Think you're too old for med school?

[abbeydesert]

Think again! I just read this incredible story about a woman who started med school at 57 and just finished her residency at age 65. Here's a link to the article: http://www.tennessean.com/sii/00/10/08/doclady08.shtml
It sure puts things in perspective for us 30 and 40-something young'uns!

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[limit]

This woman attended St. George's... So it's not that much confidence building for getting into US allopathic schools. However, this is just a bad example.

There's a guy in his 60's, a veterenarian, who recently graduated a US allopathic med school, and set up a private practice where he treats both animals and humans.

 

[VAD]

I actually think this story is very encouraging for us non-trads. Even though she attended St. Georges, she was able to receive her degree and complete her residency. I can understand why some schools may have not wanted to have a student of such an advanced age, but I bet most of us on this board are in our late20s-early 40s, so hopefully that won't be as much of a problem for us!

VAD

 

[MSepo]

I don't begrudge anyone their good luck in procuring a spot in a medical school or residency, but frankly i look at this from a different perspective. To me this situation is analogous to the type of ethics question that some interviewers have asked: if you had the choice between giving a heart transplant to a wealthy, successful septuagenerian or a twenty year-old washout, to whom would you give it? Obviously, the answer to this question is a judgment call and there is no correct answer but I wonder about the ethical implications of giving a 56-yr old woman the opportunity for which literally thousands of 20-somethings would figuratively give their right arms. And in fact, the problem is made even more complex by the fact that most of these younger medical school applicants aren't washouts and quite the opposite. Just thought i'd throw that out there...

 

[Methuselah]

Msepo, what do you perceive as an ethical implication of selecting a 56-yr old woman over a twenty-something?

 

[BigSkyDreams]

Howdy,
I too have a different perspective:
The obvious answer to the above question is to give the heart transplants to the rich old folks because they are the only ones that can afford to fully reimburse the hospital.
The young washouts will cost the coporation hundreds of thousands of dollars, and this is an inefficient way to run a business, we all know that it is profits before the people!

The assumption that the quantity of life, ie the length of practice, is more valuable rather that quality of physicians and patients interaction, ie she has the life experience and the skills to be a doctor, tends to be a sandy foundation for this house. This doctor, regardless of her age has jumped through all the hoops, where as the whims of the unproven twentysomethings is as irrelevent as the ridiculousness of the first paragraphs reasoning.

------------------
BSD
______
Work under the assumption that you will be happy one day

[This message has been edited by BigSkyDreams (edited 10-29-2000).]

 

[MSepo]

*SIGH*. You know, I don't think anyone fully reads my posts before responding to them; either that, or they don't bother thinking about them at all. I thought that at least one implication was obvious based on the example i gave about the heart transplant. As i typed, it is analagous. Whatever ethical dilemmas you can perceive in the former situation would, I believe, be just as applicable in the latter: i.e. questions of age, probable duration of practice, etc. In brief, the situation begs the question of whether it is morally right to give such a rare chance to someone who's already had his/her chances in life since they are necessarily utilizing limited academic resources. Obviously, the point would be moot if there were unlimited spots in a medical school. And just to make the point clear, I have not taken sides in this issue since I haven't made up my mind about it yet. But i do think that the situation does indeed raise a moral question.

 

[Mango]

There are a couple other things to consider. The largest of which is that the US government subsidizes our medical education. Even if you take no Stafford Loan money, the US gov't (ie tax payers) still supports you education. Med schools AND residency programs recieve funding PER student. This is why they try so hard to keep us from dropping out!

Now knowing that your tax dollars are being spent training physicians, which would you rather train:
A. A 21 year old who will serve the community for 40-50 years, or
B. A 55 year old who maybe work for 5-10?

I'm not saying which choice is correct, and I agree that many older students will make fine doctors. But you have to examine this from all sides. And from the perspective of the schools, and the government, you can appeciate why they prefer younger students. And lets not forget, a doctor who has been practicing for 30 years is much more like ly to give nice hefty donations to his/her alma matter!


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[BigSkyDreams]

Howdy MSepo,
OK I'll bite.
What would you consider the statistical average of years the a physician ought to practice in order to fulfill their obligation to 'society' (?) for being allowed to utilize one of these limited resourses?

This arguement is heading toward age discrimination at full speed. Remember that this is not the standard but a story of human determination to pursue a goal. We get onto ethically unstable ground when we classify people as unfit for participation in events based solely on factors that are outside of their control. This list includes age, gender, race, etc. The standards for entering medical school are based on performance, something that is manipulatable by the individual, she did demonstrated her ability to the adcom and she has passed her boards. Therefore, in my opinion there are no ethical implications with this case in regards to her age.

As a follow up to considering the ethical issues of age and the profession:
If years of practice or a duty to society were the standard prior to become a physician, thus implying that physicians are in short supply and must be utilized with care, should we have cosmetic surgeons that specialize in tummy tucks and breast enhancements? Could they not be fulfilling their obligation better in an underserved area? Or should we allow orthopods to retire at under the age of sixty?



