Why does the medical school application process have to be so long/early?

[Lollygag]

I'm just curious, but I feel like the medical school process just seems so long compared to college/grad school/law school...

And maybe it isn't even so much that it's a longer process, but that the process starts so much earlier in june whereas college, grad school, law school don't start submitting until October.

Is there a legitimate reason for it? Lol

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[Bangersandmash]

What does it really matter that it starts earlier than other things? Whether its law or medicine, you still have to fill out an application, take a test and get everything to a broad range of programs in as early as possible to have good chances.

Applying to college involved getting transcripts, rec letters (for better schools), taking the SAT, writing an essay and submitting apps through a common app to many different schools that usually also required secondaries. Then local alums would interview over the next few months. The only thing different about medical school is that you have to fly to your interviews.

 

[bollywoodlover]

I agree that I think it's longer than applying to any other type of grad school or college. Most deadlines are in December and you know by spring if you got in. I wish it was shorter so that we don't have to spend so much time waiting. Females especially need to get on with their lives of they want to have kids family etc. But that's the way this process is so I guess just got to deal with it. So glad I got In this year. I can't imagine the torture of having to wait another yr.

 

[Geebeejay]

I'm just curious, but I feel like the medical school process just seems so long compared to college/grad school/law school...

And maybe it isn't even so much that it's a longer process, but that the process starts so much earlier in june whereas college, grad school, law school don't start submitting until October.

Is there a legitimate reason for it? Lol

Well, compare the acceptance rates of all of these comparable application processes. Medical school is by far the lowest, and thus the more intensive process is justified. Additionally, the term "early" is pretty arbitrary....all of them require preparation and its up to you to decide when you need to start buckling down on your application.

 

[red doctober]

First, someone's complaining that they heard an adcom only spends on average ~5 mins per app. Now you're complaining that the process takes too long. Can't have it both ways.

 

[Lollygag]

Woahh lol I'm not complaining. Did you guys miss the first line?

I'm asking out of curiosity and want to know if there's something I'm missing. I think I would prefer it to be early so I can take my time and have time in between than for it to be condensed into just a few months. I just noticed that other higher education systems don't do it this way and want to know why medical school is different.

Thats all lol

 

[Lollygag]

Well, compare the acceptance rates of all of these comparable application processes. Medical school is by far the lowest, and thus the more intensive process is justified. Additionally, the term "early" is pretty arbitrary....all of them require preparation and its up to you to decide when you need to start buckling down on your application.

Hmmm that make sense

 

[LaCroix09]

I think it's, in part, another way to thin out the bunch. Not everyone is willing to fill out those apps and get them in during the summer. Much less folks that are applying to MD, DO, and TX schools.

If you finish those things and pay the big price tag, at least they KNOW you're very interested in medicine.

Other than that, I think that most of the things on the application are pretty important, and early apps = early decisions!

 

[red7]

Plus, if you do well in your premed years, write a strong application, and apply early, then you could potentially be free of all the application stress in 4-5 months (submit in June/July, get accepted in October). Once you have an acceptance in hand, everything else is icing on the cake.

 

[Praefectus]

It's a much more competitive applicant pool. Unless you had a 36+ MCAT, I'd be willing to bet that there's at least a hundred applicants with the same stats and similar extracurriculars.

 

[dbeast]

So all the lollygaggers, such as yourself, have time to get their applications in.

Heyooo!

 

[plumhill]

I'm just curious, but I feel like the medical school process just seems so long compared to college/grad school/law school...

And maybe it isn't even so much that it's a longer process, but that the process starts so much earlier in june whereas college, grad school, law school don't start submitting until October.

Is there a legitimate reason for it? Lol

I'd assume its to accomodate the fact that all schools require interviews, and that interviewing thousands of pre-meds takes a little while...to my knowledge, grad/law schools don't interview everyone, and those that offer interviews only have it as an optional part of the application process.

 

[ShenanigansMD]

Also, med schools don't know if you'll accept their offer, and applicants spend eons holding on to acceptances before making a final decision.

 

[LizzyM]

I'm involved in some doctoral programs that accept applications from September through December, interview a subset of the applicants in February and have decisions out by the first of March. Of course, the number of applicants is a small fraction (maybe 5%) of what the medical school receives, the application is half the length, and there are only 1-3 interview days. The typical applicant seems to apply to 3-4 programs.

The "apply broadly" thing is what kills us. If we received only 10% of the applications we do get but they were all excellent, we'd interview half and admit a large proportion knowing that most people would have just a couple interviews and almost everyone would have only one or two schools to chose from. The yield would be higher because the superstars would not be turning down us and 6 other schools. If we didn't feel obligated to interview so many strong candidates, we could get the interviews over in 6 weeks rather than drag it out for months.

At the end of the day, there are too many people who want to attend medical school and not enough space for everyone. Granted, some have no business in medical school but even among the well qualified there are not enough seats. That is being fixed, slowly, with more US allopathic schools opening each year and larger classes at some existing schools but it is a drop in the bucket compared with the growing number of applicants.

