What would you change about the way medical education is practiced?

[calivianya]

2 years of clerkship is horrendous.

Also making the MCAT the bar would effectively eliminate all low SES students and URMs from medicine since poor school districts do not teach science well and lower income students won't be thrilled about paying for college education in the sciences when richer students can sit the MCAT post-high school.

There is no hard requirement to take classes at all to sign up for the MCAT, so I don’t really understand this comment. The courses on Khan Academy are enough to do well without ever stepping foot on a college campus, and Khan Academy is free. I took the MCAT before I finished the premed courses, and learning the material I hadn’t had classes on yet on Khan Academy was enough for me to pull a 515.

If anything, I personally think the current system hurts URM/low SES students more - they currently have to pay for classes that are completely useless if you don’t get into med school, when they could learn the material for free online otherwise. There’s not much you can do with a handful of intro bio, intro chem, physics, etc. classes in the real world.

Removing college courses also takes GPA out of the equation, which is nice for people who worked full time through undergrad. The rich kid advantage also comes in from getting to sit pretty in an on-campus apartment and not work, while someone else might be working two jobs to pay for a place to live during undergrad, negatively impacting their grades.

---

Members don't see this ad.

 

[Ho0v-man]

There is no hard requirement to take classes at all to sign up for the MCAT, so I don’t really understand this comment. The courses on Khan Academy are enough to do well without ever stepping foot on a college campus, and Khan Academy is free. I took the MCAT before I finished the premed courses, and learning the material I hadn’t had classes on yet on Khan Academy was enough for me to pull a 515.

If anything, I personally think the current system hurts URM/low SES students more - they currently have to pay for classes that are completely useless if you don’t get into med school, when they could learn the material for free online otherwise. There’s not much you can do with a handful of intro bio, intro chem, physics, etc. classes in the real world.

Removing college courses also takes GPA out of the equation, which is nice for people who worked full time through undergrad. The rich kid advantage also comes in from getting to sit pretty in an on-campus apartment and not work, while someone else might be working two jobs to pay for a place to live during undergrad, negatively impacting their grades.

Agree with bolded. I’ve always thought this is a big reason those populations don’t pursue medicine. That’s why I didn’t initially.

I personally think gpa has more value for assessing a candidate than most think it does despite how easy it is to game it and the point you bring up above. So I think we should take at least the prereqs.

I think the argument could easily be made that having it come down to just the mcat also disproportionately hurts low SES populations because it benefits the people who can afford to sit at home and take multiple prep courses.

 

[7331poas]

There is no hard requirement to take classes at all to sign up for the MCAT, so I don’t really understand this comment. The courses on Khan Academy are enough to do well without ever stepping foot on a college campus, and Khan Academy is free. I took the MCAT before I finished the premed courses, and learning the material I hadn’t had classes on yet on Khan Academy was enough for me to pull a 515.

If anything, I personally think the current system hurts URM/low SES students more - they currently have to pay for classes that are completely useless if you don’t get into med school, when they could learn the material for free online otherwise. There’s not much you can do with a handful of intro bio, intro chem, physics, etc. classes in the real world.

Removing college courses also takes GPA out of the equation, which is nice for people who worked full time through undergrad. The rich kid advantage also comes in from getting to sit pretty in an on-campus apartment and not work, while someone else might be working two jobs to pay for a place to live during undergrad, negatively impacting their grades.

How many low SES students are going to be able to take time out of their work schedule (since they will have to work since they aren't in college) to self-study the entirety of chem 1/2 organic 1/2 biochem, physics, biology, etc? I would say a far fewer amount than the current number of low SES who can secure a federal loan to enter college.

I know for a fact that I would never have been able to self study these topics without a federal loan sponsoring my studies. I would have had to do the same thing every other student in my small town does, go to work.

Your comment about having to work two jobs is questionable. No student needs to work two jobs to go to college. Every student can access federal aid for the cost of attendence (believe it is mandated by law but I could be corrected on that).

 

[calivianya]

Agree with bolded. I’ve always thought this is a big reason those populations don’t pursue medicine. That’s why I didn’t initially.

I personally think gpa has more value for assessing a candidate than most think it does despite how easy it is to game it and the point you bring up above. So I think we should take at least the prereqs.

I think the argument could easily be made that having it come down to just the mcat also disproportionately hurts low SES populations because it benefits the people who can afford to sit at home and take multiple prep courses.

Same here with the top line. I initially wrote medicine off because of how many courses you have to take that don’t translate to any sort of valuable life skill. I’d been working for $22k/year and I knew that no matter what, if I went back to school, I wanted to be able to pay my rent and electricity and all that jazz without living off of ramen and hoping my car didn’t break down. So I decided to pursue something else that I knew would get me a job that paid a decent wage. Joke’s on me that I decided I really did want to go to medical school later, and came back after I made enough to pay for the premed courses in cash.

How many low SES students are going to be able to take time out of their work schedule (since they will have to work since they aren't in college) to self-study the entirety of chem 1/2 organic 1/2 biochem, physics, biology, etc? I would say a far fewer amount than the current number of low SES who can secure a federal loan to enter college.

