[hilbert42]

"And how hard should organic chemistry be anyway?"

Heaven forbid, it should be as hard as is necessary to achieve the stated outcome. If someone does a course in organic synthesis and graduates from that course then a company hiring the person expects him or her to be able to synthesize chemicals to the extent or level that the course coverd.

Graduates need to know what they're taught and companies expect their prospective employees to understand the work that they need to do.

When I was a student I used to sometimes whinge about the 'tough grading' in certain courses and think I was hard done by when I either failed an exam or didn't do well in it.

The fact was that the education system made it hard for me because I either wasn't good enough and or I had not done sufficient study to pass the course.

Students shouldn't be allowed to reset the standard because they think it's set too high or that they consider the work too tough.

[engineer_22]

It seems to be a pervasive attitude.

Today a group of my colleagues received their grades on a linear algebra test. The class average was below the failing mark. One of my acquaintances remarked: "The professor is going to have to do something about these grades, they can't fail the whole class!"

Maybe it's the class that should do something about the grades...

[forgetbook]

It is trivially simple for an educator(edit: typo) to write a test that every student fails, curve the grades into a normal distribution, and place blame on students while showing a normal distribution of outcomes to administration.

Do you think that practice produces better learning?

[Gigachad]

This is why external standardised testing matters. Low grades could either mean bad teaching, a test too hard, or lazy students.

Standardised tests mean that if just one class does bad, it’s probably bad teaching, if the whole country does bad, it’s a more widespread issue. If any individual does bad, it’s their own issue.

[forgetbook]

Or, this is why evaluation other than rote testing matters.

In specific situations, professional testing is relevant. The Bar, the USMLE, etc. In many more situations, quality is driven by accomplishing goals and solving problems that are by definition nonstandard.

Every practicing physician and lawyer passed their professional exam, yet, some remain more effective than others. Standardized testing is a high-pass filter. You can enforce a minimum, but cannot evaluate maxima. In this situation, a whole class did bad on an exam they all took, and there is still no way to infer whether it was the students, the instruction, or both. Lots of energy spent, very little effective training and credentialing accomplished.

[hilbert42]

Despite my comments above, some examiners can be bastards. Deliberately setting examinations to fail students is counterproductive and demoralizing (sometimes to the extent that potentially good students leave the course).

In practice, examiners who do this are usually inexperienced and they soon learn to discontinue the practice for all the obvious readons. That's why in this instance I'd be inclined to think the students are at fault as this NYC prof has long and extensive experience (he'd have learned not to so long ago).

[forgetbook]

I don't mean to assume malice where incompetence will suffice. You're correct that its generally inexperienced instructors, and in this case was a very experienced instructor.

Is it possible then, that this very experienced instructor, experienced a difficult time adapting to teaching in a new setting, and failed to adapt their examination?

The solution likely isn't for pandemic students to be told they have experience they don't have, but the structure in place created a situation where an entire class experienced the fallout from their professor's failure. In this case, the professor was fired. In many more, students bear the same punishments (both to their academic records and actual learning), while inexperienced instructors are simply told to do better next time.

Why shouldn't students have the same option to do better next time?

[hilbert42]

Clearly, I'm not fully cognizant of all the details in this case so I can only comment in general terms and obviously they can be wrong if I've not access to sufficient information.

It's quite a while since I was at university and back then there would have been very little chance of a professor being fired that easy or on those grounds.

That said, back then, the system was very fair. Students were treated with respect and often given benefit of the doubt. There were appeals mechanisms in place if students failed and they could do so if they thought they had good reasons to appeal, and so on.

Looking in at much of academia these days I see a volatile, messy quixotic buisness and I'm glad I'm not there. (It's still not fully clear to me how things have gotten so off the rails in recent years.)

In direct answer to your question I'd repeat what I said above with respect to my university experience. The system should be fair and flexible and students should always be given a chance to do better next time.

[forgetbook]

I also don't mean to make this so big as to have you throw up your hands at it--that reaction is how systems fail.

