Will the focus on primary care physicians lead to discrimination in admissions?

[goofball]

Been reading some disturbing things recently. From Medscape:

http://www.medscape.com/viewarticle/782043

Those candidates often live in the area and come from rural backgrounds and are more often women and older students, he said...

"All our data at the AAMC shows that the effect of your medical education on your career choice is relatively small. The secret sauce is admissions," he said, and choosing students with the appropriate background will be key to these primary care programs' success.

Basically, women, nontrads, and rural folk are more likely to go into primary care. I interpret this article as arguing for discrimination in favor of these groups.

I doubt that most schools will discriminate based on this stuff, since very few schools take the primary care thing seriously. But unfortunately, a few schools like OHSU, UW, Quinnipiac, etc DO look like they take the primary care thing seriously.

So is this an unintended consequence of the focus on primary care, a discrimination against traditional, urban, and male students?

I mean, it's well known that some schools strongly prefer nontrads, but that's only a few schools. I'm worried that in the future, more schools will use this primary care thing as an excuse to discriminate against some people and preferentially admit others.

Is this a reason for concern, or am I reading too much into this?

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[Planes2Doc]

It's not discrimination if people know what to do and say. It's like saying you don't want to accept any students who don't want to help the poor. It's kind of hard to find anyone who doesn't at least pretend to care about these populations. I'm assuming that the primary care interest stems from the volunteering and other activities that you'll end up doing whether you want to or not.

 

[NickNaylor]

This is exactly the kind of nonsense a pre-med should not care about much less get in a fury about. Even if that does happen, who cares? How can you do anything about it? Will it even impact you at all?

Sent from my Nexus 7

 

[cinamin]

Been reading some disturbing things recently. From Medscape:

http://www.medscape.com/viewarticle/782043


Basically, women, nontrads, and rural folk are more likely to go into primary care. I interpret this article as arguing for discrimination in favor of these groups.

I doubt that most schools will discriminate based on this stuff, since very few schools take the primary care thing seriously. But unfortunately, a few schools like OHSU, UW, Quinnipiac, etc DO look like they take the primary care thing seriously.

So is this an unintended consequence of the focus on primary care, a discrimination against traditional, urban, and male students?

I mean, it's well known that some schools strongly prefer nontrads, but that's only one school. I'm worried that in the future, more schools will use this primary care thing as an excuse to discriminate against some people and preferentially admit others.

Is this a reason for concern, or am I reading too much into this?

are you applying anytime soon? Lots of schools have a PCP mission and it isn't a very new trend... you kind of have to apply that way IMO to have success... definitely don't go to interviews saying you want to do ortho surg!!! Eventually all applicants will say they want to do PCP... a lot say they do and don't .. isnt necessarily a sin. Lots of PCP oriented school say they have a PCP mission yet churn out students matching into specialty residencies.

 

[goofball]

are you applying anytime soon? Lots of schools have a PCP mission and it isn't a very new trend... you kind of have to apply that way IMO to have success... definitely don't go to interviews saying you want to do ortho surg!!! Eventually all applicants will say they want to do PCP... a lot say they do and don't .. isnt necessarily a sin. Lots of PCP oriented school say they have a PCP mission yet churn out students matching into specialty residencies.

I've already been accepted, so it's not my problem anymore, I just fear for future applicants.

I know that most schools with primary care missions don't give a crap about primary care. But places like OHSU actually have students do extra rotations in rural, primary care settings, and are known to favor nontrad applicants. I was worried that stuff like that would become more prevalent in the future.

 

[Lexdiamondz]

I've already been accepted, so it's not my problem anymore, I just fear for future applicants.

I know that most schools with primary care missions don't give a crap about primary care. But places like OHSU actually have students do extra rotations in rural, primary care settings, and are known to favor nontrad applicants. I was worried that stuff like that would become more prevalent in the future.

If youve already been accepted, why do you even give a crap?

the things people worry about...

 

[galaxyx]

I've already been accepted, so it's not my problem anymore, I just fear for future applicants.

I know that most schools with primary care missions don't give a crap about primary care. But places like OHSU actually have students do extra rotations in rural, primary care settings, and are known to favor nontrad applicants. I was worried that stuff like that would become more prevalent in the future.