I know for a fact that I would never have been able to self study these topics without a federal loan sponsoring my studies. I would have had to do the same thing every other student in my small town does, go to work.

I guess it all comes down to the individual. I worked 40+ hours per week while carrying an 18 credit hour course load, so I personally didn’t take any time off work to study. I would have chopped off a non vital body part to have been able to stay at home instead of having to commute to college and fall asleep sitting up during the lectures just to get a piece of paper saying I was there. Pretty much had to learn entirely on my own anyway because I spent so much of class time dozing off.

I decided against taking out a loan for the prereqs just because they’re useless in the workforce. I can understand why people do, but it’s a gamble. Even $30k in loans can be a real hardship if you don’t get into medical school and the jobs you can get don’t pay well.

 

[VA Hopeful Dr]

There is no hard requirement to take classes at all to sign up for the MCAT, so I don’t really understand this comment. The courses on Khan Academy are enough to do well without ever stepping foot on a college campus, and Khan Academy is free. I took the MCAT before I finished the premed courses, and learning the material I hadn’t had classes on yet on Khan Academy was enough for me to pull a 515.

If anything, I personally think the current system hurts URM/low SES students more - they currently have to pay for classes that are completely useless if you don’t get into med school, when they could learn the material for free online otherwise. There’s not much you can do with a handful of intro bio, intro chem, physics, etc. classes in the real world.

Removing college courses also takes GPA out of the equation, which is nice for people who worked full time through undergrad. The rich kid advantage also comes in from getting to sit pretty in an on-campus apartment and not work, while someone else might be working two jobs to pay for a place to live during undergrad, negatively impacting their grades.

No kidding, that's why you take those courses as part of getting a college degree. My chemistry BS required a year of bio and a year of physics anyway so it didn't cost me any extra time to take those classes.

And a chemistry degree with get you decent paying work if you don't do med school.

 

[deleted1005514]

No kidding, that's why you take those courses as part of getting a college degree. My chemistry BS required a year of bio and a year of physics anyway so it didn't cost me any extra time to take those classes.

And a chemistry degree with get you decent paying work if you don't do med school.

That’s why I stayed an extra 18 months and got my MS. If I didn’t get into medical school I could teach at the university level upon graduation. Also got a grad assistantship so the MS was free.

 

[Rogue42]

2 years of clerkship is horrendous.

Also making the MCAT the bar would effectively eliminate all low SES students and URMs from medicine since poor school districts do not teach science well and lower income students won't be thrilled about paying for college education in the sciences when richer students can sit the MCAT post-high school.

I know others have commented, but since you responded to my original post, I figured I owed you a direct response.

Like stated, Khan Academy can teach you everything you need to know. And again, if you're 17/18 years old, and you're mature & intelligent enough to get into medical school then you're probably able to recognize that your school system sucks.

Lets face it, the system is currently rigged towards those that are rich anyways, I don't see the argument you're trying to making here. My plan would remove one highly expensive obstacle SES students face today. I wasn't highly thrilled that I had to work two jobs in college when I had buddies that didn't do jack crap, had Kaplan and Code Breakers, and all they did was study for the MCAT when I could barely find the time to breathe.

Now, instead, in high school, they can study the MCAT and if they have to work, then so be it cause that's life. But high school students have way less responsibilities, even for SES students. Also, lets not act like someone who is smart enough to get into medical school REALLY STUDIES in high school.

How many low SES students are going to be able to take time out of their work schedule (since they will have to work since they aren't in college) to self-study the entirety of chem 1/2 organic 1/2 biochem, physics, biology, etc? I would say a far fewer amount than the current number of low SES who can secure a federal loan to enter college.

If you study the MCAT in the spring of your Junior year, then you can be ready to attend medical school straight away if you can do the other things needed to be a competitive applicant. Lets say screw it, they don't, and they have to get a job straight out of HS. I can promise you they have more time to study the MCAT and work than they would if they had to study the MCAT, study for classes, AND work. Your response might be, "but richer students can do the other things to be competitive right away and low SES students might not." I would say sure, but again that difference is always there even in college.

No kidding, that's why you take those courses as part of getting a college degree. My chemistry BS required a year of bio and a year of physics anyway so it didn't cost me any extra time to take those classes.

And a chemistry degree with get you decent paying work if you don't do med school.

You might have missed his point because my original comment is what started this; the point is that if you can take the MCAT and score well without having to get a college degree or pay for pre-recs then you should be able to do so. If you want to go to college to get a degree first, then pursue medicine, then you should. But there should not be as many hoops and jump-ropes to go through to get into medical school. Taking "pre-recs" just to satisfy a GPA is wasting money, and having a bachelors degree does not = inherently more intelligent.

 

[efle]

To play devil's advocate, sustained high performance across 3-4 years of diverse course topics was much harder to achieve than a high MCAT score was. And in the prereqs, the classes put the MCAT to shame, I mean for heck's sake they dont even need a calculator for their physics section or have any free response orgo questions just low-level multiple choice.