There is still very little chance of tenured professors being fired. This exception occurs notably in the case of a longtime, but untenured instructor.

When you say the system should be fair and flexible, it really is as easy as giving students a chance to do better next time. If every student fails the final, let them retake the class and use the second grade in transcripts. If they're unable to retake, refund their tuition or give them a voucher for when they can schedule.

I'm restating other comments so you don't have to hunt them down because its a point worth making--students have no recourse against their colleges, the companies they aspire to move into, or the federal government barring declaration of bankruptcy on their loans. If we want a highly competent workforce, we need to help students train.

I'm glad your university experience worked out well, and aknowledging survivor bias in that and resisting the urge to say "glad its not me" can equip you to help future generations of students, a role that is filled by people who become your reports in your career and your children in your personal life.

[fsckboy]

your comment incorporates so much ... fail

>It is trivially simple for an educator to write a test that

while it is not trivial to write any test, it is trivial to have the test cover the material that was taught and not the material that wasn't, and that's how tests are written

> every student fails, curve the grades into a normal distribution,

then the bulk of students didn't fail under the normal meaning of grading on a curve (unless you clarify, do you mean the students had a normal distribution of "learning some material", but even the highest cohort didn't learn enough of the material to constitute getting credit for having taken the class?

> and place blame on students while showing a normal distribution of outcomes to administration.

what blame would there be to place on students if a normal distribution is shown to the administration? unless as above, all the students are failed and blamed for failure?

> Do you think that practice produces better learning?

testing students on material taught produces better learning, yes. Grading on a curve is more fair to students than not grading on a curve, as it simplifies the task for the professor to write the exam by better smooths any unevenness in the relative difficulty of the questions across different material.

[forgetbook]

I'll imply numbering:

1] Tests are written in many different ways. There is no regulatory body controlling pedagogy across institution at the college level. At best you can assume an invisible hand of the market for hiring graduates influencing student enrollment decisions, and you'll be introducing too many confounding variables to continue a productive discussion of individual tests.

2] I mean the bulk of students fail the test before the curve is applied. If even the highest cohort didn't learn enough material to constitute getting credit, I would hope they are not simply curved into a passing grade relative to each other and passed along. I would hope they are able to retake the course, learn the material, and demonstrate that learning.

3] The blame for poor performance necessitating grading on a curve to avoid bulk-of-class failure being placed on students for failing to learn, rather than an educator failing to teach.

4] Testing is not what produces learning. Testing attempts to measure competence. Receiving feedback from testing enables students to use the measurements in their learning, but the data point 'we all failed' hardly seems useful. // Grading on a curve evaluates student performance relative to each other. Grading without a curve evaluates student performance relative to the test. You can argue either is more fair if you want, but simplifying the task of the professor writing the exam is hopefully not the goal of college education. Hopefully the goal is to train students into highly competent graduates, who can perform across uneven difficulty in different material.

(edit: testing attempts to measure learning -> testing attempts to measure competence)

[hilbert42]

"At best you can assume an invisible hand of the market for hiring graduates influencing student enrollment decisions"

Yes it's done that and more. For instance, in many universities humanities courses have taken a hit because they're not as lucrative financially in either students numbers or in other ways. My profession is technical but I'm not in favor of nuking the humanities (especially so core subjects, history, philosophy, languages etc.).

What's really been lost from university education is the once-important notion of learning for its own sake—and of student life—the spirit of Gaudeamus igitur. Those notions were there but dying during my time quite some decades ago, today they've been completely subsumed or swallowed up by financial considerations. That, I think, is a shame.

In an era where financial considerations dominate, the whole issue of grades, passing examinations is crucially important because it's coupled more tightly than ever to one's livelihood than in the past. Hence, it's little wonder we're now seeing these issues looming much larger in students' minds than ever they've done in the past.