So you're worried that groups traditionally discriminated against might get some slight advantage that gets them closer to an equal playing field because they might actually be the students that are more likely to help the physician shortage in this country?

 

[goofball]

So you're worried that groups traditionally discriminated against might get some slight advantage that gets them closer to an equal playing field because they might actually be the students that are more likely to help the physician shortage in this country?

How are women/nontrads/rural folk traditionally discriminated against? Even if they don't say they prefer nontrads (some schools say they do in their mission statements), nontrads still have the advantage of several extra years to build up extracurriculars and activities. Nontrads are favored at all places in the admissions process.

Women go to med school just as much as men do now. Hell, I think in the future, medicine will become a female-dominant field, because many more women go to college than men do.

Rural students are also favored and given advantages in the admissions process.



You can't just say people are discriminated against without any proof.

 

[mimelim]

How are women/nontrads/rural folk traditionally discriminated against? Even if they don't say they prefer nontrads (some schools say they do in their mission statements), nontrads still have the advantage of several extra years to build up extracurriculars and activities. Nontrads are favored at all places in the admissions process.

Women go to med school just as much as men do now. Hell, I think in the future, medicine will become a female-dominant field, because many more women go to college than men do.

Rural students are also favored and given advantages in the admissions process.



You can't just say people are discriminated against without any proof.

 

[sinombre]

Been reading some disturbing things recently. From Medscape:

http://www.medscape.com/viewarticle/782043


Basically, women, nontrads, and rural folk are more likely to go into primary care. I interpret this article as arguing for discrimination in favor of these groups.

I doubt that most schools will discriminate based on this stuff, since very few schools take the primary care thing seriously. But unfortunately, a few schools like OHSU, UW, Quinnipiac, etc DO look like they take the primary care thing seriously.

So is this an unintended consequence of the focus on primary care, a discrimination against traditional, urban, and male students?

I mean, it's well known that some schools strongly prefer nontrads, but that's only a few schools. I'm worried that in the future, more schools will use this primary care thing as an excuse to discriminate against some people and preferentially admit others.

Is this a reason for concern, or am I reading too much into this?

lol... not even remotely true.

 

[NickNaylor]

How are women/nontrads/rural folk traditionally discriminated against? Even if they don't say they prefer nontrads (some schools say they do in their mission statements), nontrads still have the advantage of several extra years to build up extracurriculars and activities. Nontrads are favored at all places in the admissions process.

Women go to med school just as much as men do now. Hell, I think in the future, medicine will become a female-dominant field, because many more women go to college than men do.

Rural students are also favored and given advantages in the admissions process.



You can't just say people are discriminated against without any proof.

Well, you also can't make a claim like "medical schools don't care about primary care" without any proof but that didn't stop you.

Sent from my Nexus 7

 

[Gut Shot]

Is this a reason for concern, or am I reading too much into this?

Giving *some preference* to individuals with certain attributes/experiences is not tantamount to categorical discrimination against other groups. If that were true you could say that medical schools discriminate against those with lower GPAs/MCAT scores, which would be absurd.

In summary, get over it.

 

[Barcu]

This kind of issue pops up in URM debates too, and it shows that many pre-meds and even med students miss the point.

The point of med school admissions is to not pick the best applicant possible. For one, that's difficult to do because it is hard to predict. But more importantly, we are trying to pick physicians that BEST SERVE THE PATIENT POPULATION!!!!!!! So many people miss this and instead choose to complain about how they are getting screwed over. This process isn't about you as an applicant. It's about producing physicians for the population.

 

[music2doc]

This kind of issue pops up in URM debates too, and it shows that many pre-meds and even med students miss the point.

The point of med school admissions is to not pick the best applicant possible. For one, that's difficult to do because it is hard to predict. But more importantly, we are trying to pick physicians that BEST SERVE THE PATIENT POPULATION!!!!!!! So many people miss this and instead choose to complain about how they are getting screwed over. This process isn't about you as an applicant. It's about producing physicians for the population.

THIS!