 

[VA Hopeful Dr]

You might have missed his point because my original comment is what started this; the point is that if you can take the MCAT and score well without having to get a college degree or pay for pre-recs then you should be able to do so. If you want to go to college to get a degree first, then pursue medicine, then you should. But there should not be as many hoops and jump-ropes to go through to get into medical school. Taking "pre-recs" just to satisfy a GPA is wasting money, and having a bachelors degree does not = inherently more intelligent.

Is it though? I know you think it is, but can you prove its of no value?

 

[altblue]

To play devil's advocate, sustained high performance across 3-4 years of diverse course topics was much harder to achieve than a high MCAT score was. And in the prereqs, the classes put the MCAT to shame, I mean for heck's sake they dont even need a calculator for their physics section or have any free response orgo questions just low-level multiple choice.

You also went to a major grade deflater for undergrad, though, which isn't exactly representative of the average competitive applicant for USMD programs.

Difficulty of top 30 undergrad (sans Harvard, Brown etc.) >> 510+ MCAT > difficulty of typical undergrad.

For many, I'd wager, the MCAT is the barrier. College is just a grind.

 

[efle]

You also went to a major grade deflater for undergrad, though, which isn't exactly representative of the average competitive applicant for USMD programs.

Difficulty of top 30 undergrad (sans Harvard, Brown etc.) >> 510+ MCAT > difficulty of typical undergrad.

For many, I'd wager, the MCAT is the barrier. College is just a grind.

Hmmm. Fair points but I think any standard university does a lot of weeding out with their prereqs. The MCAT is only hard because of the curve; because it's mostly strong students who even reach the point where they take it.

 

[Rogue42]

Is it though? I know you think it is, but can you prove its of no value?

Solid point; no, I cannot prove something that is subjective. Can you prove that a bachelors degree adds value to how a physician practices?

I mean, I can't think of a pre-rec class that would come into play on how I practice, because everything I need to learn in medicine is taught in medical school or residency. One might argue that a bachelors degree 'rounds out' your education and makes you a whole person, but I still do not know where British Lit. and American Revolution History will help me in treating a patient.

I could look up research on what the value of bachelors degrees or pre-recs is, but most research would say that the value of a bachelors degree increases lifetime earnings which really isn't the conversation that we are having, and I bet there is no research on the value of pre-recs on education.

 

[VA Hopeful Dr]

Solid point; no, I cannot prove something that is subjective. Can you prove that a bachelors degree adds value to how a physician practices?

I mean, I can't think of a pre-rec class that would come into play on how I practice, because everything I need to learn in medicine is taught in medical school or residency. One might argue that a bachelors degree 'rounds out' your education and makes you a whole person, but I still do not know where British Lit. and American Revolution History will help me in treating a patient.

I could look up research on what the value of bachelors degrees or pre-recs is, but most research would say that the value of a bachelors degree increases lifetime earnings which really isn't the conversation that we are having, and I bet there is no research on the value of pre-recs on education.

As I'm constantly saying, our overall medical education system produces great physicians. If you want to make major changes, its up to you to show it won't harm the quality of the doctors we produce.

Also, and I believe I'm stealing @Goro 's line here, we're not producing technicians. There's definite value to having an education beyond purely medical knowledge.

Now I am biased as I went to a liberal arts undergrad so over 50% of my courses there weren't even related to my major much less my medical education. But looking back, I think it was valuable even after 7 years of practice.

 

[efle]

College is also some of the best years of many people's lives. I know I'll cherish every day of those 4 years forever. I'd hate to see bright young people truncating or missing out on the incredible American university experience just to get to their job more efficiently.

 

[sloh]

Solid point; no, I cannot prove something that is subjective. Can you prove that a bachelors degree adds value to how a physician practices?

I mean, I can't think of a pre-rec class that would come into play on how I practice, because everything I need to learn in medicine is taught in medical school or residency. One might argue that a bachelors degree 'rounds out' your education and makes you a whole person, but I still do not know where British Lit. and American Revolution History will help me in treating a patient.

I could look up research on what the value of bachelors degrees or pre-recs is, but most research would say that the value of a bachelors degree increases lifetime earnings which really isn't the conversation that we are having, and I bet there is no research on the value of pre-recs on education.

Lots of college is just signaling (IQ and conscientiousness). You guys should check out Bryan Caplan’s “The Case Against Education.”

 

[efle]

Lots of college is just signaling (IQ and conscientiousness). You guys should check out Bryan Caplan’s “The Case Against Education.”

Bingo! It's not that learning humanities really makes you provide different medical care... for premeds (and pre-law, pre-PhD for competitive places) college functions as an intellectual proving ground, succeeding in baccalaureate education is much more valuable in that regard than high school could ever be.

 

[7331poas]

Lots of college is just signaling (IQ and conscientiousness). You guys should check out Bryan Caplan’s “The Case Against Education.”