I suspect that if physician income drops by 30-50% with changes in health care delivery, the number of applicants will drop as well.

 

[Silo004]

I suspect that if physician income drops by 30-50% with changes in health care delivery, the number of applicants will drop as well.

So decrease physician income by 30-50 % and increase tuition by 20 % every year. That sounds like a great plan for decreasing the number of applicants.

 

[Doc E Brown]

They should decrease physicians pay, but that should also accompany a decrease in tuition, I'm doubtful that they'll be that fair though.

And med schools are barely increasing class size, plus you only see a couple of new schools every few years. I honestly don't think they're trying hard enough and our society will feel the consequence in 15-20 years. My guess is that schools are hesitant to increase class size because they think it will devalue their prestige, which is absurd.

 

[circulus vitios]

They should decrease physicians pay, but that should also accompany a decrease in tuition, I'm doubtful that they'll be that fair though.

And med schools are barely increasing class size, plus you only see a couple of new schools every few years. I honestly don't think they're trying hard enough and our society will feel the consequence in 15-20 years. My guess is that schools are hesitant to increase class size because they think it will devalue their prestige, which is absurd.

It probably has more to do with residency slots.

 

[NickNaylor]

They should decrease physicians pay, but that should also accompany a decrease in tuition, I'm doubtful that they'll be that fair though.

And med schools are barely increasing class size, plus you only see a couple of new schools every few years. I honestly don't think they're trying hard enough and our society will feel the consequence in 15-20 years. My guess is that schools are hesitant to increase class size because they think it will devalue their prestige, which is absurd.

There are reasons for the way things are. Maybe schools remain small so that they can provide as much financial aid to their students as possible? Maybe they do it to provide you a better teaching experience?

You're making a lot of assumptions that are based on nothing. I don't necessarily disagree with your sentiment, but thinking it all comes back to "prestige" is childish.

 

[LizzyM]

They should decrease physicians pay, but that should also accompany a decrease in tuition, I'm doubtful that they'll be that fair though.

And med schools are barely increasing class size, plus you only see a couple of new schools every few years. I honestly don't think they're trying hard enough and our society will feel the consequence in 15-20 years. My guess is that schools are hesitant to increase class size because they think it will devalue their prestige, which is absurd.

Students have to have clinical experiences and the availablity of slots to do that are often the limiting factor in the equation.

There is some wiggle room with respect to residencies because some of those slots are currently filled by US citizens from off-shore schools and the physicians trained abroad who wish to immigrate to the US. Those folks could/would/might be pushed out if the number of US med school graduates increases. If the number of new grads increases beyond the number of US residency slots, then we start to have problems.

 

[music2doc]

Well, compare the acceptance rates of all of these comparable application processes. Medical school is by far the lowest, and thus the more intensive process is justified. Additionally, the term "early" is pretty arbitrary....all of them require preparation and its up to you to decide when you need to start buckling down on your application.

Actually not true. Med school is competitive, yes, but not the most competitive nor even much more competitive than most other careers. Clinical psych comes to mind with a <10% acceptance rate at almost all legitimate programs (they have some Caribbean-esque programs that the community sees as a backdoor and extremely risky at best).

Anyway, I would argue that it's due to the sheer number of applicants. It takes much longer to screen 6000 applicants for 200 spots than 600 applicants for 5 spots.

 

[music2doc]

They should decrease physicians pay, but that should also accompany a decrease in tuition, I'm doubtful that they'll be that fair though.

And med schools are barely increasing class size, plus you only see a couple of new schools every few years. I honestly don't think they're trying hard enough and our society will feel the consequence in 15-20 years. My guess is that schools are hesitant to increase class size because they think it will devalue their prestige, which is absurd.

This has little to do with our physician shortage. That is a result of residency spots. As for devaluing their prestige -- don't make me laugh! Med schools' waitlists are often as long as twice the size of their matriculating class and waitlists, by definition, only include students you would be willing to take. At one top 40 program that I have been affiliated with, the Director of Admissions has stated she would be comfortable presenting a class made up of the 4th string of candidates -- i.e., the ones that not only got waitlisted in the upper half (2nd string/#1-160) or waitlisted in the lower half (3rd string/#161-320), but actually the top students the adcom outright rejected post-interview! I don't think having a prestigious group of students or turning qualified applicants down is the motivation behind not expanding class size. It's a simple matter of limited resources for the clinical core rotations (i.e., M3 year).

 

[KnuxNole]

Because they find pleasure in torturing poor souls 🙁

College apps were easy peasy. Just apply to schools, maybe write a small essay or two, and just wait. Med school apps are a whole song and dance(which is something a LOT of laypeople never understood when explaining it to them). Residency apps are slightly easier, but still longer than necessary :|

 

[Doc E Brown]

My apologies for the brashness of my first post.

