I am the last person in the world that would defend how the medical industry operates, but this post is ******ed. Being a doctor is a job, and like any other job you generally do it as you are trained to do to the best of your abilities.

The skills to be a good physician are very different than the skills to excel in the other fields you mentioned, so a direct comparison of "brilliance" is kind of ******ed.

Suffice it to say, I am really confused. lol

I never said doctors are dumb people, like questioner is implying. My complaints have more to do with the how the industry is structured. I think family doctor's are very competent to the extent of their knowledge and training, I just believe this knowledge and training is more limited than most laypeople realize.

I don't know what you think laypersons think family practice docs can do, but like you said that's sortof outside of the scope of the OP. I was just taking a light hearted stab at you

[QUOTE=tcc1;24530259]I disagree - when you're seeing patients the amount of processing that you are likely to achieve is higher than what is in the classroom setting. That means you're more likely (and indeed, this has been my experience) to remember that patient, presentation, symptoms, etc very clearly.


I didn't say you weren't. I said you misuderstood his post.


I'm familiar with the routine.


No, real world learning doesn't require experience, it provides experience.


Correct.

You're on the right track. You're passionate and commited. Medicine is an admirable proffesion to pursue. Just make sure you practice it with honor. And pay attention! You'll get better grades!

Thanks for life lessons

Layperson, who said I was a layperson? I've taught more doctors than have taught you! lol

I wish I was talking about GP's!

Perhaps ill advised, hardly ******ed if it's accurate. Thank you for making my point. If a doctor performs to the best of his abilities, according to his training, we'd prefer him to have excellant training, and be more able rather than less. The more students we flunk, the fewer borderline doctors we have. And it's not "just a job, like any other job", Few jobs consist of making life and death decisions.

Some people think there are different kinds of brilliance. I think there is a fundamental brilliance which may channel itself many ways. I didn't say doctors weren't intelligent. I said they're unlikely to be as brilliant as in some other fields. This is a fact, not a supposition.

The skill set is different, granted. A superior doctor posesses many qualities beside brute intellect. Compassion and empathy to name a couple, but also curiosity, and deductive logic. Unfortunately, they also posesses the ability to do harm.

Sorry doctors don't get a pass, just cause they're doctors. They have to be held to a higher standard, This begins in the classroom and never ends. See, it's not about the doctors at all. It's about the patients.

Its easy to say "of course it effects quality of performance." It almost assuredly does. The problem is, the solutions proposed are thus far worse than the disease. What we have now are increasingly stringent work hour guidelines, which leads to one inevitable consequence: more transfers of care. It just so happens that the majority of medical errors are attributable to transfers of care. So in order to alleviate long hours, you have shorter shifts, which leads to more transfers of care, which leads to worse patient outcomes.

Its interesting that the 80-hr work week guidelines have been in place for a solid decade now, and there isnt really even ANY data to suggest that they are accomplishing what they set out to accomplish, namely, better patient outcomes.

So their solution is to just continue reducing hours, putting massive demands on residency programs, especially in fields like surgery, where it is just simply entirely unrealistic to expect that it takes the same hours to train a surgeon as it does every other field.

There are no work hour restrictions for practicing physicians. There are many surgeons who work >100 hours a week, on a regular basis, in order to be there for their patients. This means, at times, operating while tired, when you are the only one available.

Training residents to be incapable of this is not just automatically better.

What that means is simply refusing to be a part of the ACGME any longer. It has its consequences but its not impossible by any means. It would probably take some unity from all the surgical subspecialties, but its conceivable.

I'll defer to you on it. There are definitely cases where being there matters more than being fresh.

Still, even though I can't think of a realistic alternative, the current situation hardly seems ideal to me. It seems like there has to be a better way.

I don't see how this kind of thing will be sustainable as medical technology advances, higher degrees of specialization are necessary, and procedures become more complex.

And one less practicing doctor. Honestly, competent people who want to live in hell aren't that easy to come by. I think truly "brilliant" people can generally handily get a 35+ on the MCAT, and people diligent enough to succeed in medicine can handily get a competitive GPA.