------------------
BSD
______
Work under the assumption that you will be happy one day

 

[MSepo]

BigSkyDreams:
Regarding your first post, the 1st paragraph was obviously meant to be facetious but I don't understand your 2nd. You imply that the 20-somethings are bound to obey some kind of "Uncertainty Principle"
where they have to trade "quantity of life" for "quality of life" in providing care. By that line of reasoning, everyone should, for example, wait until they are 40, 50, 60-somethings to get married and have families because 20-somethings don't have the maturity and "experience" to do so. Unless you don't agree that it is more difficult to be a parent and spouse (oftentimes amateur doctors in their own right) - and increasingly these days, it seems - than it is to be a doctor (I'm guessing most people will agree with me on this point); and the role as familymember is made even more difficult by lack of any formal training. Furthermore, this is not only pretty poor logic for you to dismiss the hopes of anyone - regardless of age or experience -as "uproven whims;" its also inconsistent with what appears to be your own contention that EVERYONE ought to be given an equal shot - age discrimination against the young? I'd like to know what measuring instrument you used to do that, because I could use one of those.

 

[dolly]

I've worked in a hospital for five years. Sorry to say, we have lost more young doctors than old. (Car accidents, drug overdose, drown during epileptic seizure, heart attack). Other young doctors have left the business to pursue other interests (they realized that they were not cut out for the profession.) No man knows the number of his days.

 

[MSepo]

BSD:
In response to your second post:
"What you consider the statistical average...blahblah?"

I think 29.545yrs is a good average duration for one to have met their obligation.

Of course the argument is heading towards age discrimination; that's precisely the point and where the ethical dilemma arises. That is, perhaps age discrimination against the one should be permitted for the good of the many. Should she be allowed/excluded from the opporunity to benefit humanity based on her age? There would be no ethical implications if she were the only person applying to medical school. However, given the intense competition for relatively few spots in medical school, the question remains: who will best serve society? If it can be assumed that two people separated in age by 30yrs can reasonably be expected to provide the same level and quality of care, it is perhaps in our best interest to choose the one who statistically can sustain that care for the longest duration.

 

[MSepo]

Dolly:

Thanks for your input but an n of one out of a Population of thousands is pretty unreliable data.

 

[dolly]

Thanks for your reply Msepo. I was offering my personal angle of the topic at hand from my experience. Just as others are doing on this post. No reliable statistics or data were to be inferred. Sorry you misunderstood.

 

[UHS2002]

Isn't there a place for everybody?

This lady didn't take a place of a younger student, She went the Caribean route, where anybody can get in as long as they have a hertbeat.

Now she is working at the VA, where no young doctor wants to work.

So, young'ens out there, fear not! She did not take the place that was rightfully yours in med school, nor that coveted place you hope to have 8 years from now.

 

[imtiaz]

Hey! The VA is a wonderful place for aspiring surgeons. I've seen some pretty cool stuff at the VA that I probably wouldn't have seen if I went to a "mainstream" hospital. The patients at VA hospitals are sicker and as a result I would think that you get exposure to a wide variety of cases. I for one, am definitely going to try to get a residency slot at at VA hospital, you wouldn't believe how many pneumonectomies, TKA's, endovascular grafts, inguinal hernias, laryngectomies, orchiectomies(OUCH!), traechiotomies, and a S***LOAD of amputations (shall I go on?) I've seen at the VA. If I volunteered somewhere else I'd be passing out flowers or dispensing urine filled bottles!

Imtiaz

[This message has been edited by imtiaz (edited 10-30-2000).]

 

[Methuselah]

Mango, with all due respect, I disagree with what you think is the "greatest consideration" in deciding between the youngster and the oldster.

You said: "Now knowing that your tax dollars are being spent training physicians, which would you rather train:

A. A 21 year old who will serve the community for 40-50 years, or

B. A 55 year old who maybe work for 5-10?"

The 55-yr old has been in the working world and paying taxes 34 years longer than the 21-yr old. If ANYONE is entitled to a tax-subsidized loan, it's the oldster.
Personally, I have no problem with the most qualified applicant being selected. If the 55 yr-old only works 5 years, then there will be an opening for someone else when they are through.