I do realize other, maybe more important, factors that contribute to a small class size, most notably residency spots and a lack of resources. But I still think that prestige is a contributing factor and here's why:

If you look at top Ivey league schools, they have not increased their class size for years. This is definitely not due to a lack of resources or residency spots since these schools are among the wealthiest. Why are they not increasing their class size? I don't see any other reason besides wanting to keep their sence of prestige. Now I don't think that Ivey league schools are an exception, but rather we see a trickling down effect whereby the next "best" school to an Ivey will only increase their class size by a small amount, and the next in line will increase their class size by a little more. This creates a stronger division between top tier schools, who are not abiding by the aamc's class size increase recommendation, and the low tier schools, who are more compliant towards increasing their class size. This further contributes to the false notion that an Ivey league medical education is better than any other school, when in fact the training is almost the same. And I think that these top tier schools want to keep it this way. Source: http://www.thecrimson.com/article/2007/10/22/med-school-keeps-class-size-steady/

Furthermore, the arguments for residency spots and lack of resources are true but I think that not enough emphasis is put on improving these. Like LizzyM said, we still have US residency spots taken up by off-shore trained physicians (citizens and immigrants), so in reality we do have the residency spots available if we were to only allow stateside trained physicians enter residency, which would allow for an increase in class size.
To put this another way, I don't understand why residency spots and lack of resources are a limiting factor, can't these be improved easily with a reallocation of resources?

I'm posting this with utmost respect, I don't mean to sound douchey or offend anyone.

 

[LizzyM]

Boston is a big city but it has 2 other medical schools. Providence, a relatively small city. Ditto New Haven. New York is big but has 2 "Ivy" medical schools as well as being home to several other medical schools. Philadelphia has one Ivy and several other medical schools. Hanover, New Hampshire and the surrounding area is so small that students there are shipped out to Vermont and even California for clinical experiences.

The fact remains that you can't expand the number of students in a medical school unless you have room in your surgical suites, labor and delivery suites, your outpatient facilities and so forth for students to have the opportunity to have hands on experiences and sufficient faculty to observe and offer feedback. There just aren't enough sick people in NH, Boston, RI, New Haven, NYC, and Philly to justify the expansion of the med schools in those locations.

Furthermore, at schools that put a premium on research experience, there need to be sufficient opportunities for those types of experiences as well.

 

[HughMyron]

Drop all physician pay by 30-50%?

I've heard a lot of people say that medicine is a terrible career choice, but very few people are THAT pessimistic lol. Such a drop would completely eliminate many specialties from consideration. You'd bankrupt yourself going for FP, Psych, or Peds.


Anyways, by the time I have kids my age, medicine probably won't be a viable career to enter anymore. The med school loans will probably be well over 600K at graduation, and reimbursement will have dropped through the floor. But people won't care, med schools will still be bombarded with applications from naive save-the-world idealists and Asian prestige seekers.

 

[DAPI]

My apologies for the brashness of my first post.

I do realize other, maybe more important, factors that contribute to a small class size, most notably residency spots and a lack of resources. But I still think that prestige is a contributing factor and here's why:

If you look at top Ivey league schools, they have not increased their class size for years. This is definitely not due to a lack of resources or residency spots since these schools are among the wealthiest. Why are they not increasing their class size? I don't see any other reason besides wanting to keep their sence of prestige. Now I don't think that Ivey league schools are an exception, but rather we see a trickling down effect whereby the next "best" school to an Ivey will only increase their class size by a small amount, and the next in line will increase their class size by a little more. This creates a stronger division between top tier schools, who are not abiding by the aamc's class size increase recommendation, and the low tier schools, who are more compliant towards increasing their class size. This further contributes to the false notion that an Ivey league medical education is better than any other school, when in fact the training is almost the same. And I think that these top tier schools want to keep it this way. Source: http://www.thecrimson.com/article/2007/10/22/med-school-keeps-class-size-steady/

Furthermore, the arguments for residency spots and lack of resources are true but I think that not enough emphasis is put on improving these. Like LizzyM said, we still have US residency spots taken up by off-shore trained physicians (citizens and immigrants), so in reality we do have the residency spots available if we were to only allow stateside trained physicians enter residency, which would allow for an increase in class size.
To put this another way, I don't understand why residency spots and lack of resources are a limiting factor, can't these be improved easily with a reallocation of resources?

I'm posting this with utmost respect, I don't mean to sound douchey or offend anyone.

I seem to disagree. What if the school just can't increase the class size without major overhauls.

I have no knowledge of how Harvard or any other Ivy operates, but just go with my examples here. - Think about if the anatomy lab is already maxed with 165 students. Say they only have 20 tables, that would put them at 8-9 people per group. So for them to increase they would need to renovate the anatomy lab to have more tables or add more people to each group. Also, what if all the MS1's have all their lectures in a lecture hall with only 165 seats. (Don't say students don't attend anyways, cause I'm sure there are a few mandatory classes everyone goes to) They would need a new MS1 lecture hall or need to give the same lecture twice. Same thing could go with simulation labs, PBL classes, etc. If several of these problems exist, it may just not be feasible to increase class size at the moment.