OP, you are claiming they are "discriminating" against certainly people as if this were a "bad thing"; HOWEVER, what they are really doing is selecting for the groups they anticipate will serve the needs of the country most effectively. Your original post makes it quite evident you just simply do not get it. Hopefully, by the end of your M1 orientation you will begin to understand why your OP comes off as ridiculous.

 

[goofball]

Well, you also can't make a claim like "medical schools don't care about primary care" without any proof but that didn't stop you.

Sent from my Nexus 7

IIRC there are schools out there that talk about primary care at length, but send less than 8% of their grads to family practice.

 

[circulus vitios]

This kind of issue pops up in URM debates too, and it shows that many pre-meds and even med students miss the point.

The point of med school admissions is to not pick the best applicant possible. For one, that's difficult to do because it is hard to predict. But more importantly, we are trying to pick physicians that BEST SERVE THE PATIENT POPULATION!!!!!!! So many people miss this and instead choose to complain about how they are getting screwed over. This process isn't about you as an applicant. It's about producing physicians for the population.

The metrics by which applicants are judged fail at doing this.

 

[music2doc]

The metrics by which applicants are judged fail at doing this.

Yes, they do fall short. Hence the problems we have. That said, do you have a better suggestion? We already know MCAT & GPA predict in the wrong direction in many cases (in terms of primary care and underserved needs).... So what do you suggest? The best predictor of future behavior is past behavior. That suggests that we look for people who have experience working w the populations we desire to see served or who have done similar activities....

 

[NickNaylor]

IIRC there are schools out there that talk about primary care at length, but send less than 8% of their grads to family practice.

Sorry, I don't count what you "remember correctly" as proof. Ultimately it doesn't matter, but if you're going to call people out for not providing proof for reasonable claims, then you should expect to be called out for not providing proof for ridiculous ones. Also, schools do not decide what interests you have and the pros and done of various specialties. You are trying to put the blame on schools for something that has almost next to nothing to do with them.

Sent from my Nexus 7

 

[music2doc]

IIRC there are schools out there that talk about primary care at length, but send less than 8% of their grads to family practice.

Care to name a few? The ones I am familiar with that claim to care about primary care put out quite a few and are "top ranked" for putting out PCPs....

 

[LizzyM]

Been reading some disturbing things recently. From Medscape:

http://www.medscape.com/viewarticle/782043


Basically, women, nontrads, and rural folk are more likely to go into primary care. I interpret this article as arguing for discrimination in favor of these groups.

I doubt that most schools will discriminate based on this stuff, since very few schools take the primary care thing seriously. But unfortunately, a few schools like OHSU, UW, Quinnipiac, etc DO look like they take the primary care thing seriously.

So is this an unintended consequence of the focus on primary care, a discrimination against traditional, urban, and male students?

I mean, it's well known that some schools strongly prefer nontrads, but that's only a few schools. I'm worried that in the future, more schools will use this primary care thing as an excuse to discriminate against some people and preferentially admit others.

Is this a reason for concern, or am I reading too much into this?

Schools are going to choose students who fit well with their mission, particularly when their funding (either governmental and/or philanthropic) depends on meeting the needs and expectations of their stakeholders including legislators and the larger society. There are many parts of the country that have insufficient numbers of primary care providers. The justification for funding new medical school and expanding current schools is to meet that unmet need.

So, looking at the people who choose primary care (which is not just family medicine but also general pediatrics, general internal medicine, and, some would argue, obstetrics and primary well woman care as provide by gynecologists), what are predictors that could be identified pre-admission that predict primary care practice 8 years later? Is it discriminatory to say "these are the characteristics of people most likely to meet society's need for primary care providers and therefore we should select people with these characteristics for admission to our medical school."?

It is easier to become a non-trad from a rural area than it is to change your gender . Just take a job in a rural area for 3-4 years and then apply to medical school. Not interested in that option? Maybe you aren't a good fit for that school and its mission.

 

[NickNaylor]

It is easier to become a non-trad from a rural area than it is to change your gender . Just take a job in a rural area for 3-4 years and then apply to medical school. Not interested in that option? Maybe you aren't a good fit for that school and its mission.

I don't think you understand... THEY'RE TAKING MY HARD EARNED SPOT.