No surprise, the guy is a libertarian strategist.

Who would have thought that mechanical engineering courses were teaching signaling instead of statics all along.

 

[Rogue42]

Bingo! It's not that learning humanities really makes you provide different medical care... for premeds (and pre-law, pre-PhD for competitive places) college functions as an intellectual proving ground, succeeding in baccalaureate education is much more valuable in that regard than high school could ever be.

Why should medical education involve itself in "lets see whose cockamadoodle is bigger" competitions? At the cost of mental health, money, opportunities, etc? Let the intellectual proving ground and cockamadoodle competitions be in medical school. Again, lets not forget that a 500 or better on the MCAT is indicative of passing boards regardless of age.

 

[Splenda88]

Bingo! It's not that learning humanities really makes you provide different medical care... for premeds (and pre-law, pre-PhD for competitive places) college functions as an intellectual proving ground, succeeding in baccalaureate education is much more valuable in that regard than high school could ever be.

Let's ban most FMGs from applying to US residency....

 

[efle]

Why should medical education involve itself in "lets see whose cockamadoodle is bigger" competitions? At the cost of mental health, money, opportunities, etc? Let the intellectual proving ground and cockamadoodle competitions be in medical school. Again, lets not forget that a 500 or better on the MCAT is indicative of passing boards regardless of age.

Sorry I dont follow, how would we identify the best people for medical school in medical school?

While it's true that the average admitted statistics are well above the threshold to predict passing, I'm fine with that. I'd rather we have exceptional minds in medicine than passable ones.

 

[efle]

Let's ban most FMGs from applying to US residency....

Do FMGs usually finish medical school at 17-18 years old, and having never lived independently?

 

[Splenda88]

Do FMGs usually finish medical school at 17-18 years old, and having never lived independently?

No... 22-23.

 

[efle]

No... 22-23.

Oh so basically they do university by a different name. Seems like the same as american premeds with maybe 2 year diff? I definitely think our system could widely adopt the 1-year preclinical at which point things would be almost identical, like 6 vs 7 total years

 

[Splenda88]

Oh so basically they do university by a different name. Seems like the same as american premeds with maybe 2 year diff?

Almost everywhere in the world people got into med school directly from high school at 17-18 yr old... and med school is 5-6 yrs. People are done with med school when they are 22-23. There is one in my program who we be an attending at 25.

 

[efle]

Almost everywhere in the world people got into med school directly from high school at 17-18 yr old... and med school is 5-6 yrs. People are done with med school when they are 22-23. There is one in my program who we be an attending at 25.

Oh interesting how similar is the competition? Like is there an equivalent to the MCAT that they have 17 year olds taking, and is high school GPA actually a valuable tool there where you can't halfass your way to a 4.0? What percent of applicants get into med school overall?

 

[Splenda88]

Oh interesting how similar is the competition? Like is there an equivalent to the MCAT that they have 17 year olds taking, and is high school GPA actually a valuable tool there where you can't halfass your way to a 4.0? What percent of applicants get into med school overall?

It was extremely competitive where I am from... because all the med schools were public and were free.

 

[efle]

It was extremely competitive where I am from... because all the med schools were public and were free.

Do you know what percent of applicants get in? I suppose here in America we do have BSMD tracks that also decide whether 17 year olds will be good med students. Im not a huge fan of that but they're definitely competitive!

 

[Splenda88]

Do you know what percent of applicants get in? I suppose here in America we do have BSMD tracks that also decide whether 17 year olds will be good med students. Im not a huge fan of that but they're definitely competitive!

I would say < 20%...

 

[Splenda88]

Do you know what percent of applicants get in? I suppose here in America we do have BSMD tracks that also decide whether 17 year olds will be good med students. Im not a huge fan of that but they're definitely competitive!

In all honesty, I am not advocating for BSMD programs... I am advocating for 2-3 yr prereqs and 3 yrs of med school... Get rid of the BA/BS requirement, and restructuring the MD curriculum to be 18 months + 18 months.

If some people think a BA/BS degree would make them more mature to attack med school curriculum and make them a better physician, they can do it by all means, but don't make it a requirement.

 

[altblue]

In all honesty, I am not advocating for BSMD programs... I am advocating for 2-3 yr prereqs and 3 yrs of med school... Get rid of the BA/BS requirement, and restructuring the MD curriculum to be 18 months + 18 months.

If some people think a BA/BS degree would make them more mature to attack med school curriculum and make them a better physician, they can do it by all means, but don't make it a requirement.

The issue is that the people most in need of more maturity oftentimes wouldn't recognize this. My upperclassman mentor repeated his first year and attributed it to coming directly from undergrad and being unproductive/burnt-out, which yes has a lot to do with working too hard/mental health, but could also be influenced by how mature one is. My stats were solid but my clinical volunteering and shadowing were very borderline so I didn't apply the year before graduation, and that was essentially the only reason why I didn't. But the time off was crucial for building life skills and emotional intelligence, and I'm not sure how M1 would've gone if I hadn't developed those skills.

