Two Articles that Challenge the Validity of Medical School Admissions

[mimelim]

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so you will opt for an average doctor who holds your hand versus a superior doctor who spends less time with you?

I pay my doctors to do their job, and to do it well, not to hold my hand and tell me everything will be OK.

This makes you a part of a very very small minority of patients. Also, it isn't just patients, it is building a referral network. The reality is that you really need both, good bedside manner and good medicine to be a good physician. It isn't about spending more or less time, it is about respecting the patient. I honestly think that physicians that genuinely care about their patients make better doctors. Even the radiologists or others who have little to no direct patient contact. This isn't about hand holding or sitting down for hours. This is about basic respect and care. Medicine is not all science and numbers, there is a fair amount art behind practice.

Also, you need to remember that of all the medical students accepted, only a small fraction go into radiology or pathology. The vast majority will have a ton of patient contact every day. It is absolutely miserable to watch brilliant doctors who don't understand basic patient communication or critical thinking try to practice medicine. You see it all the time with IMGs. I know 3 residents, all graduates from India, all had 250+ Step 1/2, all crushed their classes, all speak more than proficient English, but they are barely functional, even as upper level residents because they have significant difficulty administrating effective patient care. They are the ultimate examples of people that can easily cut it academically, but are poorly suited to practice medicine. Largely went into it for prestige (family pressure++), excelled because they are the best of the best in a country were schools are much more competitive than hours, but lack the interest in caring for patients and develop a clock in, clock out mentality.

 

[Status Sciaticus]

I was under the impression that it's not a good idea to be so narrowly focused on one branch of medicine if you're going to med school. What if you don't get to be a radiologist?

What patient wants a doctor (in any specialty) who just holds their nose and tolerates their patients for the bare minimum amount of time? I've never trusted doctors who I can sense don't care about me.

I don't think a doctor can be considered "superior" just because they are good at school but their bedside manner sucks. The relationship between doctor and patient has an effect on the patient's well-being. It's not about hand-holding and saying they'll be ok. It's about listening and trust and honesty. Like I said, there are plenty of brilliant people who want to be doctors who also care about patients, so people who are trying to avoid clinical experience and volunteering but still feel entitled to a spot in medical school should be weeded out.

Again, you didnt answer the question, but tried to find a way around it.

Your explanation doesnt apply to all doctors. There are surgeons who are superior because they receive better training or have access to better facilities.

So my question stands.... do you want a superior surgeon who doesnt hold your hand to operate on you, or do you want an average surgeon who does?

 

[The Bunk]

Again, you didnt answer the question, but tried to find a way around it.

Your explanation doesnt apply to all doctors. There are surgeons who are superior because they receive better training or have access to better facilities.

So my question stands.... do you want a superior surgeon who doesnt hold your hand to operate on you, or do you want an average surgeon who does?

Lol, I'm not "trying to find way around it." I'm looking it at it from a different perspective than you. I think you're setting up a false dichotomy here where a patient has to choose between an impersonal genius or a mediocre bleeding-heart. Why are those the only choices? I'm saying the "superior" doctor you originally asked me about is both highly competent and caring.

 

[Status Sciaticus]

Lol, I'm not "trying to find way around it." I'm looking it at it from a different perspective than you. I think you're setting up a false dichotomy here where a patient has to choose between an impersonal genius or a mediocre bleeding-heart. Why are those the only choices? I'm saying the "superior" doctor you originally asked me about is both highly competent and caring.

I am sure there are.

The reason I only gave you those two options were because you said that the seats taken up by indifferent students should be given to those who care more about patients.

So if there were only those two surgeons, who would you pick?

 

[muddyduck7]

Aren't ADCOMs also selecting students that will benefit their peers and the student body as a whole as well? Isn't that the point of diversity?

 

[Mornhavon]

.

 

[The Bunk]

I am sure there are.

The reason I only gave you those two options were because you said that the seats taken up by indifferent students should be given to those who care more about patients.

So if there were only those two surgeons, who would you pick?

First of all, I did not say that spots should be given to average students with big hearts over the indifferent students. I said that there are so many equally strong students applying to med school that priority should be given to the ones who actually care.

As to your poorly framed question, I think it would depend on a bunch of factors beyond what you provided. If it's a tricky procedure, then maybe I would go with the robot. If it was an appy, then maybe I'd choose the nice one. I don't know because it's kinda hard to make decisions about unrealistic, poorly defined, hypothetical situations.