 

[goofball]

Care to name a few? The ones I am familiar with that claim to care about primary care put out quite a few and are "top ranked" for putting out PCPs....

For example, FIU was a new school that claimed to have a primary care mission, but its first match list said only 3/40 people went to FP. Pretty much EVERY school I interviewed at said something to the effect of how primary care was important to them and how they involved students in the community, but very few seem to care about sending grads to it. It's just lip service as usual.

http://www.kevinmd.com/blog/2012/12/medical-schools-care-primary-care-shortage.html
Is a link that should tell it better than I can.


I'm not blaming FIU or anyone else, its hard to get people interested in primary care. I just think there's a difference between schools that pay lip service to primary care and schools that wholeheartedly make it a part of their curriculum.

For example, OHSU takes time away from all its other rotations to make a new, extra rotation in rural community medicine. How many other schools with "primary care missions" do that?

 

[music2doc]

For example, FIU was a new school that claimed to have a primary care mission, but its first match list said only 3/40 people went to FP. Pretty much EVERY school I interviewed at said something to the effect of how primary care was important to them and how they involved students in the community, but very few seem to care about sending grads to it. It's just lip service as usual.

http://www.kevinmd.com/blog/2012/12/medical-schools-care-primary-care-shortage.html
Is a link that should tell it better than I can.


I'm not blaming FIU or anyone else, its hard to get people interested in primary care. I just think there's a difference between schools that pay lip service to primary care and schools that wholeheartedly make it a part of their curriculum.

For example, OHSU takes time away from all its other rotations to make a new, extra rotation in rural community medicine. How many other schools with "primary care missions" do that?

CU does similar things, MCV/VCU (part of M1/M2 preceptorships). I can't say that I looked at that since rural wasn't really my thing... My interests are more international and my school has a very strong international presence with WHO reps on faculty and hosting the PTS (Panamerican Trauma Society, which is the primary trauma-related support to PAHO, the Latin American arm of the WHO).

Being new, FIU has no real experience in how to best effect a PCP mission. They can pretty much say whatever they want, so I wouldn't take what they say for anything more than a quick 'n' dirty slogan.

 

[ZeaL6]

For example, FIU was a new school that claimed to have a primary care mission, but its first match list said only 3/40 people went to FP. Pretty much EVERY school I interviewed at said something to the effect of how primary care was important to them and how they involved students in the community, but very few seem to care about sending grads to it. It's just lip service as usual.

http://www.kevinmd.com/blog/2012/12/medical-schools-care-primary-care-shortage.html
Is a link that should tell it better than I can.


I'm not blaming FIU or anyone else, its hard to get people interested in primary care. I just think there's a difference between schools that pay lip service to primary care and schools that wholeheartedly make it a part of their curriculum.

For example, OHSU takes time away from all its other rotations to make a new, extra rotation in rural community medicine. How many other schools with "primary care missions" do that?

Why are you only quoting family practice numbers? Primary care includes more than just that..

 

[goofball]

Why are you only quoting family practice numbers? Primary care includes more than just that..

Those numbers are not reliable because IM/Peds includes people who subspecialize.

 

[ZeaL6]

Those numbers are not reliable because IM/Peds includes people who subspecialize.

Obstetrics/Gynecology is technically primary care, and many of those IM/Peds subspecialties such as cardiology I feel could still be as well. Also, there is a shortage of emergency medicine too and I feel like many of the schools encode that as part of their primary care cause, but I may be off base.

 

[KnuxNole]

IM and Peds still count towards primary care. OB/GYN is sometimes lumped into it too.

 

[HSUReddie]

Those numbers are not reliable because IM/Peds includes people who subspecialize.

They're still included when schools usually talk about having a strong desire to produce primary care physicians. It still counts. You can't just throw it out because maybe half of those people will go do peds critical care or peds cardio or something like that.

Back to the original point... I guess I'm sort of confused on why you're worked up about this. If the school is serious about their mission statement on really being a primary care driven school, what's wrong with them accepting students who will more likely go to primary care? I'm sure it goes beyond them just accepting every student with a semi-decent application who happens to be older, female, and from the sticks. If people don't fit the mission statement or feel of the school, that's probably not a school they should be applying to in the first place.