And pretty much everyone who has a 3.5 GPA and a 35 on the MCAT gets into medical school (if they really want to do so). There are exceptions, but they're rare.

And those people, even though they're virtually everyone in the US who has what it takes to succeed in medical school and actually wants to take on hundreds of thousands of dollars in debt and work constantly for about a decade before they're eligible to really start their career, often of working constantly for many more decades, while paying out the nose for malpractice insurance, simply don't number enough to fill all the necessary positions.

And on a more cynical note, medical schools don't look good if they have high drop-out rates. Even though I think it's impossible to design a fool-proof admissions process, a medical school will be judged as being lax in its admissions if its students don't make it through. They're supposed to be admitting students who will become doctors, and for prestigious schools they're supposed to be admitting students who will become highly successful doctors. Furthermore, they're devoting large amounts of resources to each student.

It really doesn't help a school's bottom line to be culling the herd after they're admitted.

Yea I didn't mean anything by it, just really don't have any idea about the benefits of ACGME membership and what leaving it might entail.

Per the original post, and assuming your facts are correct, this is the definitive answer.

And this concludes the argument. Well said.

Which is unfortunate.

As a side note, to anyone who has to schedule surgery:

Always try to get the surgeon's first slot of the day if at all possible even if it means scheduling the surgery for a day that is less convenient for you. Not only are they hopefully going to be in fairly good form, but you are much less likely to have your surgery delayed.

Besides the hand-off argument (which is definitely the biggest thing I see sited by physicians), I've been told in several fields that the educational value of "running the ship" through the night with limited attending presence would be almost impossible to provide during "normal working hours".

True. But do you want the one with a 3.5 GPA and 35 MCAT diagnosing and operating on you? Especially if it's life or death? Having no further information?

So use your nurse practioners and family health associates to take up the slack. They aren't as well trained, but they're supervised by a physician. Let's face it, the majority of medical cases do not require the oh so difficultly won skills of a doctor. Most will get better with minimal intervention, or none at all. For the small percentage who require critical care, barely got through med school won't cut it. Would any cardiac interventionist, be better than none? I honestly don't know. I guess few barely passed med school students could become cardiac interventionists.



So does the Navy when training their pilots. What do you think their cost per pilot is? I've heard a million dollars. Or their wash-out rate? Bet it's greater than the 5% previously stated to be med school's. Do you think the Navy would tolerate a minimally competent pilot? With the safety of the entire air wing at stake? I don't. So, what's the difference. Bad pilots kill people. So do bad doctors.


No, but it's better than the alternative. The entire structure of medicine needs to be overhauled. Pay doctors enough to attract the best and brightest. Throw away the idea of tuition. Have students contract to provide services to the poor for a couple years instead, or teach those behind them. You'd be more likely to get the best, because you'd have a larger reservoir from which to draw.

Eliminate family practice and such as specialties. They're redundant. NP's and Pa's provide similar care with much less initial investment, and less lengthy training, thus we'll have more of them.! Increase med school minimum requirements and wash out for less. It's becoming so specialized and technology dependant, only the multi-taskers will keep up anyway. Eleminate the GP. He's a dinosaur. The day of the nice, neighborly country doctor is done. Make medicine a rigorus and respected science.

Cheap labor.
There is no other explanation.
Hospitals are businesses.
It's same in Europe, medical personnel are way overworked.

However, I remember hearing from my niece who in her medical student years went for 6 months in Australia (student exchange or somesuch) that the Aussie doctors are more chill, a lot more free time compared to Euro doctors etc.

I've seen scrubs too.

wut.

Medical school is a competitive process, and I would be surprised if there were any spots left unfilled at the end of the admissions process. So, if you're on the admissions committee (like I happened to be) and you make a bad decision on a candidate and that candidate ends up washing out, you've not only lost the resources you've invested into the initial matriculant, you've also lost that "slot" for four years. That's what I meant by losing two spots

yeah i understand that, but that is still only losing 1 slot. Those resources go to that 1 slot. you are only losing one person that could have been a doctor by wasting that slot, not two.

ok fair enough, you understand what i mean though. My point is it's a waste of a spot for that graduating class