Also, like LizzyM said, they would need to secure more MS3 positions, which may just not exist. You can't just start cramming more students into a particular rotation. It would lead to less firsthand experience and an overwhelmed attending.

 

[45408]

Also, med schools don't know if you'll accept their offer, and applicants spend eons holding on to acceptances before making a final decision.

That was the painful part for me. I did all my interviews in September, was accepted to two of them by October. Waited until November to be told that I wouldn't be told until February if I was accepted or waitlisted at the third one. Found out in February that I was waitlisted, and then it wasn't until May that the real waitlist shuffle happens. 🙄

 

[LizzyM]

Drop all physician pay by 30-50%?

I've heard a lot of people say that medicine is a terrible career choice, but very few people are THAT pessimistic lol. Such a drop would completely eliminate many specialties from consideration. You'd bankrupt yourself going for FP, Psych, or Peds.


Anyways, by the time I have kids my age, medicine probably won't be a viable career to enter anymore. The med school loans will probably be well over 600K at graduation, and reimbursement will have dropped through the floor. But people won't care, med schools will still be bombarded with applications from naive save-the-world idealists and Asian prestige seekers.

The median in family practice is $176,000. Drop it to $123K with a minimum of $100K (current bottom 10% make 140K). Cry me a river.

The solution will be to offer incentives to new grads to locate in areas that are underserved and to give bonuses to pay off school loans and to get started in practice but not use that additional amount as a baseline from which raises are calculated.

As more physicians are salaried employees rather than entrepreneurs/ small business owners, salaries will decline. The move to big insurance exchanges run by the gov't for the poor and working poor is going to exacerbate this trend.

 

[Doc E Brown]

I seem to disagree. What if the school just can't increase the class size without major overhauls.

I have no knowledge of how Harvard or any other Ivy operates, but just go with my examples here. - Think about if the anatomy lab is already maxed with 165 students. Say they only have 20 tables, that would put them at 8-9 people per group. So for them to increase they would need to renovate the anatomy lab to have more tables or add more people to each group. Also, what if all the MS1's have all their lectures in a lecture hall with only 165 seats. (Don't say students don't attend anyways, cause I'm sure there are a few mandatory classes everyone goes to) They would need a new MS1 lecture hall or need to give the same lecture twice. Same thing could go with simulation labs, PBL classes, etc. If several of these problems exist, it may just not be feasible to increase class size at the moment.

Also, like LizzyM said, they would need to secure more MS3 positions, which may just not exist. You can't just start cramming more students into a particular rotation. It would lead to less firsthand experience and an overwhelmed attending.

I think both problems can be solved by adding sections. For example, the anatomy lab or lecture can have varying sections at different times during the day, just like the coursework in undergrad. Same goes with MS3 rotations, just add more sections and it'll probably have to be with a different attending unless he/she wants the extra work.
Why don't they do this? There must be a reason that I'm overlooking.

 

[HughMyron]

The median in family practice is $176,000. Drop it to $123K with a minimum of $100K (current bottom 10% make 140K). Cry me a river.

That's fine and all, but then you have to deal with paying back the loan, malpractice insurance, other fees, and of course taxes. After all that you probably have less than 50K.

We know salaries are going to decline, the question is only "by how much"? Call me an optimist (lol), but I really doubt that a plurality of physicians will lose half their income.

 

[Lollygag]

I think both problems can be solved by adding sections. For example, the anatomy lab or lecture can have varying sections at different times during the day, just like the coursework in undergrad. Same goes with MS3 rotations, just add more sections and it'll probably have to be with a different attending unless he/she wants the extra work.
Why don't they do this? There must be a reason that I'm overlooking.

Yea but wouldn't that all come right back down to resources? If you add more sections then you'll have to either hire more people to teach those sections, or pay the people teaching those sections more money. And if neither is feasible, then you would have to decrease the length of the sections to accommodate everybody which would result in less clinical experience for the students.

Not that I know anything about how medical school's operate their budget lol, but just a wild guess

It may not seem like *that* big of a deal at the moment, but over time it could come back and bite everyone

So all the lollygaggers, such as yourself, have time to get their applications in.

Heyooo!

Lol

 

[LizzyM]

I think both problems can be solved by adding sections. For example, the anatomy lab or lecture can have varying sections at different times during the day, just like the coursework in undergrad. Same goes with MS3 rotations, just add more sections and it'll probably have to be with a different attending unless he/she wants the extra work.
Why don't they do this? There must be a reason that I'm overlooking.