I'm matriculating to a school that heavily emphasizes primary care... Pretty sure there's more males than females... majority of the students are from a heavily urban county... and a good mix of trads and non trads. And they still manage to match mostly primary care specialities.

 

[rain4venus]

I'm matriculating to a school that heavily emphasizes primary care... Pretty sure there's more males than females... majority of the students are from a heavily urban county... and a good mix of trads and non trads. And they still manage to match mostly primary care specialities.

The point that is often made is that you shouldn't be looking at recent graduates at time of matching, but that you should be looking 5 or so years after graduation and see how many of a school's graduates have actually gone on to a career in primary care. And the number I heard wasn't 50% but more like 80% of IM residents would go on to subspecialize (I don't know about peds), but then again I don't remember where I heard that so take it with a grain of salt.

ETA: goofball, what field do you anticipate wanting to go into?

 

[Planes2Doc]

Yes, they do fall short. Hence the problems we have. That said, do you have a better suggestion? We already know MCAT & GPA predict in the wrong direction in many cases (in terms of primary care and underserved needs).... So what do you suggest? The best predictor of future behavior is past behavior. That suggests that we look for people who have experience working w the populations we desire to see served or who have done similar activities....

Here's the moral of the story... Primary care is less desirable for certain reasons. One of them is MONEY. I realize that talking about money during any type of interview is taboo, but to believe that investment bankers are doing their work because of the thrill of using their skills and the joys of underwriting securities sounds dumb. But with medical students and physician, somehow people on this site think that anyone going in it for the money sounds dumb. It's all dumb. People might become physicians because it is a meaningful worthwhile career, but to throw out the notion that money is irrelevant is just plain idiotic. Plus, with the beat-down that medical students get once they get into medical school, I think a lot of that idealism gets washed away. If you go into the allopathic forum, you'll see that the SDN members there are actually honest about their desire to make money.

But despite this, I think that we should stop ignoring the fact that people want to make a good salary. Once we come to accept this, we'll see that there aren't many ways to predict a good candidate for primary care medicine.

You're right, GPA and MCAT are bad predictors.

So people go to ECs then. They must be a great predictor, right? Well, I remember making a thread a while back showing how they are probably doing the exact opposite. I'll explain that in a nutshell.

So let's pretend you have a pre-med that becomes a "ZERO to Mother Teresa" applicant as a freshman in college. They pick up a laundry-list of activities that show their "desire to help the underserved." Since these activities are started early on, the ADCOMs will generally have no reservations about the authenticity of the ECs. Because after all, longevity equals caring, right?

But here's the thing. Picking up a large number of ECs while maintaining a good GPA and getting a high MCAT must mean you're pretty talented, right? So if you have a "ZERO to Mother Teresa" applicant with excellent stats, you'll have a shot at top schools assuming you have research.

So now the ADCOMs are all excited because they accepted this very caring person with so many genuine activities and great stats. This means that they are definitely going to help the underserved because they showed such commitment during college, right? Well, if these people did so well in college and on the MCAT while juggling those activities, I'm guessing they'll do well in medical school as well, making AOA and rocking the boards.

And finally, what does that translate to? Someone who shoots for the competitive residencies, like the ROADS specialties. Not quite the future family physician ADCOMs may have wanted, right? Or maybe the ADCOMs are putting up a facade themselves, and just want students that will end up matching into the best residencies and become leaders in medicine? That's a possibility as well.

I've only met one person who openly discussed during his interview that he wanted to be a family physician in a rural area. He grew up in a rural area and had a great story. Otherwise, I would not take any applicant who randomly tells of their desire to serve as a family physician seriously. It sounds like a very forward case of trying to tell ADCOMs what they want to hear.

But what if that's not what ADCOMs want to hear in the first place?!

DUN DUN DUN!!!

EDIT: In all seriousness, you can realistically solve this by accepting lower stats students, regardless of ECs. If you can pinpoint the type of students that will just "barely" pass the boards, they'll be forced into primary care whether they like it or not. I think that the focus on over-achievers with "killer ECs" is going to end up with competitive medical students that will gun for the best residencies possible.