(In my time student protested and demonstrated and often did so violently (anti-Vietnam war rallies, 1968 student riots etc.) but from my recollection there was none of the angst about courses/grades that there is here today (except of course for usual level of time immemorial complaints that have always been part of the background noise of universities.)

[forgetbook]

Forgive me for being suspicious of any invisible hand based argument.

I hope you'll be glad to hear that in my time, learning for its own sake is/was still seen as important, in humanities as much as any other area.

Freedom from the domination of financial considerations may be based more on individual conditions than systemic ones. There were certainly students worried about money in the 70's--it sounds like many of them are more accurately described as would-be students who simply didn't have the opportunity to attend at all. I do not fault today's would-be students who do have that opportunity for seeing their performance as tightly coupled to their livelihood.

(edit: to clarify, suspicion of an invisible hand argument means "if we can't articulate the cause, how are we purporting to know the effect?")

[cafard]

Damn near fifty years ago, I had a multivariate calculus teacher who thought it was amusing to provide tests where the curve peaked about 49%. I was lazy and neglectful of doing the homework problems, so I don't blame him for my own performance. But it didn't seem like a good way to run a class.

I should say that he did not curve on 50% and grade on 90%: I think that a 50% was probably a B- or a C. But it was a while ago.

[hilbert42]

"provide tests where the curve peaked about 49%"

Fucking smart Alec, he'd have deserved it if students had let his tires down.

The only possible saving grace would have been if he'd demonstrated beyond reasonable doubt that multivariate calculus would provide the means to get such precision, ipso facto the class results (complete with workings out). Even then, it's a ratshit idea of the worst order.

[forgetbook]

It is/can be entertaining to be a smart Alec. Many people in higher education roles view themselves as researchers, and teaching (not just students, but the work of teaching itself), as beneath them.

[hilbert42]

"...work of teaching itself), as beneath them."

Smart Alec yes—so long as no one's hurt. It's easy to understand how teaching is considered beneath them as it's distraction. It seems to me that a possible (or partial) way of ameliorating the problem would be to teach students from the outset that the principal role of a university is educate and that if they which to do research under the auspices of a university then they must expect disruption as routine.

Whilst I understand that being disrupted is irritating, the fact that they consider teaching beneath them seems shortsighted. I am not a teacher but on ocassions I've had to teach and I quickly discovered that there's nothing to hone one's own knowledge more than to teach. When teaching in front of a class, 'knowledge' that one's thinks one's clear about in one's mind quickly distills into either actual knowledge or embarrassing garbage.

One wonders then why teaching isn't more highly valued with this lot (whenever I've had to teach I've considered it a privilege and it boosted my ego to boot—especially when in debate with intelligent students who ask interesting questions—some of which yours truly couldn't answer).

[pydry]

>Maybe it's the class that should do something about the grades...

Why?

[cannaceo]

I completed medical school back in 2012. Here's the unfortunate rub with this particular class--organic chemistry is a requisite for medical school and probably shouldn't be. The class is mostly pre-med students and very few chemistry majors. It seems that once upon a time some administrators decided that students should complete 2 years of chemistry and organic chemistry happened to be the most common second year course available.

Physics courses, at least at my alma mater, were separated in to physics for physics majors("honors physics"), physics for engineers, and physics for life sciences. A similar structure would be a great compromise to maintain the quality of education for those continuing on to perform organic synthesis versus those who want to be physicians. I was exposed to exactly zero organic chemistry in medical school or beyond.

[Ekaros]

Maybe there should be an entire pre-med degree. Or at least half of it, fully focused on the subject. Some other countries just straight up admit to med-school and those who don't pass examinations end up doing things like chemistry, and rightfully treated as such students.

[hilbert42]

"Maybe there should be an entire pre-med degree."

I think there's something to that (but also it is applicable to some other professions). Trouble is it would change the complete order of things (having a 'higher' high school as a prep or similar). Unfortunately, it'd never happen as too much is already tied up in keeping in place the artificial dividing line that separates high school and higher education (think economics, whingeing employers, etc., etc.).