I started in my mid-twenties and I still found the extra time valuable. It's hard for me to understand how an 17-19 year old can make a fully informed decision on medical school when I know so many 21-22 year olds who struggle with that. Perhaps cultural differences may make it more appropriate in countries with a faster training path, but in the US it doesn't seem like the best timeline.

The extra classes in the humanities and social sciences from a BA/BS are useful from an ancillary perspective as well. In general they teach you about aspects of psychology, economics or race/ethnicity you wouldn't learn about in detail in medical school - all of which have bearing on patient care or activism/lobbying in medicine. From my program, most medical students are reasonably socially aware as well and willing to listen to a constructive argument - some of my favorite conversations were with people of different belief systems. I attribute this partially to "soft science" courses that nearly all medical students have taken in their college career. You can make the argument that bioethics, behavioral science or the psychiatry module fills in this gap but it's far easier and more effective to do so when people have been exposed to 3-5 courses of qualitative social analysis.

 

[Splenda88]

The issue is that the people most in need of more maturity oftentimes wouldn't recognize this. My upperclassman mentor repeated his first year and attributed it to coming directly from undergrad and being unproductive/burnt-out, which yes has a lot to do with working too hard/mental health, but could also be influenced by how mature one is. My stats were solid but my clinical volunteering and shadowing were very borderline so I didn't apply the year before graduation, and that was essentially the only reason why I didn't. But the time off was crucial for building life skills and emotional intelligence, and I'm not sure how M1 would've gone if I hadn't developed those skills.

I started in my mid-twenties and I still found the extra time valuable. It's hard for me to understand how an 17-19 year old can make a fully informed decision on medical school when I know so many 21-22 year olds who struggle with that. Perhaps cultural differences may make it more appropriate in countries with a faster training path, but in the US it doesn't seem like the best timeline.

The extra classes in the humanities and social sciences from a BA/BS are useful from an ancillary perspective as well. In general they teach you about aspects of psychology, economics or race/ethnicity you wouldn't learn about in detail in medical school - all of which have bearing on patient care or activism/lobbying in medicine. From my program, most medical students are reasonably socially aware as well and willing to listen to a constructive argument - some of my favorite conversations were with people of different belief symptoms. I attribute this partially to "soft science" courses that nearly all medical students have taken in their college career. You can make the argument that bioethics, behavioral science or the psychiatry module fills in this gap but it's far easier and effective to do so when people have been exposed to 3-5 courses of qualitative social analysis.

It's done all over the world... None of us make a fully informed decision when it come to doing medicine. Heck! I was nurse for ~ 8 yrs before going into medicine and looking back I can say my decision was not fully informed.

If a few immature people have to flunk out for the greater good, so be it. It's life! It happens everywhere.

 

[Rogue42]

Sorry I dont follow, how would we identify the best people for medical school in medical school?

While it's true that the average admitted statistics are well above the threshold to predict passing, I'm fine with that. I'd rather we have exceptional minds in medicine than passable ones.

Again, a gpa is almost useless. A 3.0 in chemical engineering is way more impressive than a 3.8 in communications, yet med schools already will take the 3.8 over the 3.0. Leading to the “take what ever major you want” crap. Don’t act like college somehow stratifies people for medical school in such a way that only the GREAT minds make it through. It’s simply not true.

Oh interesting how similar is the competition? Like is there an equivalent to the MCAT that they have 17 year olds taking, and is high school GPA actually a valuable tool there where you can't halfass your way to a 4.0? What percent of applicants get into med school overall?

Again, anyone can half-tail their way into a 4.0 given the right circumstances?

As for competition, the only think separating some people in my class from a Harvard student is an MCAT score. So what competition are you talking about? The same competition people already face with against others in the race for highest MCAT? Because if it is, then again, the MCAT can be taken without all the other hoops.

The issue is that the people most in need of more maturity oftentimes wouldn't recognize this. My upperclassman mentor repeated his first year and attributed it to coming directly from undergrad and being unproductive/burnt-out, which yes has a lot to do with working too hard/mental health, but could also be influenced by how mature one is. My stats were solid but my clinical volunteering and shadowing were very borderline so I didn't apply the year before graduation, and that was essentially the only reason why I didn't. But the time off was crucial for building life skills and emotional intelligence, and I'm not sure how M1 would've gone if I hadn't developed those skills.

I started in my mid-twenties and I still found the extra time valuable. It's hard for me to understand how an 17-19 year old can make a fully informed decision on medical school when I know so many 21-22 year olds who struggle with that. Perhaps cultural differences may make it more appropriate in countries with a faster training path, but in the US it doesn't seem like the best timeline.

The extra classes in the humanities and social sciences from a BA/BS are useful from an ancillary perspective as well. In general they teach you about aspects of psychology, economics or race/ethnicity you wouldn't learn about in detail in medical school - all of which have bearing on patient care or activism/lobbying in medicine. From my program, most medical students are reasonably socially aware as well and willing to listen to a constructive argument - some of my favorite conversations were with people of different belief symptoms. I attribute this partially to "soft science" courses that nearly all medical students have taken in their college career. You can make the argument that bioethics, behavioral science or the psychiatry module fills in this gap but it's far easier and effective to do so when people have been exposed to 3-5 courses of qualitative social analysis.