 

[BigSkyDreams]

Howdy MSepo,
It seem that we disagree in philosophy. I tend toward not being so utilitarian (An assumption, not an attack) in my though because when carried to the logical end result in absurd practices. Nazi euthanasia or American eugenics are the strongest and most detestable examples I can think of. The age issue should not be a concern for the any applicant for the reasons stated in the posts above that anyone (literally) that completes the requirements should be on equal footing with other premeds of the similar scores and experience. This is not a statistically viable option because as a society we may not see the greatest return for the effort, I agree, however these are some of the intangilbe elements in life that add vitality and attractiveness to the prospect of waking up and getting out of bed. I am very much a realist who has seen absolutely miraculous things occur. In the light of hope, faith and love, the statistics pale and science fails to explain away even the smallest of these happenings. I believe have experience enough in life to test and conclude that we can not build efficiency to every apsect of our behavior (We are not Ayn Rand's John Galt) and society (Nor Bill Gates.) The true ethical and moral dilemma is born out of assuming that we have reached a point that we have figured it all out and place limitations on when and what people can accomplish. This is diametercally opposed to the human spirit that is constantly redefining itself and break down the status quo. As an example is how this doctor went out side the standard US allopathic and achieved her purpose.

On the issue of whims, I meant to convey the sentiment that the hypothetical whining younger premeds that wish to increase their odds by limiting the field of players are not demonstrating the maturity to be professionals, and sould be summarily disregarded.

SIDE NOTE: The idea of having people wait until later in life to marry and have children does appeal to me but I can not defend this with any logical or statistical arguement, just a desire for more forethought in choosing a partner that might lead to less divorce (broken homes) prompts me to say so. Again I am not a sociologist and have not reseached whether marriage at latter ages with a more discriminating agenda when selecting a mate leads to a happier and prolonged union.


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BSD
______
Work under the assumption that you will be happy one day

[This message has been edited by BigSkyDreams (edited 10-30-2000).]

 

[MSepo]

"...absurd practices [such as] Nazi euthanasia or American eugenics..."

I'm quite shocked that you put age discrimination - which is, I'm assuming, what we're still talking about - on what appears to be equal footing with either of these particular examples. In this case, such a practice doesn't have nearly the same "logical conclusions" as Nazi exterminations (I'm surprised you use the word euthanasia). After all, we're not talking about establishing a "Logan's Run" society here. For example, suppose we, as a society, were to establish the practice of prohibiting anyone over the age of say, 50, from participating in a particular event or job (with the consensus that such a practice has been deemed to be for the common good). To me this is not much different from the traditional taboo/stigma associated with incest, for example. We have not sought to supress such a practice because it is inherently evil, but rather because it has severe biological risks to the species, i.e. not beneficial. And notice also that age discrimination is fundamentally different from excluding a particular race or sex. One cannot change one's race or
sex <- (i know, i know). However, since on average EVERYONE can be expected to live to at least 50, they too will be subject to the same law, which in fact ceases to be discriminatin as a result.
Finally, let me point out that we do not have a difference in philosophy since I do not believe I've EXPRESSLY advocated the establishment of such practices. My original post's intent was to stimulate some interesting point-counterpoint and I hope I've done that...
PS
I think that "waiting to get married and have children" situation also raises some interesting points that would make for a good thread...

 

[Mitch]

I think we should take everyone over the age of 50 and put them on ice floes in the artic. Clearly, everyone over the age of 50 has out lived their usefulness and has nothing left to offer. Look at Linus Pauling, for example. What did he do that was worthwhile after age 50? To the ice floes, you old foggies.

 

[BigSkyDreams]

Howdy MSepo,
The Nazi govenment started out by 'euthanasizing' the old then moved swiftly to the mentally ******ed, the physically handicapped and so on (order maybe out of order, effects the same, classic slippery slope as the peoples hearts hardened to human value therefore why not kill some more...) This was deemed for the common good. I used this term because it was the mentality of the participants who started out with what was then (in their minds)good intentions.

I DO NOT SUPPORT WHAT THEY DID NOR THE THOUGHT PROCESS BEHIND REACHING THE CONCLUSION THAT SOCIETY BENEFITS BY RIDDING ITSELF OF THOSE THAT IT DEEMS UNWORTHY (?) OF FULL CITIZENSHIP RIGHT WHICH INCLUDE PROTECTION FROM BEING MURDERED.

The reason I used this particular example is because the thought was started with good intention of making society more efficient, ie less drag on the government funds and thus freeing up resources. The simplified version of what I believe started this with (Yes I do know that this may not be your position, rather just a thought exercise) is that there are citizens that have reached an age that disqualifies them from participation in certain activities on the basis that we can not afford to squander limited resourses. Using this, carried it out to include more than just medical school seats, but also life prolonging treatments for the elderly, etc. Obviously we truely are considering this "logan-esque" ideal in todays society. That is the problem with utilitarian or common good ethics, the importance of the individual is lost in the name of progress or efficiency. I just can not support that as a rule, my experience in the military as the triage coordinator (Treatment NCO) has shown that at extreme times there is a need to withhold medical treat or resources from the wounded, but this is ONLY during times of emergency.
Seats in Medical School are limited, but the standard to enter is performance not where society will best be served (great good for the greatest number.)

The common good vs the right of the individual is a long and drawn out arguement that I would rather not continue on this thread, lets talk about over a couple of pints instead.
Thanks for a good conversation.

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BSD
______
Work under the assumption that you will be happy one day