The whole process seems archaic...

[ThinkTooMuch]

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Wow. I just read about this "scramble" and it sounds archaic.Can no one think of a better system? "furiously" making calls, as one person desribed it. There has to be a better way.

I get the impression that a lot of medical school related practices are outdated and rigid. Everything from the dichotomy of patient care provided by sleep deprived indivuals (100K deaths due to medical errors annually doesn't seem to bother anyone), to the "scrambe" to paying residents extremely low wages.

I think its time to bring medical education out of the dark ages.

 

[ngkats]

Heathen!! Go back to the evil future from whence you came!

 

[ThinkTooMuch]

lol.

i know my delivery wasnt that good, but I am being serious.

 

[greg1184]

Not to mention the idea that the "see one, teach one, do one" method of teaching invasive procedures is actually adequate for a resident to learn do do it properly.

 

[Pinkertinkle]

What would u propose we change?

 

[WellWornLad]

Won't somebody PLEASE think of the children.

But seriously, a good proportion of those 100k were on their way out anyway.

Also, someone should do something about the systematic dehumanization of patients that is endemic to medical education.

 

[Rendar5]

Wow. I just read about this "scramble" and it sounds archaic.Can no one think of a better system? "furiously" making calls, as one person desribed it. There has to be a better way.

I get the impression that a lot of medical school related practices are outdated and rigid. Everything from the dichotomy of patient care provided by sleep deprived indivuals (100K deaths due to medical errors annually doesn't seem to bother anyone), to the "scrambe" to paying residents extremely low wages.

I think its time to bring medical education out of the dark ages.

yeah medical errors suck, but so far, the implementation of better sleep practices doesn't seem to have reduced patient mortality despite the obvious theorietical effect that it should have. Which means there may be something to the really really really knowing the patient that so many hours on call produce. Personally, I think if we restrict work hours we need to do so sensibly. hell, get rid of call and post-call and have a steadier influx of patients and dont' ahve days where you're ridiculously overswamped and overburdened. it'll mean less light days, but improves knowing ur patients whil allowing work hour reductions to help the way they're supposed to.

Ran that by an IM bound MS4 today who hated the idea since she'd never have easier days or something like that. but i'm wondering if it wouldnt' be better

 

[VoiceofReason]

yeah medical errors suck, but so far, the implementation of better sleep practices doesn't seem to have reduced patient mortality despite the obvious theorietical effect that it should have. Which means there may be something to the really really really knowing the patient that so many hours on call produce.

Have patient outcomes gotten worse? No? Alright then let me sleep dude.

 

[Rendar5]

Have patient outcomes gotten worse? No? Alright then let me sleep dude.

Hey, no argument from me on that one 🙂 My only point is that we can't say reducing work hours saves lives. It just saves my sanity.

 

[45408]

Deaths due to medical errors is a very hard thing to study. It would be much, much more useful to look at "number of years lost" from the expected lifespan. If a 95-year old dies of an infection resulting from a bed sore that arose from the nursing home aides forgetting to turn her over regularly, that's a very different error than giving someone the wrong blood transfusion or giving a drug to a patient that causes a severe allergic reaction. These studies don't separate that sort of thing out. If the error caused your death, but you were going to die within a day, then I don't care. If it caused your death, and you would have lived another 5-50 years, then it's a big deal.

 

[colbgw02]

Regarding the match, it certainly has its problems. But when you consider the percentage of people for whom it actually works, it's a pretty remarkable system. Not too many people are around to tell the tales of what it was like before the match, but my understanding is that it was a total goat rodeo. I'm sure the scramble is a mess, but it doesn't really detract much from the over all effectiveness of the system.

 

[Isoprop]

Regarding the match, it certainly has its problems. But when you consider the percentage of people for whom it actually works, it's a pretty remarkable system. Not too many people are around to tell the tales of what it was like before the match, but my understanding is that it was a total goat rodeo. I'm sure the scramble is a mess, but it doesn't really detract much from the over all effectiveness of the system.

That's a good point. I always felt like the match was a weird, random process.

Does anyone know how it was set up before the match?

 

[PremedIowa]

That's a good point. I always felt like the match was a weird, random process.

Does anyone know how it was set up before the match?

http://kuznets.harvard.edu/~aroth/papers/JAMA.OriginsAndHistoryNRMP.Roth.pdf

Life sucked before the match. Students were often offered internships late in the second year of med school and given less than a week to decide.

 

[ThinkTooMuch]

http://kuznets.harvard.edu/~aroth/papers/JAMA.OriginsAndHistoryNRMP.Roth.pdf

Life sucked before the match. Students were often offered internships late in the second year of med school and given less than a week to decide.

interesting. though i am of the opinion there is always room for improvement.

 

[PremedIowa]

interesting. though i am of the opinion there is always room for improvement.

I definitely agree there is room for improvement. I think one change that could be made would be to hold a second match 2-3 weeks after the first to give programs time to interview candidates by phone and rank them in a reasonable way. This could eliminate some of the scramble insanity for many applicants and programs.