The Med School Admissions Process

[little_late_MD]

Just a question for all you potential doctors out there:

Do you think the methodology that medical schools have adopted in terms of their admissions is helping or hurting health care in this country? The way admissions are structured today, only the top of potential applicants are granted admission. However, as any one who has had any real experience with the medical field can tell you, just because someone is intelligent does not translate into them being a good doctor. Not to be overly critical of doctors in general, but you probably could program a computer or two to do all the diagnostic work most MDs perform. Doesn't that mean the human element is the more important part of medicine? Are life and death decisions just too important to give to those who have not proven themselves on the academic battlefield? Today medicine is one of the most respected professions. However, if you look back into the not-so-far-away past, the doctor was seen as having the same status as the cook or the housekeeper. Should medical schools admit more students, and allow the rigor of the curriculum to weed out those who are not qualified?

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[caffeine37]

It seems as though people who already have MDs have an interest in maintaining the prestige of their degree, which they can accomplish by limiting the incoming number of students.

 

[hardy]

Not to be overly critical of doctors in general, but you probably could program a computer or two to do all the diagnostic work most MDs perform. Doesn't that mean the human element is the more important part of medicine?

There is one reason that computers are not used for such things, they cannot think. Sure, they can do differentials, order tests and even prescribe treatment, but in many cases things are not that simple. That is when the human comes in and has to decide whether something is this or that and if the course of treatment is appropriate. Currently, you cannot quantify all parameters such that a computer could process them.

Should medical schools admit more students, and allow the rigor of the curriculum to weed out those who are not qualified?

Look at Europe for that.
Sure, this is a possibility but the parameters in the US are different. You cannot charge somebody $40k in tuition a year if the chance for becoming a doctor is about 30%.

 

[little_late_MD]

I forgot to add this little nugget of information.

There was an expected surplus of doctors predicted for the beginning of the 21st century. The AMA lobbied hard to limit the number of new medical school openings as well as to cap the number of enrollments in current medical schools. They predicted that physicians would be driving cabs or doing pantomime on the boardwalk by the turn of the century. Turns out that never happened, and the current prediction is for a shortage of 85,000-200,000 doctors by the year 2020.

You think medical care is expensive now...

 

[EndSong]

Europe provides a good example of how healthcare can change. Personally, and I'm not just saying this because I'm currently applying, I think the numbers of accepted applicants should be increased. The demand for healthcare is still steady if not increasing and the whole baby boomer generation is about the retire if not already retiring. As things seem to stand a lot of the public hospitals and clinics already seem understaffed.

I think if every school in the country increased seats by say 10 to 20, we'd easily have an extra 1200 to 2400 doctors a year which could translate to a lot more treatment.

I'd wager that at least 75% of the applicants applying to medical school each year are more than capable of handling the medical school courseload and could make good if not wonderful doctors yet the current system only accepts approx less than 50% of the applicants.

 

[dajimmers]

I haven't researched it much other than reading Atul Gawande's Complications, but he cites evidence showing that computers using logistics and percentiles can diagnose better than doctors in many cases, requiring fewer expensive tests and misdiagnoses.

However, he also cites that the average American, and definately the average doctor, would not go for a system like this. Besides just protecting their own employment, doctors feel the human element is important. And I think most patients agree. Especially in today's medical world, where the beliefs, customs, and wishes of the patient is so important in determining treatments.

Uh, I think I've swayed from the topic...

 

[neovenom]

i don't think the current admission process places too much emphasis on intelligence. that's more like a given: every competitive candidate should be academically gifted so that they can handle to volume of info one learns in med school. if anything, i think admission committees tries to look for the human aspects (as you put it) that sets the candidates apart. they try to look for someone who's got a record of helping others, leading groups, or committed to a cause. not to mention i'm sure they try to see if you're an effective communicator and a mature individual during the interview process.

as for weeding out people in med school, i agree that it'd be a big waste of money for the students who don't make it. i think there is already a rigorous weeding out in undergrad. at my school, only 10-15% of the pre-med freshmen were still on track by graduation; and a handful of those actually make it into med school.

 

[Jon Davis]

as for weeding out people in med school, i agree that it'd be a big waste of money for the students who don't make it. i think there is already a rigorous weeding out in undergrad. at my school, only 10-15% of the pre-med freshmen were still on track by graduation; and a handful of those actually make it into med school.

To add to this thought, the pre-med curriculum has become tougher due to increased competition. Not to mention all the extra-cirriculars that students MUST complete to be competitive. Looking at some apps, I am amazed that some students have the ability to maintain an insane amount of extra-cirriculars, publish papers, have high grades, etc. The applicant pool has, in my opinion, evolved at a rapid pace. I don't even know if many ad comms truly understand the pressure pre-meds currently go through in this era.