Let me spell it out in a very simple way. Let's say you want every student to have a 2 month rotation in an outpatient general medicine/family practice clinic. If there are 20 FTE family practice and gen med docs with whom you have an affiliation you can take 20 students full-time in 2 months and 120 students over the course of a year. Increase your class size by 10% to 132 students are where are those extra 12 students going to train? Unless you can find 2 more FTE faculty in primary care, you have too many students. This can have a negative effect when it comes time to be evaluated for accreditation.

Could you imagine someone letting you shadow and then saying, "I hope you don't mind but I have 3 other students shadowing me today so you'll have to take turns standing in the hall becuase ya'll won't fit in the exam room."? You wouldn't want that experience on rounds, either, which is why schools cap classes as they do.

 

[DAPI]

I think both problems can be solved by adding sections. For example, the anatomy lab or lecture can have varying sections at different times during the day, just like the coursework in undergrad. Same goes with MS3 rotations, just add more sections and it'll probably have to be with a different attending unless he/she wants the extra work.
Why don't they do this? There must be a reason that I'm overlooking.

And who decides who gets shafted with the afternoon sections (1:00-4:00) and who gets the much better morning section (9:00-12:00)? Or even worse, an evening section (6:00-9:00)? No one wants to be in class on a Friday till 9:00 and no one is going to want to teach that.

This could also cause conflicts with the 'early clinical exposure classes' - or whatever you want to call them. Because if currently students (MS1/MS2's) have class 9-12 and then have clinical exposure class on an afternoon, they can get there around 1 and stay much later than required to see some interesting case if they want, but if you switch it around to the morning, they (if they like going to class) will have to leave at 12:00ish to make it to class at 1:00 and not be able to get that extra exposure if they wanted. This could also apply to sim-lab time, research time, etc.

I think another issue with this would be having 2 or 3 different people lecturing and each section getting a different lecture. Guest lecturers aren't going to want to stick around all day to teach the same thing three times. And faculty lecturers have clinical jobs they cannot neglect. This would lead to each section having a different lecturer and lecture and some students would be getting a lesser education. I know this happens in undergrad all the time, but I, as a student, would not even consider a school like this for medical school because you know someone is going to get the short end of the stick.

 

[LizzyM]

That's fine and all, but then you have to deal with paying back the loan, malpractice insurance, other fees, and of course taxes. After all that you probably have less than 50K.

We know salaries are going to decline, the question is only "by how much"? Call me an optimist (lol), but I really doubt that a plurality of physicians will lose half their income.

Very few docs pay malpractice insurance from their salaries. That is an expense of the practice. If they are employed by a hospital, the hospital picks up that tab. I'd love to see only the applications of people who'd be happy to be a physician if it paid half what it does.

 

[ChartaBona]

Drop all physician pay by 30-50%?

I've heard a lot of people say that medicine is a terrible career choice, but very few people are THAT pessimistic lol. Such a drop would completely eliminate many specialties from consideration. You'd bankrupt yourself going for FP, Psych, or Peds.


Anyways, by the time I have kids my age, medicine probably won't be a viable career to enter anymore. The med school loans will probably be well over 600K at graduation, and reimbursement will have dropped through the floor. But people won't care, med schools will still be bombarded with applications from naive save-the-world idealists and Asian prestige seekers.

You won't go bankrupt if you don't take out any loans to begin with. I'm anticipating a pay drop, though not that large, by the time we become attendings. This is partly factoring into my decision to apply to HPSP. If I get it, I'll be getting a stipend of 26k/yr while most are going into debt ~60-75k/yr.

As for OP's question: More and more people are applying each year, and they're applying to more and more schools. You've got some people applying to 30+ medical schools, and I don't think the system was designed to handle this volume. Keep in mind that it's mostly medical students, MD's, DO's, and PhD's taking time out of their VERY busy schedules to assess these applications. It's not like you can hire someone off the street to speed up the process.

 

[Lollygag]

Let me spell it out in a very simple way. Let's say you want every student to have a 2 month rotation in an outpatient general medicine/family practice clinic. If there are 20 FTE family practice and gen med docs with whom you have an affiliation you can take 20 students full-time in 2 months and 120 students over the course of a year. Increase your class size by 10% to 132 students are where are those extra 12 students going to train? Unless you can find 2 more FTE faculty in primary care, you have too many students. This can have a negative effect when it comes time to be evaluated for accreditation.

Could you imagine someone letting you shadow and then saying, "I hope you don't mind but I have 3 other students shadowing me today so you'll have to take turns standing in the hall becuase ya'll won't fit in the exam room."? You wouldn't want that experience on rounds, either, which is why schools cap classes as they do.

Wait now that I'm thinking about it, this all explains why medical schools are so strict on transfer students and why some medicals schools don't even allow transfers at all.

Like it just takes 1 more student and everythings screwed up

 

[Doc E Brown]

Yea but wouldn't that all come right back down to resources? If you add more sections then you'll have to either hire more people to teach those sections, or pay the people teaching those sections more money. And if neither is feasible, then you would have to decrease the length of the sections to accommodate everybody which would result in less clinical experience for the students.