[JamesBarney]

I always thought the point of organic chemistry was to be a weed out course for med students.

Most doctors I know don't know jack shit about organic chemistry. They're operating at a level of abstraction much much higher.

[hilbert42]

"Here's the unfortunate rub with this particular class--organic chemistry is a requisite for medical school and probably shouldn't be"

I've not studied medicine but I've some organic chemistry knowledge thus I've come across this bane of contention previously from others. It doesn't take long for organic chemistry to get bogged down in technical details that I reckon wouldn't be needed by most medical professionals. For instance the angle formed between a benzene ring and an amine group after bonding. That's useful info to chemists but to few others.

But where to we draw the line and how do we determine whether it's actually relevant? I'll make an observation on that question at the risk of encroaching upon your profession with an example (please bear with me I'm not a professional pharmacologist).

Let's start with a well-known example: the metabolism of ethanol by the liver. If I put on a chemist's hat then I'd not be expected to know much more than that the liver employs enzymes to partially oxidize ethanol to acetaldehyde thence from there to acetic acid and finally water and carbon dioxide.

However, if I specialized in the area then I'd need to know much more such as the Gibbs free energy for each metabolic stage and calculating that suddenly becomes very complicated, it'd require me to know much more about the liver's physiology and its enzyme processes. If so, then I'd posit the level of knowledge I'd require would be more than would be expected of you if you were, say, a general practitioner.

Viewing it from your side, you'd have to know enough basic organic chemistry to make sense of the various stages the liver goes through to reduce ethanol to H2O and CO2 such as the basics of Gibbs free energy as ethanol's metabolism provides the body with energy thus you'd have to have an overview of how enzymes go about their work—alcohol dehydrogenase/ADH for instance.

This is where drawing lines gets complicated. If we treat an enzyme as a black box that does various things then we can map out an overall picture of how the liver does its job and perhaps that's all the average practitioner needs to know (I'm not familiar with the extent of that requirement). However, if you are required to have a thorough understanding of how enzymes work then a much greater knowledge of organic chemistry would be required. For instance, the chemistry of alcohol dehydrogenase/ADH and it's complicated, so too the final stage of ethanol's elimination wherein acetyl coenzyme A is involved.

From an outsiders' perspective, it doesn't seem reasonable to me that to do their job that those on the first line of medicine would need chemistry to a depth required to understand how acetyl-CoA works at the molecular level. That would seem a waste of time.

On the other hand a basic understanding of organic chemistry seems necessary to have a cognizant overview of the workings of the liver.

Looking in from the outside it's a difficult call. My own doctor usually writes prescriptions in a drug's proprietary name, on occasions he asks if I want the cheaper generic version to which I always answer yes, he's then been been known to ask me for its chemical name having forgotten it (for some unclear reason he seems to assume that I know more chemistry than he does).

Perhaps this is an indicator that many if not most doctors practice drug/pharmacy medicine at a much higher level than that of molecular chemistry—if so then it would seem that having to have detailed knowledge of the subject at this low level is unnecessary.

Apologies if that seemed a little short on in depth. I intended more but omitted some relevant stuff for brevity (there's more to discuss about this topic but there's practical limits to that on HN). Also, as my profession is electronics, my emphasis may seem a little off not having the same familiarity with the issues as you would have.

[senortumnus]

I appreciate your effort in this post. I am a practicing physician and also a person who majored in biochemistry, rather than the more pre-med focused biology/chemistry major offered at my institution. My opinion is that organic chemistry is a great window into the complexity of biologic chemistry that happens to be the foundation of medicine.

Is it necessary for all physicians to peer through this window in order to practice quality medicine? Perhaps not. But does it give us an appreciation, and humility for, the astounding complexity of biologic systems that underpin all clinical interventions? Ideally so. At some point during pre medical training there should be - to be blunt - a filter that separates adaptable and bright students from those who hazily wish to pursue medicine but do not have the capacity to do so at a high level.