 

[goofball]

The point that is often made is that you shouldn't be looking at recent graduates at time of matching, but that you should be looking 5 or so years after graduation and see how many of a school's graduates have actually gone on to a career in primary care. And the number I heard wasn't 50% but more like 80% of IM residents would go on to subspecialize (I don't know about peds), but then again I don't remember where I heard that so take it with a grain of salt.

ETA: goofball, what field do you anticipate wanting to go into?

It's still really early because I'm class of 2017, but here's what I have decided.

High STEP 1 Score: take a year off to do research and hope for a career in Plastics. Apply to General Surgery as a backup.
Medium STEP 1 Score: General Surgery or EM
Low STEP 1 Score: FM or IM.

 

[LizzyM]

Knowing how to select for future primary care providers requires looking at graduates 4-5 years after graduation and finding those working as primary care providers then looking back at their characteristics at admission and finding predictors of primary care as a choice.

You know what? I would not be surprised if slightly below average MCAT and slightly below average gpa and lower income family background are predictors.

The best way to get family practioners may be to select people who will be unlikely to rock the boards and qualify for a ROAD residency. Horrifying, I know. It just may be that the best candidates for medical school admission are not "the best" candidates

 

[Planes2Doc]

Knowing how to select for future primary care providers requires looking at graduates 4-5 years after graduation and finding those working as primary care providers then looking back at their characteristics at admission and finding predictors of primary care as a choice.

You know what? I would not be surprised if slightly below average MCAT and slightly below average gpa and lower income family background are predictors.

The best way to get family practioners may be to select people who will be unlikely to rock the boards and qualify for a ROAD residency. Horrifying, I know. It just may be that the best candidates for medical school admission are not "the best" candidates

So does this mean we technically agree?! See my edit from 3:09PM that was four minutes before this post?!

 

[LizzyM]

So does this mean we technically agree?! See my edit from 3:09PM that was four minutes before this post?!

We were writing at the same time. Fine minds think alike. Don't worry, the top tier is still going to go looking for the best of the best to enhance their prestige (important to their stakeholders) and train the next generation of leaders in academic medicine as well as super-subspecialists.

 

[Planes2Doc]

We were writing at the same time. Fine minds think alike. Don't worry, the top tier is still going to go looking for the best of the best to enhance their prestige (important to their stakeholders) and train the next generation of leaders in academic medicine as well as super-subspecialists.

Indeed they do! I definitely agree with this. It makes perfect sense.

 

[rain4venus]

But what if that's not what ADCOMs want to hear in the first place?!

DUN DUN DUN!!!

I do wonder about this some. My boyfriend and I are both from a very small town and neither of us has any interest living in a city. He is 90% certain he wants to do primary care.

It seems natural that if schools have primary care missions that it's a good idea for him to explain that he's from a rural area and wants to end up in a rural area doing primary care, but if everyone is right, and most schools are just faking a commitment to churning out PCPs, it might hurt his chances to admit that he's not trying to gun for the most competitive residencies...

(he's a rural nontrad so I hope he does get some discrimination in his favor especially since he sincerely has a commitment to rural primary care)

 

[Gut Shot]

For example, FIU was a new school that claimed to have a primary care mission,

FIU's mission statement can be found here. You will note that it says nothing about primary care.

The message from the Dean can be found here. You will note that it, too, says nothing about primary care.

 

[goofball]

FIU's mission statement can be found here. You will note that it says nothing about primary care.

The message from the Dean can be found here. You will note that it, too, says nothing about primary care.

Wtf, those guys duped me.

"Where do you see yourself in 10 years?" (Most cliche question in the book, sigh)
"Well, I've worked with a neurologist for several years, and thus..."
"You do realize that we have a primary care mission, right?"

 

[Planes2Doc]

Wtf, those guys duped me.

"Where do you see yourself in 10 years?" (Most cliche question in the book, sigh)
"Well, I've worked with a neurologist for several years, and thus..."
"You do realize that we have a primary care mission, right?"

