in the developed world despite being the most expensive and most technologically-advanced.

Here's another one for you: In Los Angeles County, economic hardship is directly associated with lower life expectancy. We're talking about 6-7-year difference in life expectancy between those on extreme ends of the economic spectrum. If health inequality stemming from social inequality were a disease with a biological mechanism of action that caused an equivalent reduction in life-span, there would be an entire sector of the pharmaceutical industry devoted to it, and nobody would balk at spending a few medical school lectures dedicated to the topic.

Being more inclusive and adding in more public health, social justice, and environmental science classes on a benign level is at best tolerable with the possible negative outcome of it being analogous to its effect on undergraduate students.

People need to be discerning with what does and does not constitute discrimination, but at the end of the day, structural inequality is a very real thing and I see nothing wrong with undergraduate students being passionate about wanting to change the social structure that disproportionally benefits the elite minority. I disagree with the notion that adding these subjects to the curriculum is at best "tolerable"; at best, it will lead to greater awareness and focus on reducing social inequality, and thus, healthcare inequality, leading to better health outcomes for society as a whole.

 

[deleted407021]

...I see nothing wrong with undergraduate students being passionate about wanting to change the social structure that disproportionally benefits the elite minority...

And here comes the pushback.

 

[Dro133]

And here comes the pushback.

He said, conveniently ignoring the rest of my post.

 

[deleted407021]

He said, conveniently ignoring the rest of my post.

You must think I’m not in agreement with you. I’m saying that people might be fine with students theoretically learning these things but it’s when they threaten systemic change that their progressiveness stops.