 

[TruTrooper]

i don't think the current admission process places too much emphasis on intelligence. that's more like a given: every competitive candidate should be academically gifted so that they can handle to volume of info one learns in med school. if anything, i think admission committees tries to look for the human aspects (as you put it) that sets the candidates apart. they try to look for someone who's got a record of helping others, leading groups, or committed to a cause. not to mention i'm sure they try to see if you're an effective communicator and a mature individual during the interview process.

as for weeding out people in med school, i agree that it'd be a big waste of money for the students who don't make it. i think there is already a rigorous weeding out in undergrad. at my school, only 10-15% of the pre-med freshmen were still on track by graduation; and a handful of those actually make it into med school.

I agree. You have to demonstate that you can handle the unimaginable volume of info that you have to take in during medical school. Of course, you don't have to have a 3.9 or 4.0 to get in, but your resume have to at least indicate that you won't give up or fall far behind at any given point if you get admitted.

 

[Shredder]

Just a question for all you potential doctors out there:

Do you think the methodology that medical schools have adopted in terms of their admissions is helping or hurting health care in this country? The way admissions are structured today, only the top of potential applicants are granted admission. However, as any one who has had any real experience with the medical field can tell you, just because someone is intelligent does not translate into them being a good doctor. Not to be overly critical of doctors in general, but you probably could program a computer or two to do all the diagnostic work most MDs perform. Doesn't that mean the human element is the more important part of medicine? Are life and death decisions just too important to give to those who have not proven themselves on the academic battlefield? Today medicine is one of the most respected professions. However, if you look back into the not-so-far-away past, the doctor was seen as having the same status as the cook or the housekeeper. Should medical schools admit more students, and allow the rigor of the curriculum to weed out those who are not qualified?

i think its hurting the system bc we should be admitting smarter ppl, and with fewer hurdles. human element is useless, leave that for the nurses while the mean docs are busy saving lives

i dont know what youre talking about, medicine men have always been among the most highly respected

 

[-Goose-]

human element is useless, leave that for the nurses while the mean docs are busy saving lives

please tell me i lost the sarcasm in this post...

wtf

 

[stupibname]

i think its hurting the system bc we should be admitting smarter ppl, and with fewer hurdles. human element is useless, leave that for the nurses while the mean docs are busy saving lives

i dont know what youre talking about, medicine men have always been among the most highly respected

I have to agree with u... it seems most doctors juts stop by the patients room during rounds.. talk with em for like 2 mins... ask them if their in pain... then move on... It's really the nurses that spend the intensive hours with patients to make them comfortable and happy... and even then... after a while nurses get callous as well when they have to deal with grumpy patients... How can people who volunteer at hospitals keep on pushing that docotrs actually spend excessive time with pateints making them feel better.. it's just not feasible for them to do that... they are generally far too buys.

 

[Will Ferrell]

i think its hurting the system bc we should be admitting smarter ppl, and with fewer hurdles. human element is useless, leave that for the nurses while the mean docs are busy saving lives

i dont know what youre talking about, medicine men have always been among the most highly respected

Amen!!

 

[Jon Davis]

i think its hurting the system bc we should be admitting smarter ppl, and with fewer hurdles.

100% agreee. Read my post above.

human element is useless, leave that for the nurses while the mean docs are busy saving lives.

100% disagree. Doctors must deal with the human element treating patients. People aren't to be treated like cash-carrying cattle. They deserve respect, acknowledgement, compassion, etc when treated by doctors and other professionals. If you're being sarcastic, it is vague at best.

 

[DrBowtie]

I think what Shredder is trying to say is that the value of your doc is best spent by him seeing more patients for short periods of time. Nurses getting paid less can spend more time with the pts and being "human".

1 Doc @ $100/hr vs 5 Nurse @ $20/hr

 

[-Goose-]

i guess i didn't lose the sarcasm...

you have to wonder sometimes...

 

[Rendar5]

I think what Shredder is trying to say is that the value of your doc is best spent by him seeing more patients for short periods of time. Nurses getting paid less can spend more time with the pts and being "human".

1 Doc @ $100/hr vs 5 Nurse @ $20/hr

Doing a good job as a doc requires spending time w/ patients, since most of the info u need is often in the history.

 

[DrBowtie]

Doing a good job as a doc requires spending time w/ patients, since most of the info u need is often in the history.

H&Ps could be done by other healthcare workers.