Haha. Or you can say that you shadowed a plastic surgeon and that you want to be a plastic surgeon for the underserved. The poor need boob jobs and weapons-grade bacteria toxins too.

On a serious note though, I shadowed a FM physician. He once said to me after I asked about his schedule, that every Sunday is "kids day" for him. He can make plans to spend every single Sunday with his kids no matter what. As a medical student today, I finally realize the value of this.

As cheesy as it sounds, maybe family physicians do have it good in some ways. They are probably happier because they can spend time with their families. Also, if you have a private practice in a wealthy area like the North Shore suburbs of Chicago, you can do extremely well too.

But seriously, don't underestimate the value of being able to spend time with your kids on a given day all the time without having to worry about anything else.

 

[goofball]

Yeah, it's really surprising how, according to lifestyle surveys at least, the people in lower-reimbursing specialties tend to be happier than people in the higher-reimbursing fields. I have no idea why.

 

[Planes2Doc]

Yeah, it's really surprising how, according to lifestyle surveys at least, the people in lower-reimbursing specialties tend to be happier than people in the higher-reimbursing fields. I have no idea why.

What's the point of making boatloads of money if you have no time to spend it, let alone share it with someone you care about?

Despite everyone in my college graduating class drooling over investment banking, the investment bankers I personally know left the field because they were so miserable. The same goes for doctors. Some might be married to their job, and others won't want that. You learn that pretty fast in medical school. This is why ROADS specialties are so competitive, unlike fields like neurosurgery.

 

[SpacemanSpifff]

EDIT: In all seriousness, you can realistically solve this by accepting lower stats students, regardless of ECs. If you can pinpoint the type of students that will just "barely" pass the boards, they'll be forced into primary care whether they like it or not. I think that the focus on over-achievers with "killer ECs" is going to end up with competitive medical students that will gun for the best residencies possible.

Is that what we really want? To create a population of PCPs who are potentially less driven, less ambitious? It seems like the ideal solution would be for schools to recruit stellar applicants who will likely practice in underserved areas (Ideal being the key word). I would hate to think that my FP or the pediatrician who cared for me as I was growing up were forced into their specialties by poor academic performance. But unfortunately it is difficult to accurately predict which applicants may or may not pursue those opportunities, so maybe you're right.

Rural students are also favored and given advantages in the admissions process.
You can't just say people are discriminated against without any proof.

What are those advantages exactly? Being so far from big hospitals that you had to drive hours just to seek out volunteer and shadowing opportunities? Some interviewers asking you questions like you grew up without running water? I wouldn't claim that being from a rural area crippled me in the admissions game, but it certainly made some things a little more difficult.

 

[obscurehero]

I've found that the further we get in our training, the more practical and less idealistic we become. People start to realize that they need to pay off their six-figure debt. They realize they'd like to buy a house and have money for kids. PCP's don't get paid terribly well. To add to that, a lot of students don't want to do long-term and chronic-care management. Others really want to practice in a more procedural field etc. etc.

So yes, it seems that those that I know that match to FM end up being those didn't think they'd be competitive for other fields and those that are still really idealistic and think that it'd be the best match for them. That said, at least at my school, the vast vast vast majority of students I know matching in FM really do want to do FM and are passionate about it. There are at least a few students I know who got >240 step1 scores who plan on FM or have already matched in FM. That's just my own experience so I'm not sure what the larger trends are.

I do know, however, that at our school they opened up a new more primary care focused clerkship track and they had virtually ZERO interest despite the boast that that track would have better training because there would be such a high faculty to student ratio. The faculty were perplexed. So, I think while medical education has been focusing on primary care for awhile now, students aren't really there yet...at least from what I can tell.

 

[goofball]

What are those advantages exactly? Being so far from big hospitals that you had to drive hours just to seek out volunteer and shadowing opportunities? Some interviewers asking you questions like you grew up without running water? I wouldn't claim that being from a rural area crippled me in the admissions game, but it certainly made some things a little more difficult.

Most medical schools are upfront about the fact that they give preference to applicants from rural areas. A bit like affirmative action I guess.

 

[mimelim]

What's the point of making boatloads of money if you have no time to spend it, let alone share it with someone you care about?