Not that I know anything about how medical school's operate their budget lol, but just a wild guess

It may not seem like *that* big of a deal at the moment, but over time it could come back and bite everyone




Lol

The funding for new sections (more profs or increasing pay on existing profs) will come directly from the tuition of new students. Med schools would actually make money this way considering how expensive tuition is.

Let me spell it out in a very simple way. Let's say you want every student to have a 2 month rotation in an outpatient general medicine/family practice clinic. If there are 20 FTE family practice and gen med docs with whom you have an affiliation you can take 20 students full-time in 2 months and 120 students over the course of a year. Increase your class size by 10% to 132 students are where are those extra 12 students going to train? Unless you can find 2 more FTE faculty in primary care, you have too many students. This can have a negative effect when it comes time to be evaluated for accreditation.

Could you imagine someone letting you shadow and then saying, "I hope you don't mind but I have 3 other students shadowing me today so you'll have to take turns standing in the hall becuase ya'll won't fit in the exam room."? You wouldn't want that experience on rounds, either, which is why schools cap classes as they do.

This is a good point, I wasn't considering a limit to attending docs; however, I'm not sure if these docs are actually the limiting factor. Are affiliated docs actually at a limit to the number of students possible during rotations? If so, can't the school hire more affiliated docs with the increase in revenue that would be generated from the tuition of new students?

And who decides who gets shafted with the afternoon sections (1:00-4:00) and who gets the much better morning section (9:00-12:00)? Or even worse, an evening section (6:00-9:00)? No one wants to be in class on a Friday till 9:00 and no one is going to want to teach that.

This could also cause conflicts with the 'early clinical exposure classes' - or whatever you want to call them. Because if currently students (MS1/MS2's) have class 9-12 and then have clinical exposure class on an afternoon, they can get there around 1 and stay much later than required to see some interesting case if they want, but if you switch it around to the morning, they (if they like going to class) will have to leave at 12:00ish to make it to class at 1:00 and not be able to get that extra exposure if they wanted. This could also apply to sim-lab time, research time, etc.

I think another issue with this would be having 2 or 3 different people lecturing and each section getting a different lecture. Guest lecturers aren't going to want to stick around all day to teach the same thing three times. And faculty lecturers have clinical jobs they cannot neglect. This would lead to each section having a different lecturer and lecture and some students would be getting a lesser education. I know this happens in undergrad all the time, but I, as a student, would not even consider a school like this for medical school because you know someone is going to get the short end of the stick.

Yeah there is always going to be a better section or a better prof teaching, just like it was in undergrad. There's really no way around that, but I don't think that should be a reason not to have sections, we all dealt with it in college. And I think you're assuming that all sections need to be on the same day? They could alternate days and still keep the same time.

I'm not educated enough on students staying longer hours on clinical exposure classes so I won't comment on that, but, assuming that students need to rearrange their class time, it's the same time block being taken out of they day so I don't see why they can rearrange their other commitments.

You have a point with guest lecturers, I don't know how common they are in med schools. The med school should be able to hire more faculty lecturers with their increase in revenue. Yeah there are differences between profs and their teaching style but in the end it all boils down to the same education. We all had diff teachers for our pre-reqs and not every medical student in the states has the same prof - my point is that you're gonna learn the material either way.

My point in this discussion is not that there will be no problems when you increase class size because of course it's more difficult to manage. My point is that this can be done without jeopardizing the medical education. My college had 30,000 students, it's just kinda annoying to hear med schools say that they can't handle more than 500.

 

[DAPI]

Yeah there is always going to be a better section or a better prof teaching, just like it was in undergrad. There's really no way around that, but I don't think that should be a reason not to have sections, we all dealt with it in college.1 And I think you're assuming that all sections need to be on the same day? They could alternate days and still keep the same time.

I'm not educated enough on students staying longer hours on clinical exposure classes so I won't comment on that, but, 2 assuming that students need to rearrange their class time, it's the same time block being taken out of they day so I don't see why they can rearrange their other commitments.

You have a point with guest lecturers, I don't know how common they are in med schools. The med school should be able to hire more faculty lecturers with their increase in revenue. 3 Yeah there are differences between profs and their teaching style but in the end it all boils down to the same education. We all had diff teachers for our pre-reqs and not every medical student in the states has the same prof - my point is that you're gonna learn the material either way.

My point in this discussion is not that there will be no problems when you increase class size because of course it's more difficult to manage. My point is that this can be done without jeopardizing the medical education. My college had 30,000 students, it's just kinda annoying to hear med schools say that they can't handle more than 500.

1) Yes, if you are in a block style curriculum, like a lot of med schools are, students go to class everyday for the same subject. There would be no way to alternate this... Or it would be the most convoluted schedule ever.