1. Without a bachelors requirement, one wouldn’t be burnt out.
2. The good news is that admissions committees STILL get to decide who gets in. if an 18 year old can put together a competitive application, then there isn’t a reason they shouldn’t be able to apply. The admissions committee then gets the privilege to interview said application to determine fit and maturity level.

Imagine going to medical school and be done with residency by 23-24 and not have 400k in debt but instead 100k. Someone could work 1 year to pay off loans OR pay off loans in residency, and leave if they wanted to instead of being 30 with a family, mortgage, car payment, 400 grand in debt, burnt out,and no way out

 

[sloh]

Again, a gpa is almost useless. A 3.0 in chemical engineering is way more impressive than a 3.8 in communications, yet med schools already will take the 3.8 over the 3.0. Leading to the “take what ever major you want” crap. Don’t act like college somehow stratifies people for medical school in such a way that only the GREAT minds make it through. It’s simply not true.

Again, anyone can half-tail their way into a 4.0 given the right circumstances?

As for competition, the only think separating some people in my class from a Harvard student is an MCAT score. So what competition are you talking about? The same competition people already face with against others in the race for highest MCAT? Because if it is, then again, the MCAT can be taken without all the other hoops.

1. Without a bachelors requirement, one wouldn’t be burnt out.
2. The good news is that admissions committees STILL get to decide who gets in. if an 18 year old can put together a competitive application, then there isn’t a reason they shouldn’t be able to apply. The admissions committee then gets the privilege to interview said application to determine fit and maturity level.

Imagine going to medical school and be done with residency by 23-24 and not have 400k in debt but instead 100k. Someone could work 1 year to pay off loans OR pay off loans in residency, and leave if they wanted to instead of being 30 with a family, mortgage, car payment, 400 grand in debt, burnt out,and no way out

Yep, GPA’s/grades in high school, college, and med school are unreliable proxies. Even more so now due to grade inflation. This is why we have standardized tests like the SAT/ACT, MCAT, Step 1/2

 

[altblue]

It's done all over the world... None of us make a fully informed decision when it come to doing medicine. Heck! I was nurse for ~ 8 yrs before going into medicine and looking back I can say my decision was not fully informed.

If a few immature people have to flunk out for the greater good, so be it. It's life! It happens everywhere.

Sure, nobody can be fully informed, but I'd bet your decision was more informed than that of the average 18 year old. More than a few people would flunk out if the starting age was lowered. Wouldn't that serve as a waste of resources and do those students a disservice as well?

You haven't addressed my point on the benefits of a broader education the humanities and social sciences, either. Even if a BS/BA did do certain students a disservice in terms of life planning, a more thorough liberal arts background can directly benefit patients and medicine as a whole. Again, having a foundation in the humanities makes it easier to have stronger intellectual discussions, makes doctors into better writers, and builds awareness of the world before they even arrive into medical school. My background is mostly in neuroscience and I don't particularly enjoy reading or writing, so it's not like this comes from the perspective of a humanities PhD looking to push a pet interest; it's just pragmatically the right call to encourage diverse coursework for the sake of medical education. And a BS or BA requirement does just that.

 

[efle]

Again, a gpa is almost useless. A 3.0 in chemical engineering is way more impressive than a 3.8 in communications, yet med schools already will take the 3.8 over the 3.0. Leading to the “take what ever major you want” crap. Don’t act like college somehow stratifies people for medical school in such a way that only the GREAT minds make it through. It’s simply not true.

Everyone takes the prereqs, which are the classic weedouts. My genchem 1 started with 900 and by Ochem II and Biochem there were 300. Weedout is a very real phenomenon. The crowd that goes to university, makes good enough grades in prereqs, scores well enough on the MCAT and gets in to US MD programs are a pretty heavily selected-for group.

Again, anyone can half-tail their way into a 4.0 given the right circumstances?

As for competition, the only think separating some people in my class from a Harvard student is an MCAT score. So what competition are you talking about? The same competition people already face with against others in the race for highest MCAT? Because if it is, then again, the MCAT can be taken without all the other hoops.

Maybe we just had very different college experiences. At my school the B+/3.3 bin still had an average MCAT score in the top 10%. For the crowd making a high (3.8+) GPA, the majority scored in the top 3%. I guess if my school was somehow easier than multiple choice orgo and physics problems you could do in your head, I might see it your way.

 

[altblue]

1. Without a bachelors requirement, one wouldn’t be burnt out.

Don't you think people would be burnt out after the drama of high school? Or after 2 years of biology, chemistry and physics? The upperclassman also made it clear that immaturity was also the issue - point being, time and experience mature us.

