When did Doctors become helpless against BC and GME?

[VA Hopeful Dr]

Doing it helps. People in other countries often start med school at 18 cause they don't need to do regular college first. If they can do it no reason we can't. Their doctors turn out fine

I fail to see why this constantly comes up. Our system produces good doctors and takes roughly the same amount of time as other places. Why fix what isn't broken?

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[KnuxNole]

I personally can't think of any 18 year old that would be mature enough to handle me school. Plus, all those years studying and working hard, for Americans, it's important for them to at least take their time, and be sure of what they want, as well as have some personal growth and know who they are. College helped a lot with that, I would have probably been a wreck if I went straight to med school from high school....especially since I'm high school I didn't even have a career choice.

Hell, when I was 18, I was more focused on building a Pokemon team instead of a med school application...

 

[anbuitachi]

I fail to see why this constantly comes up. Our system produces good doctors and takes roughly the same amount of time as other places. Why fix what isn't broken?

We don't. We take 4 years college then 4 years MD. Then 3-7 years residency. That longer than most of the world.

 

[Osteoth]

Doing it helps. People in other countries often start med school at 18 cause they don't need to do regular college first. If they can do it no reason we can't. Their doctors turn out fine

Except their school is free, so if they drop out its an "oh no big deal", vs. if you take out loans for a 6 year program you're all of a sudden either switching fields and setting yourself back possibly tens of thousands of dollars...

I personally can't think of any 18 year old that would be mature enough to handle me school. Plus, all those years studying and working hard, for Americans, it's important for them to at least take their time, and be sure of what they want, as well as have some personal growth and know who they are. College helped a lot with that, I would have probably been a wreck if I went straight to med school from high school....especially since I'm high school I didn't even have a career choice.

Like above, I think its more a commitment financially here than in most other western countries, and as a result students really need to make sure they're really willing to go through the training.

The financial aspect of our training is really, IMO, what differentiates American doctors vs. doctors around the world. If we didn't have any med school tuition costs we'd be much more open to a single-payer, even knowing that salaries are going to go down some. As it stands we have people on loans and also people whose families sacrificed to pay for their education. Very difficult to come up with a situation that addresses both of those groups adequately while also decreasing costs & maintaining salaries.

 

[VA Hopeful Dr]

We don't. We take 4 years college then 4 years MD. Then 3-7 years residency. That longer than most of the world.

You mean like in the United Kingdom where they take 6 years of medical school and then a minimum of five years in residency just to become a general practitioner? Yeah that's one year less than us, hardly worth changing our entire graduate medical education system for.

 

[anbuitachi]

You mean like in the United Kingdom where they take 6 years of medical school and then a minimum of five years in residency just to become a general practitioner? Yeah that's one year less than us, hardly worth changing our entire graduate medical education system for.

No i meant Asia, where most people live

 

[VA Hopeful Dr]

No i meant Asia, where most people live

Details please

 

[W19]

@VA Hopeful Dr

3 years of prereqs (no need to get a degree)

18 months basic science and 18 months of clinical science (3 months IM/FM/Neuro, 6 wks of OBGYN, 6 wks of surgery, 6 wks of Peds, 6 wks of psych)... 2 months can be used for board preps (CK+CS); 1 months for residency interviews and the other 6 months are for electives.

I can't make a case for residency because I have not been thru it yet. But all I saw was that 3rd year IM/FM residents were functioning independently in the hospitals I rotated. I also know one Canadian who graduated at my school that is doing 2-year FM residency in Canada.

I combine IM/FM/Neuro into 3 month because there is a huge overlap b/t IM and FM. 3 wks of inpatient FM at my school is like IM inpatient all over again. There are few US schools that don't even have a FM rotation.

Also there is some overlap b/t IM and Neuro. So my point is IM/FM/Neuro can be made into 1 month IM inpatient, 1 month neuro, and 1 month outpatient medicine that they can call label as ' adult primary care'

Where am I wrong here?

 

[anbuitachi]

Details please

in india MBBS is 5.5 years after high school. thus saving you 2.5 YEARS and lot of money. They also only look at scores i believe so it saves students a lot of money from BS stuff like interviews/hotels, wasting time on essays, etc.

China has changed recently i believe, not sure about current system. But back in the older days, They do 5 years of 'med school' straight out of high school. So you enter 'med school' at 17/18, finish at 23, and you can look for jobs. You are now a 'junior doctor' under the wing of senior doctor for like a year or so, and after that you get a pay raise and you are on your own in the hospital. I imagine for surgery it's different.

 

[KnuxNole]

It does work for those foreign countries, but here in America, I would never want to live like that. Plus, American teenagers are different than those Asian kids. Most of them are highly studious. For us....haha, not even close.

 

[anbuitachi]

It does work for those foreign countries, but here in America, I would never want to live like that. Plus, American teenagers are different than those Asian kids. Most of them are highly studious. For us....haha, not even close.