 

[Rendar5]

They could. But if I'm treating a patient, I'm gonna want to do that stuff myself.

Besides, I don't feel like being relegated to a simple relay station between the H/P person, the lab tech, and the pharmacist.

 

[DrBowtie]

Fair enough. I'm not saying I agree one way or the other exclusively. I was just offering a counter idea.

It seems that although quality time with physicians has decreased, the quick in and out doc in the boxes have started to pop up all over the place. 20 min in and out with 5 min face time. They wouldn't be popping up if there wasn't demand. Some pts want to go in get a 2 min screen, get their rx and get on with their life.

 

[Shredder]

They could. But if I'm treating a patient, I'm gonna want to do that stuff myself.

Besides, I don't feel like being relegated to a simple relay station between the H/P person, the lab tech, and the pharmacist.

many docs might want to (myself not included), but demands may not allow it. shortage of docs means that docs dont get time to shoot the breeze with all their patients, they have to keep moving along. get the vital info, call the shots, and proceed.

a doc might be better at administering the human element than another healthcare worker would (volunteer, nurse, PA), just like a doc is probably better at secretarial work than his secretary. but, due to the concept of comparative advantage, the doc must do what he does best--prescribe, diagnose, or operate. there are plenty of other shoulders to cry on besides MD shoulders

it would be beneficial for the healthcare industry if paraprofessionals like nurses, nurse anesthetists, and PAs were permitted to overlap/compete for some duties with docs instead of letting docs have a monopoly. this has vastly improved the eyecare industry with competition between optometrists, opticians and opthalmologists

 

[DrBowtie]

many docs might want to (myself not included), but demands may not allow it. shortage of docs means that docs dont get time to shoot the breeze with all their patients, they have to keep moving along. get the vital info, call the shots, and proceed.

a doc might be better at administering the human element than another healthcare worker would (volunteer, nurse, PA), just like a doc is probably better at secretarial work than his secretary. but, due to the concept of comparative advantage, the doc must do what he does best--prescribe, diagnose, or operate. there are plenty of other shoulders to cry on besides MD shoulders

it would be beneficial for the healthcare industry if paraprofessionals like nurses, nurse anesthetists, and PAs were permitted to overlap/compete for some duties with docs instead of letting docs have a monopoly. this has vastly improved the eyecare industry with competition between optometrists, opticians and opthalmologists

I hope I was correct in my clarification of what you meant above. You might want to clarify yourself if it wasn't.

 

[Shredder]

Some pts want to go in get a 2 min screen, get their rx and get on with their life.

yeah, i swear, if all of the human element is that bloody important, cant they just create a new job for it and let docs practice pure medicine in peace without worrying about all of that? humanism school or something. id love to have a mean doc who was strictly business, then let the pro humanist swoop in afterward and console me

also those ppl you bring up are the ones whose time is valuable i would think. those at county hospitals/free clinics would probably love to have people listen to them talk on and on about their woes in life and misery

 

[DrBowtie]

yeah, i swear, if all of the human element is that bloody important, cant they just create a new job for it and let docs practice pure medicine in peace without worrying about all of that? humanism school or something. id love to have a mean doc who was strictly business, then let the pro humanist swoop in afterward and console me

also those ppl you bring up are the ones whose time is valuable i would think. those at county hospitals/free clinics would probably love to have people listen to them talk on and on about their woes in life and misery

I think this mostly applies to outpatient fp. If it is an ordeal to drag your 3 children along to the doc or take a day off of work and the results are the same the pt will favor quicker service...just like any other business that pts want efficiency.

With inpatient, I think that most pts think they have a serious issue and need reassurances.

 

[GoodEats]

For those of you who prefer the greater human touch, there are patients out there who will pay more to see you. I've heard anecdotal evidence of doctors who work out-of-network in order to provide more thorough care for their patients. These patients must then obviously pay more for the service, but they find it worth their money. Many others do not.

Shredder, don't you have a TRIZ assignment or Pugh chart to complete?

 

[Centinel]

Yeah, one time this patient went up to an ophthalmologist that I used to work for and said, "Look, I will pay you whatever hourly rate you think is fair for you to sit here and listen to my worries and fears and respond to them."

 

[LabMonster]

For those of you who prefer the greater human touch, there are patients out there who will pay more to see you. I've heard anecdotal evidence of doctors who work out-of-network in order to provide more thorough care for their patients. These patients must then obviously pay more for the service, but they find it worth their money. Many others do not.

Very true - these lucrative practices are popping up because there is obviously a demand. Let the market decide where policy-makers and health care administration have failed.

That said, I'll give the "human touch" to those who need it and leave it out when they don't.