Despite everyone in my college graduating class drooling over investment banking, the investment bankers I personally know left the field because they were so miserable. The same goes for doctors. Some might be married to their job, and others won't want that. You learn that pretty fast in medical school. This is why ROADS specialties are so competitive, unlike fields like neurosurgery.

Neurosurgery is pretty darn competitive. Certainly as competitive as ROADS specialties

 

[obscurehero]

I second this. I'm not sure what planes2doc is talking about.

Also, radiology looks like a bad field to get into. At least if what I've been hearing is true. But that's neither here nor there.

 

[Gut Shot]

Yeah, it's really surprising how, according to lifestyle surveys at least, the people in lower-reimbursing specialties tend to be happier than people in the higher-reimbursing fields. I have no idea why.

That's not surprising at all, if you think about it.

To make a lot of money in medicine these days you generally have to be in one of two types of fields:

1. Procedure-heavy, high liability, long work hour fields like neurosurgery, or;
2. High volume/high reimbursement fields, like radiology (although the clock is running out).

People in 1#. are unhappy because they are working their asses off, have no life, and have a propensity to get sued. People in #2 are unhappy because they have targets painted on their backs. Only a matter of time before competition increases (like interventional rads did to cardiology) or reimbursement gets cut.

But hey, if you're in a low paying field then you're off the radar. I'm not a PCP, but if I were I could move almost anywhere in the country and get a salaried gig with (low) six figure earning, a nice benefits package, ample time off, and even loan forgiveness if I were flexible with geography. Doesn't sound too bad, eh?

 

[SpacemanSpifff]

Most medical schools are upfront about the fact that they give preference to applicants from rural areas. A bit like affirmative action I guess.

Really? Which ones specifically?

 

[Planes2Doc]

Is that what we really want? To create a population of PCPs who are potentially less driven, less ambitious? It seems like the ideal solution would be for schools to recruit stellar applicants who will likely practice in underserved areas (Ideal being the key word). I would hate to think that my FP or the pediatrician who cared for me as I was growing up were forced into their specialties by poor academic performance. But unfortunately it is difficult to accurately predict which applicants may or may not pursue those opportunities, so maybe you're right.

Of course that's not what we really want. But what else can we expect to happen? Pre-meds, believe it or not, are normal people like you and I. They aren't some special morally superior beings that have no interest in money and instead run on do-goodery. They are normal people with normal interests and expectations. If we wanted everyone to help the underserved, then we would have to move away from society.

I remember when I worked at my last job, there were people from all different backgrounds that were working the same position as me. One of them came from another airline's management, another came from the front-line at the airport, another was previously a pre-med and had to go back to work, and my boss used to work in reservations. Aside from specific fields like investment banking that have a specific track for people to take, most jobs in corporate America look at people with all sorts of different resumes. People write their own story.

On the contrary, medical school admissions has made the facade so bad that you can't tell anything about anyone anymore. When I go into the WAMC forum, I can read about a wide variety of activities. Whether someone is volunteering in the ED, volunteering at a free clinic, volunteering for an Alzheimer's something, tutoring underprivileged children, or doing the millions of other things you see all the time; it shows one thing. Conformity. These ECs generally say nothing about people. If they did, there wouldn't be a PCP shortage nor would the underserved still be underserved.

What also blows my mind is if there is a primary care shortage, shouldn't their salaries go up due to supply and demand? Well it's not, and low salaries aren't typically a motivating factor for people. Clearly there is a big disconnect between the bleeding heart Mother Teresa wannabees that get admitted to medical school who suddenly are gunning for ROADS specialties once they start school and the applicants that ADCOMs thought they saw.

So when everyone and their mother is pretending to be a bleeding heart applicant, can there by any other way besides accepting students that will be forced to do a PCP specialty because they have no other choice?

Neurosurgery is pretty darn competitive. Certainly as competitive as ROADS specialties

I remember reading in a few places that it's easier than certain ROADS specialties, due to the horrible life style of neurosurgery.

 

[goofball]

Neurosurgery is pretty darn competitive. Certainly as competitive as ROADS specialties

Do you think that competitiveness will decrease when NeuSu programs become 8 years long rather than 7?