Lol there are far fewer studious kids here in America, but still way more than enough to fill up med school classes

 

[VA Hopeful Dr]

@VA Hopeful Dr

3 years of prereqs (no need to get a degree)

18 months basic science and 18 months of clinical science (3 months IM/FM/Neuro, 6 wks of OBGYN, 6 wks of surgery, 6 wks of Peds, 6 wks of psych)... 2 months can be used for board preps (CK+CS); 1 months for residency interviews and the other 6 months are for electives.

I can't make a case for residency because I have not been thru it yet. But all I saw was that 3rd year IM/FM residents were functioning independently in the hospitals I rotated. I also know one Canadian who graduated at my school that is doing 2-year FM residency in Canada.

I combine IM/FM/Neuro into 3 month because there is a huge overlap b/t IM and FM. 3 wks of inpatient FM at my school is like IM inpatient all over again. There are few US schools that don't even have a FM rotation.

Also there is some overlap b/t IM and Neuro. So my point is IM/FM/Neuro can be made into 1 month IM inpatient, 1 month neuro, and 1 month outpatient medicine that they can call label as ' adult primary care'

Where am I wrong here?

Couple problems I see with this.

First, if you're doing 3 years of pre-reqs anyway why not go ahead with 1 more year. That way if medicine doesn't work out (or you don't get in), you have something to fall back on and aren't left with no degree.

Second, with only 18 months of pre-clinical I'm assuming you're either getting rid of summer or getting rid of some of the fluffier classes. The former I think is unwise as 18 months or fairly rigorous academics without a decent break is going to cause some problems (look at all the mental health issues we have in the current system). If the latter, you'll be fighting an entrenched academic core who doesn't want their pet causes to go unrecognized.

The combining IM/FM/Neuro is actually a decent idea most of the time. Used to be the FM service would round on peds, adults, and OB all at the same time. Since most places don't do that anymore, it really has become mostly an IM service.

Third, the last year being mostly independent is kinda the point. That's the year where you basically prove to both yourself and your attendings that you're ready to graduate while fine-tuning how you actually are going to do things when you're on your own. I think taking away that year is extremely unwise.

 

[VA Hopeful Dr]

in india MBBS is 5.5 years after high school. thus saving you 2.5 YEARS and lot of money. They also only look at scores i believe so it saves students a lot of money from BS stuff like interviews/hotels, wasting time on essays, etc.

China has changed recently i believe, not sure about current system. But back in the older days, They do 5 years of 'med school' straight out of high school. So you enter 'med school' at 17/18, finish at 23, and you can look for jobs. You are now a 'junior doctor' under the wing of senior doctor for like a year or so, and after that you get a pay raise and you are on your own in the hospital. I imagine for surgery it's different.

I'm not sure Chinese medicine is one we want to follow.

How does India do post-graduate medical education?

 

[anbuitachi]

I'm not sure Chinese medicine is one we want to follow.

How does India do post-graduate medical education?

Why? Are you saying health care in China is inferior to ours?

 

[Goro]

@VA Hopeful Dr

3 years of prereqs (no need to get a degree)

18 months basic science and 18 months of clinical science (3 months IM/FM/Neuro, 6 wks of OBGYN, 6 wks of surgery, 6 wks of Peds, 6 wks of psych)... 2 months can be used for board preps (CK+CS); 1 months for residency interviews and the other 6 months are for electives.

I can't make a case for residency because I have not been thru it yet. But all I saw was that 3rd year IM/FM residents were functioning independently in the hospitals I rotated. I also know one Canadian who graduated at my school that is doing 2-year FM residency in Canada.

I combine IM/FM/Neuro into 3 month because there is a huge overlap b/t IM and FM. 3 wks of inpatient FM at my school is like IM inpatient all over again. There are few US schools that don't even have a FM rotation.

Also there is some overlap b/t IM and Neuro. So my point is IM/FM/Neuro can be made into 1 month IM inpatient, 1 month neuro, and 1 month outpatient medicine that they can call label as ' adult primary care'

Where am I wrong here?

I know that pre-meds and medical students salivate at the idea of cutting out time in the road to the medical degree, but they are also ignorant of a major change in medical education, at the pre-med, medical, and even graduate medical levels. These are the requirements of core competencies.

Boards are moving towards this, med school curricula are moving towards this, and both COCA and LCME now require med schools to document and prove that they are engaging in a competency-based education. ACGME requires residencies to have their graduates master these.

Scientific knowledge is only 1/6th of this equation.

The required core competencies are:
patient care,
medical knowledge,
professionalism,
systems-based practice,
practice-based learning and improvement,
interpersonal and communication skills


Here's an example from Dartmouth:
https://geiselmed.dartmouth.edu/faculty/pdf/competencies.pdf

 

[VA Hopeful Dr]

Why? Are you saying health care in China is inferior to ours?