 

[cookiemonsters]

Do adcoms have contempt for people of lower SES but not from races you'd expect that from?

I don't think there's necessarily contempt, but I don't think it plays much into their decision. Which is unfortunate.

 

[Status Sciaticus]

First of all, I did not say that spots should be given to average students with big hearts over the indifferent students. I said that there are so many equally strong students applying to med school that priority should be given to the ones who actually care. (Also, I said this after you gave me your two options, so that cannot be why you asked.)

As to your poorly framed question, I think it would depend on a bunch of factors beyond what you provided. If it's a tricky procedure, then maybe I would go with the robot. If it was an appy, then maybe I'd choose the nice one. I don't know because it's kinda hard to make decisions about unrealistic, poorly defined, hypothetical situations.

so just because they dont get all gushy with their patients, they are 'robots' ?
Please.....

 

[The Bunk]

so just because they dont get all gushy with their patients, they are 'robots' ?
Please.....

Lol, you don't have to get so huffy. It was just shorthand because I'm tired of writing out "book smart with poor bedside manner" over and over. There is obviously a big middle ground between "gushy" and "robot," but I think it's safe to say that empathy and caring hugely important qualities for a good doctor.

 

[Drrrrrr. Celty]

Bad research is bad.

Do you think Adcoms are using these things as a measure of how you will preform in medical school? No, they rather are using them as measures of how they will preform after medical school and as doctors ( As well as a brief psych eval). So sure, these things may not relate to being good in medical school, but it probably relates to how and what these people will do as doctors.

 

[Mt Kilimanjaro]

Bad research is bad.

Do you think Adcoms are using these things as a measure of how you will preform in medical school? No, they rather are using them as measures of how they will preform after medical school and as doctors ( As well as a brief psych eval). So sure, these things may not relate to being good in medical school, but it probably relates to how and what these people will do as doctors.

One study I linked included internship.

Do you have links to the studies that show these variables correlate with good outcomes post residency?

 

[Tommyguns89]

the likelihood that those 100 applicants coming from wealthy white families who can afford the best education, resources, and education would be astronomically high.

So it wouldnt be much different from how it is now.

 

[Status Sciaticus]

So it wouldnt be much different from how it is now.

and that is the reason affirmative action was implemented.

That is also the reason why there is a box to check if you consider yourself disadvantaged, either via SES or coming from an underserved area.

 

[jvquarterback]

1. The essay is a test of exclusion. The real question the authors should have asked is how good is the sensitivity of the essay for exclusion of potential medical students.

2. The interview is a test of either inclusion or exclusion. The authors should have looked at the reproducibility of scores for interviewees in the top and bottom quintiles.

3. There is an enormous self-selection bias for self-reported clinical experience. If the authors did mv analysis of experience with the MCAT score and GPA (real predictive indicators of med school gpa) I doubt there would be a difference. Ask yourself this - what were the GPA and MCAT scores of students accepted at USHUS who had no clinical experience?

About what you would expect from a journal with an impact score of 2.

 

[notbobtrustme]

I don't think there's necessarily contempt, but I don't think it plays much into their decision. Which is unfortunate.

I don't think most adcoms look that closely at the data. Having money comes with so many advantages. You don't have to work to feed the family, you don't have any stress about living/food/transportation/healthcare. You have better access to tutors, private schooling, more extracurriculars. Your parents will know more influential people and be able to put you in contact with them. All these advantages compound from the day you come out of the womb to the day you apply to med school.

 

[Drrrrrr. Celty]

One study I linked included internship.

Do you have links to the studies that show these variables correlate with good outcomes post residency?

Not at all, it would be impossible to quantify or realistically qualify such things. That being said, it is the reason for why interviews, essays, etc are conducted. Medical school adcoms are looking for students that fit their school's medical mission more times than not. And chances are that someone who fits the psychological profile of someone who is likely to fit the school's mission is more likely going to go apply themselves to that mission than someone who does not.

You follow? Adcoms aren't searching for the next MD/PhD who will do Neurodermoradiation oncology at MGH, but rather the person who will fit their mission.


Regardless trying to make a premise based on the non-existent relationship between two factors is not really all the useful when those two factors were never assessed for that reason.