2) Um what? Have you ever wanted to stay late shadowing a doctor (or do some other interesting thing you wanted to do), but couldn't because you knew you had to go to an attendance mandatory class? Yeah... you can't just rearrange your schedule in school because you feel like it.

3) Yeah, but I'll guarantee you some students in some section learned it better because of the professor and not individual motivation or dedication to the class.


It just seems like a large undertaking that schools are unwilling to do for reasons other than prestige.

 

[HughMyron]

Very few docs pay malpractice insurance from their salaries. That is an expense of the practice. If they are employed by a hospital, the hospital picks up that tab. I'd love to see only the applications of people who'd be happy to be a physician if it paid half what it does.

FP salary is less than 40% of Rads or Anes. Why not just compare applications of someone interested in FP and someone who says they're interested in Rads?

Edit: nvm I misread your words. My question still stands tho.

 

[circulus vitios]

FP salary is less than 40% of Rads or Anes. Why not just compare applications of someone interested in FP and someone who says they're interested in Rads?

FM is ~$175k. Rads and gas are $300-400k.

 

[KnuxNole]

I seem to disagree. What if the school just can't increase the class size without major overhauls.

I have no knowledge of how Harvard or any other Ivy operates, but just go with my examples here. - Think about if the anatomy lab is already maxed with 165 students. Say they only have 20 tables, that would put them at 8-9 people per group. So for them to increase they would need to renovate the anatomy lab to have more tables or add more people to each group. Also, what if all the MS1's have all their lectures in a lecture hall with only 165 seats. (Don't say students don't attend anyways, cause I'm sure there are a few mandatory classes everyone goes to) They would need a new MS1 lecture hall or need to give the same lecture twice. Same thing could go with simulation labs, PBL classes, etc. If several of these problems exist, it may just not be feasible to increase class size at the moment.

Also, like LizzyM said, they would need to secure more MS3 positions, which may just not exist. You can't just start cramming more students into a particular rotation. It would lead to less firsthand experience and an overwhelmed attending.

Those mandatory classes are total lamesauce. If there were two sections of lecture, and lecture was optional, it wouldn't make a big difference in theory. However, like you mentioned later, the guest lecture and faculty with clinical duties can factor into all of this.

You can have a giant lecture of 200-300 students. Not everyone will show up(after the first week), and I doubt in a class of 100 people, it's any different than sitting in a class of 200-300. Of course there are those students that sits in front and asks 100 questions in class/asks 100 questions during rounds in rotations. They can still do that in a larger class. Lab is another story though....

 

[music2doc]

The funding for new sections (more profs or increasing pay on existing profs) will come directly from the tuition of new students. Med schools would actually make money this way considering how expensive tuition is.

Actually, as a rule, schools lose money on students, although this is made up for elsewhere and these costs are absorbed by research dollars, grants, etc. What we pay in tuition -- believe it or not -- does not actually pay the entire cost of our training (as exorbitant as the fees are). IIRC, Colorado actually passed a law one year that required OOS students to pay the entire cost of their medical education. That cost was about $90k/yr. I assume some modifications were made b/c CUSOM is about $80k/yr for OOS students now. (I know it has dropped from its maximum a few yrs back.)

A better estimate of the cost of training a med student can be found here and they give an estimate of about 200-250 pounds or $325k-400k. Of course, that's in the UK, so who knows what it costs here.

This is a good point, I wasn't considering a limit to attending docs; however, I'm not sure if these docs are actually the limiting factor. Are affiliated docs actually at a limit to the number of students possible during rotations? If so, can't the school hire more affiliated docs with the increase in revenue that would be generated from the tuition of new students?

Yes, the M3 year is the real issue with schools' increasing class sizes. Rotations are the limiting factor and this involves a combination of limited faculty and limited patient volumes, clinic/hospital space, etc. You have to remember they're not JUST training M3s. There are often a variety of other learners with the same group -- maybe 2 M3s, an M4, a P4, an intern, a PGY3, an M1/M2 shadowing, etc. You can only get so many of those into a given pt's room so schools have to limit the number of each type working with/following a given care team. This results in practical limits, which is what LizzyM was referring to above.

Yeah there is always going to be a better section or a better prof teaching, just like it was in undergrad. There's really no way around that, but I don't think that should be a reason not to have sections, we all dealt with it in college. And I think you're assuming that all sections need to be on the same day? They could alternate days and still keep the same time.

The professional curriculum is MUCH more rigid than your UG curriculum. We have two entire offices committed to oversight of the curriculum (one is the administrative arm and has full jurisdiction over everything we are taught, the other handles technological learning resources and implementation as well as curriculum development). Also, courses are taught by large teams of faculty. You cannot simply replace one faculty member with another as each is teaching in his/her own area of expertise. Occasionally, we will end up asking the course director a question during a review session pertaining to someone else's lecture and we are basically given a, "I think it's xyz, but please check with Dr. Abc to be sure as I'm not entirely sure and what you were taught by Dr. Abc is what will be on the exam."