2. The good news is that admissions committees STILL get to decide who gets in. if an 18 year old can put together a competitive application, then there isn’t a reason they shouldn’t be able to apply. The admissions committee then gets the privilege to interview said application to determine fit and maturity level.

The thing is, the admissions committee can't fully determine this. Nobody can at that age. They can make good decisions for grown 21 to 40 year olds, but how do they make those judgment calls when a good chunk of 18 year olds simply probably aren't ready. It's easy to put on a show for those committees and I wouldn't expect them to sort it out. Like, one of our full-rides is an immature a***** who's gotten multiple professionalism complaints from students, and he's 22-23. Imagine if he was 19 or 20... Invariably some people will be let in who aren't ready, because it's just too hard to tell from 2 30-minute interviews/MMIs.

Imagine going to medical school and be done with residency by 23-24 and not have 400k in debt but instead 100k. Someone could work 1 year to pay off loans OR pay off loans in residency, and leave if they wanted to instead of being 30 with a family, mortgage, car payment, 400 grand in debt, burnt out,and no way out

most people don't have 400k in principle, but sure, it's not all about making medical students as happy as possible. but it's about letting in well-educated medical students who are ready for the profession. 2 more years of undergraduate-level debt won't break the bank.

 

[efle]

Don't you think people would be burnt out after the drama of high school? Or after 2 years of biology, chemistry and physics? The upperclassman also made it clear that immaturity was also the issue - point being, time and experience mature us.


The thing is, the admissions committee can't fully determine this. Nobody can at that age. They can make good decisions for grown 21 to 40 year olds, but how do they make those judgment calls when a good chunk of 18 year olds simply probably aren't ready. It's easy to put on a show for those committees and I wouldn't expect them to sort it out. Like, one of our full-rides is an immature a***** who's gotten multiple professionalism complaints from students and he's 22-23. I can't imagine the situation if 18 or 19 year olds were admitted. Invariably some people will be let in who aren't ready, because it's just too hard to tell from 2 30-minute interviews/MMIs.


most people don't have 400k in principle, but sure, it's not all about making medical students as happy as possible. but it's about letting in well-educated medical students who are ready for the profession. 2 more years of undergraduate-level debt won't break the bank.

I watched a BS/MD sub-I from a Top 20 program tell a dead baby joke to some residents that did not land. He must have had fantastic SAT scores, though

 

[Rogue42]

Look, happy for all of you who felt like their undergraduate education meant something. Good for you. That also means that, at 18, you would have chosen that path anyways then right? My education, to me, felt like nothing more than a 4 year hoop to jump through while spending my money to do it.

For me, I can’t imagine - like stated - how my non-major related pre-recs are worth anything to me. There are very few facts that I can recall from any of those classes. I can also guarantee my freshman comp course papers were trash.

Until there is some actual research on how freshmen comp makes me a better doctor, I won’t believe it.

The entire medical field is self-selected so there will never be good enough research for these phenomena. Are we all floating around with bachelors degrees with high gpas and MCATS because we are simply smarter than the average human? Maybe. But we also are the same group that self selected the entire process to begin with.

It seems that y’all are all forgetting that none of us got here by chance and pure luck. The 18 year old who IS intelligent enough to get into medical school in the US will get in regardless of whether it’s at 18 by the standards I set forth or 22.

The resources train students would cost tremendously less if the entire process in time and money costed less. That’s business.

 

[Lawpy]

College degrees weren't prerequisite for med school before so it makes no sense to require having them now. Colleges suffer from horrible debt problem and it's completely unrealistic to force people to be in debt to get into med school and pile even more debt on them.

 

[Goro]

As I'm constantly saying, our overall medical education system produces great physicians. If you want to make major changes, its up to you to show it won't harm the quality of the doctors we produce.

Also, and I believe I'm stealing @Goro 's line here, we're not producing technicians. There's definite value to having an education beyond purely medical knowledge.

Indeed.

The point of a pre-med education is NOT to be a mini-medical school. You're not going to need to know about the Grignard reaction as a doctor.

The whole idea is to prepare you for med school by training you to learn how to learn.

And suprisingly, some of the pre-reqs do creep into what you need to know as a doctor. despite my own distaste for Physics, number SDNers point out it's need in various clinical parameters.

I also remember a time when a psychiatrist colleague of my was lecturing about about a particular ADHD drug and how a different med in the same class was simply its stereoisomer.

I never expected a clinician to ever use the term "stereoisomer"!

 

[VA Hopeful Dr]

I never expected a clinician to ever use the term "stereoisomer"!

Happens all the time.

Celexa and Lexapro, Claritin and clarinex, Prilosec and nexium.

Also there's a reason we use levodopa specifically

And this is just off the top of my FP head, I'd bet the specialists know more than I do.

 

[AnatomyGrey12]

Happens all the time.

Celexa and Lexapro, Claritin and clarinex, Prilosec and nexium.

Also there's a reason we use levodopa specifically

And this is just off the top of my FP head, I'd bet the specialists know more than I do.

Stereoisomers... Gross.