Yes, I am.

Also this: Police to Guard Chinese Hospitals to Stop Attacks on Doctors

 

[W19]

As anyone who has been through it can tell you, functioning "independently" while simultaneously having a safety net is (a) invaluable and (b) not the same as actually functioning independently.

I don't get why you and @VA Hopeful Dr want to maintain the status quo that is inefficient and sucking up time and money out of med students. I can already see you being the head of the LCME or AAMC or NBME in a few years

 

[VA Hopeful Dr]

I don't get why you and @VA Hopeful Dr want to maintain the status quo that is inefficient and sucking up time and money from med students. I can already see you being the head of the LCME or AAMC or NBME in a few years

Because we have a system that works well.

Now I completely agree that the cost should come down. Tuition for my state school in 2005 was 24k/year. That same school is now 37k/year. That's over a 50% increase in just over 10 years.

But that's a separate issue from retooling the entire medical education system.

 

[anbuitachi]

Yes, I am.

Also this: Police to Guard Chinese Hospitals to Stop Attacks on Doctors

Have you not heard of the Bronx Lebanon hospital shooting that just happened a few weeks ago in NYC?

The two anesthesiologists who were murdered in Boston?

The article says 60 percent of medical personnel have been verbally abused before. Pretty sure it's 100 percent in the US.

 

[VA Hopeful Dr]

Have you not heard of the Bronx Lebanon hospital shooting that just happened a few weeks ago in NYC?

The two anesthesiologists who were murdered in Boston?

The article says 60 percent of medical personnel have been verbally abused before. Pretty sure it's 100 percent in the US.

Yes 2 incidents makes us the equal of China. Well done.

 

[W19]

Yes 2 incidents makes us the equal of China. Well done.

But the abuse is real...

 

[VA Hopeful Dr]

But the abuse is real...

No argument, but most service industry jobs get that too. We're just not as special anymore.

 

[anbuitachi]

Yes 2 incidents makes us the equal of China. Well done.

Why equal, and not inferior? Superiority complex dood? jk

but china has 1.3B people, 4x our population pretty much all stuffed on one coast. So there are bound to have abuse. A lot of these healthcare issues are just consequences of rapid improvements in everything. Yea their health care is not as good as ours yet, but its definitely not far behind. They spend a LOT less per capita than we do and their life expectancy is only a couple years less (even more impressive when you consider the conditions they grew up in)

 

[VA Hopeful Dr]

Why equal, and not inferior? Superiority complex dood? jk

but china has 1.3B people, 4x our population pretty much all stuffed on one coast. So there are bound to have abuse. A lot of these healthcare issues are just consequences of rapid improvements in everything. Yea their health care is not as good as ours yet, but its definitely not far behind. They spend a LOT less per capita than we do and their life expectancy is only a couple years less (even more impressive when you consider the conditions they grew up in)

Our life expectancy is skewed by our violent death rate.

The Myth of Americans' Poor Life Expectancy

 

[anbuitachi]

Our life expectancy is skewed by our violent death rate.

The Myth of Americans' Poor Life Expectancy

Theirs is skewed by not letting all the old severely demented bed bound vent dependent trached pegged paced to live for years in the hospital

 

[VA Hopeful Dr]

Theirs is skewed by not letting all the old severely demented bed bound vent dependent trached pegged paced to live for years in the hospital

Doubtful, otherwise Europe's is also skewed since many of them don't do that type of thing either.

 

[anbuitachi]

Doubtful, otherwise Europe's is also skewed since many of them don't do that type of thing either.

Its just a USA thing?

 

[SurfingDoctor]

Though I've known some exceptional Indian doctors who did their medical school in India, there was a reason they all came to the US to do post-graduate training (after doing a residency in India). Their GME is not something to aspire too.
Problems plaguing medical education: Why India suffers a severe lack of quality doctors : Featurephilia
Special Report: Why India's medical schools are plagued with fraud

 

[VA Hopeful Dr]

Its just a USA thing?

I can't speak to the whole of the world, but the US is the only country that I know with certainty doesn't deny care on a routine basis based on things like age.

 

[evilbooyaa]

My medical school started a joint undergrad/MD admissions program. I interviewed some of the first candidates as an M4. My god.

BS/MD programs are overall pretty successful at a hard task - find interested 18 year olds, and get them through undergrad without having them melt-down or change their mind of careers. I imagine most BS/MDs programs have upwards of 75-80% retention into medical school.

And yes, you as somebody who was at least 8 (if not more) years older than the applicant thought they were immature. Whoop-de-doo.

Yes, you can scream 'millenials lulz' and roll your eyes all you want, but those kids are going to grow up and probably be just fine as doctors. They may have a bit more rough patches right when they enter medical school, but if they're smart enough and have the stats for BS/MD they'll likely push through and make it.