Basically, trying to have multiple sections of a given course would be a logistical nightmare, not to mention we [frequently] share our faculty with the Schools of Pharmacy, Dentistry, Physical Therapy, etc. and they are not hired to be instructors -- they are hired as researchers and clinicians. In other words, their time is committed to research, not to teaching so it would be unfair to them to start adding sections. Keep in mind that being faculty at a medical school is nothing like being faculty at an UG. You can't really extend your UG experiences to med school and expect things to be comparable. They're not.

I'm not educated enough on students staying longer hours on clinical exposure classes so I won't comment on that, but, assuming that students need to rearrange their class time, it's the same time block being taken out of they day so I don't see why they can rearrange their other commitments.

Huh?

You have a point with guest lecturers, I don't know how common they are in med schools. The med school should be able to hire more faculty lecturers with their increase in revenue. Yeah there are differences between profs and their teaching style but in the end it all boils down to the same education. We all had diff teachers for our pre-reqs and not every medical student in the states has the same prof - my point is that you're gonna learn the material either way.

First, there wouldn't really be any increase in revenue. (As mentioned above, they would be likely to LOSE revenue as a result of this without an increase in other moneys coming in as a result.)

Second, basically all of your lecturers are "guest" lecturers. It would be a logistical nightmare and totally impractical. Also, accreditation teams would have some serious issues with the lack of standardization.

My point in this discussion is not that there will be no problems when you increase class size because of course it's more difficult to manage. My point is that this can be done without jeopardizing the medical education. My college had 30,000 students, it's just kinda annoying to hear med schools say that they can't handle more than 500.

 

[Eon]

Also, like LizzyM said, they would need to secure more MS3 positions, which may just not exist. You can't just start cramming more students into a particular rotation. It would lead to less firsthand experience and an overwhelmed attending.

What about compensating/adding more physicians to help with the overabundance of students? I feel like the answer is simple, maybe I'm not thinking wholly.

 

[music2doc]

Those mandatory classes are total lamesauce. If there were two sections of lecture, and lecture was optional, it wouldn't make a big difference in theory. However, like you mentioned later, the guest lecture and faculty with clinical duties can factor into all of this.

You can have a giant lecture of 200-300 students. Not everyone will show up(after the first week), and I doubt in a class of 100 people, it's any different than sitting in a class of 200-300. Of course there are those students that sits in front and asks 100 questions in class/asks 100 questions during rounds in rotations. They can still do that in a larger class. Lab is another story though....

This is true. Half the class takes the lecture courses online anyway... As long as you have space for their exams....

 

[DAPI]

What about compensating/adding more physicians to help with the overabundance of students? I feel like the answer is simple, maybe I'm not thinking wholly.

This has been addressed above, but the answer is basically, there are only so many pediatricians (or insert specialty) in an geographic location and only so many are willing/qualified/available to be an educator of medical students.

 

[Eon]

This has been addressed above, but the answer is basically, there are only so many pediatricians (or insert specialty) in an geographic location and only so many are willing/qualified/available to be an educator of medical students.

I should've been more clear. I was emphasizing the point of overcompensation for those willing so that it becomes a larger incentive to help.

 

[LizzyM]

I should've been more clear. I was emphasizing the point of overcompensation for those willing so that it becomes a larger incentive to help.

First of all, most of the clinical training, particularly in outpatient settings, are provided by voluntary faculty which means that in exchange for admitting privileges a physician spends some months each year training students. This decreases a physician's productivity and actually costs him/her money; the voluntary faculty are not paid.

It would be tough to get voluntary faculty to take on more duties. Could we pay them to get them to take students... sure but we'd have to pay them for every student, not just the incremental increase. As it is now, tuition does not cover the full cost of educating students. If we increase the number of students and increase cost by paying voluntary faculty, we'd lose a lot of money.

Furthermore, there are only so many patients in a geographic area. Not every student will be able to scrub on a c-section if the number of c-sections is less than the number of students.

 

[KnuxNole]

Solution: Women, make more babies

 

[HughMyron]

It's a lot harder to make a medical school than to make a law school just because of the clinical stuff. Law schools can just make a professor talk at a group of 70 people. Medical schools need to do that AND provide tons of (very expensive) practical and clinical experience.

 

[45408]

Very few docs pay malpractice insurance from their salaries. That is an expense of the practice. If they are employed by a hospital, the hospital picks up that tab. I'd love to see only the applications of people who'd be happy to be a physician if it paid half what it does.

You'd have physicians retiring in droves if their salaries dropped by 50%, because they could live as well/better on their retirement plans. If you cut a pediatrician's salary in half, she'd be making less than a nurse.

Anyway, if reimbursements were cut by half, a physician's salary would drop more like 75%. The overhead is fixed, and since it's about 50% of physician reimbursements, it's the physician salary that would really get axed.