 

[Splenda88]

Sure, nobody can be fully informed, but I'd bet your decision was more informed than that of the average 18 year old. More than a few people would flunk out if the starting age was lowered. Wouldn't that serve as a waste of resources and do those students a disservice as well?

You haven't addressed my point on the benefits of a broader education the humanities and social sciences, either. Even if a BS/BA did do certain students a disservice in terms of life planning, a more thorough liberal arts background can directly benefit patients and medicine as a whole. Again, having a foundation in the humanities makes it easier to have stronger intellectual discussions, makes doctors into better writers, and builds awareness of the world before they even arrive into medical school. My background is mostly in neuroscience and I don't particularly enjoy reading or writing, so it's not like this comes from the perspective of a humanities PhD looking to push a pet interest; it's just pragmatically the right call to encourage diverse coursework for the sake of medical education. And a BS or BA requirement does just that.

I did address your point before but not directly to you... Studies have shown that FMGs provide comparable care to AMG... Most of these FMGs have ZERO background in social science and humanities...

We should not make policies because we want to catch a few that are not mature enough while ignoring the vast majority who will lose over > 800k in opportunity cost.

By the way, I am sure more education is arguably better. But does the benefit outweigh the opportunity cost? That is the question we should all focus on?

 

[You shall know the Truth]

I completely agree...but I guess that begs the question: should dentistry be integrated into medicine too then? (A rather big question, I know)

Yes, it should.

 

[Splenda88]

This is just like pediatric hospitalist fellowship... I was talking to a PGY3 peds resident the other day who told me she is applying to peds hospitalist fellowship... I looked our GME website to see how many months these peds residents do inpatient medicine; and It's a freaking 26 months. You are telling me you need a fellowship to treat inpatient peds.

 

[Goro]

This is just like pediatric hospitalist fellowship... I was talking to a PGY3 peds resident the other who told me she is applying to peds hospitalist fellowship... I looked our GME website to see how many months these peds residents do inpatient medicine; and It's a freaking 26 months. You are telling me you need a fellowship to treat inpatient peds.

A Heme/Onc colleague of mine once told me that "Medicine is knowing more and more about less and less".

 

[anbuitachi]

Like someone said, make more combined programs. There's only a handful at the moment, but numbers should be drastically increased.

Many countries already do this. It works, saves time, and money.

Other than that i think currently, medical school can be reduced to 3 years. decrease pre clinical to 1.5 yrs, and clinical to 1.5 yrs. With step being pass/fail, no need to spend as much time studying and in many places 2nd half of 4th yr is pretty much just waiting for med school to end... with plenty of time off while paying tuition.

 

[KnuxNole]

There is a reason they put us to a grueling 60-80 hrs/wk of residency... People learn almost nothing in didactic. There have been published studies on that.. I am assuming most (or all) physicians read about cases that they have seen for the first time or diseases they are not too familiar with.. Spending 3-5hrs/wk to do that won't prevent one from spending time with their love ones.

Didactics are mandatory in every training program

If that is useless, how do you propose residents should be learning their material that isn’t self studying? Asking as a general sense since I have seen this notion talked about - how resident didactics are pointless, waste of time, takes away from Patient care, ruins wellness

Out of curiosity, what specialty do you feel pgy2 to 3 didn’t have much difference?

I’m FM but I saw a HuGE difference, by far

 

[deleted697308]

the cost of college/medical school education is absolutely absurd. I didn't listen to high school counselors who told me to take out loans and pick a private school. I ended up picking a cheaper school close to home and did community college classes in the summer to save myself money. i know some people who are a million dollars in debt because of a private medical school and undergrad.

i think the mcat is a reasonable exam. i only used free resources and shelled out money solely for the section banks and did well. i heard from older students the classes were trash and never took them. but unfortunately learning a lot of these things takes networking/meeting older students who have taken these exams before.

pre-clinical at my school isn't modeled to step 1 at all but rather small facts that the PhD deems important. the semester before step 1 was absolutely terrible. i think we should take nbme exams instead if we want to go for a 1.5 year curriculum. i think test taking strategies should also be emphasized. I also wish spots would go to AMGs first and then any empty spot after that IMGs like how Australia and Canada do it, especially considering how much debt many med students are in and the stress when they don't match and have that debt burden.

 

[Bacchus]

Indeed.

The point of a pre-med education is NOT to be a mini-medical school. You're not going to need to know about the Grignard reaction as a doctor.

The whole idea is to prepare you for med school by training you to learn how to learn.

And suprisingly, some of the pre-reqs do creep into what you need to know as a doctor. despite my own distaste for Physics, number SDNers point out it's need in various clinical parameters.

I also remember a time when a psychiatrist colleague of my was lecturing about about a particular ADHD drug and how a different med in the same class was simply its stereoisomer.

I never expected a clinician to ever use the term "stereoisomer"!

Albuterol vs xoponex. Celexa vs lexapro. I more talk stereoisomers with the residents.

FWIW, I had to look up Grignard reactions but remembered it when I saw the orgo diagrams.