There are many career paths for those who can not adapt and learn at the high level which has been traditionally been required to complete medical school. We can, as a society, either lower the standards or maintain that high level of requirement that has been the badge of "MD." My bias of course, having completed 13 years of education after high school, is to recommend that we do not lower the standards of the MD process. The system, as it has evolved to date, has plenty of opportunity for those who desire less rigorous training, for example nurse practitioner and physician assistant tracks. There is still a place in this world for highly trained and motivated individuals who wish to be the best in their field. Signed, a professional who benefited from the strong institutions that create medical doctorates.

[hilbert42]

The position you've put about medicine is essentially as I've come to understand it having viewed it from the outside.

Had I wanted to do medicine I've no doubt that I'd have thought twice about it given the long and tenacious path I'd have had to have taken to get there. My interests were always in basic science and engineering, so I was never in the position of having to make those awkward decisions.

That said, it wasn't a completely black and white process, at one stage I started pharmacy but changed my mind, that may be obvious from my earlier comments.

I've no doubt that filtering is needed to weed out the less motivated but as I've said elsewhere, I've concerns about how it's done. If good people are weeded out because of say their circumstances then society loses the benefit of their input.

My opinion about organic chemistry is that it is a tremendous subject and I have an abiding interest in it. I think this puts me in a good position to appreciate the dilemma medical people face when confronted with the subject. As you know it can get complicated quickly and getting to grips with it can take a lot of work and time—time that many cannot afford to commit.

Thanks for your thoughtful comments.

[cannaceo]

While I agree that we shouldn't lower the standards of the MD process I am not convinced that proficiency at organic chemistry is predictive of physician quality. I'd rather see physicians studying computer science than ochem as tech seems more relevant to the future of medicine. To that extent I'm always willing to entertain reform.

[hilbert42]

"I am not convinced that proficiency at organic chemistry is predictive of physician quality"

Reckon that's true from the very small sample of my own doctors. It would be nice if we had anecdotal info from MDs who reckon it was actually useful and the reason for why it was.

[cannaceo]

I appreciate your thoughtful response. Some of the concepts you mentioned, such as Gibbs free energy, are covered in intro physics, intro biology, and biochemistry courses that are also required as a physician. I believe one biochemistry class as an undergrad and one year of biochemistry instruction in the first 2 years of medical school.

A simplified organic chemistry course could cover the theory of SN1/SN2 attacks, orbitals, some ochem principles, some medical-focused examples of organic chemistry, and some basic mechanisms. It would not require students to creatively solve synthesis questions on exams or memorize long lists of reactions. To that extent maybe even the first of the two part classes is enough.

I never heard of anyone talk about organic chemistry as anything other than a filter class for pre-meds. It's a bit of academic hazing to wash out weaker pre-meds from the undergrad program. Maybe because it effects the university's match rate. Students care about their undergrad's medical school match statistics when they apply. From what I remember hazing does wash out the weaker students who don't have as high of general intelligence or work ethic.

[Siddarth1977]

My school had weed out classes in my program, but it had nothing to do with graduate admissions or competitive rankings.

The point was that it's better to have a student struggle and make adjustments earlier rather than later in their education. Regardless if that adjustment is "spend more time studying" or "change from STEM to something easier", it's better for it to happen in a students first year than fourth year in college.

The system seemed to work well to me. Lots of smart kids who didn't have to work very hard in high school learned early that they were going to have to work harder in college. Other kids realized they were better changing majors. Everyone who was still in the program their junior year had the confidence that they could graduate.

[hilbert42]

"Lots of smart kids who didn't have to work very hard in high school learned early that they were going to have to work harder in college."

Some don't learn early either. I was smart enough to coast along for quite a while doing little and then I suddenly had to apply myself (it was a bit of a shock). I had to relearn how to apply myself and it was harder than I anticipated.

Of course, this never applied to truly brilliant kids (they're the ones I envy). It also doesn't help when one's parents kept pointing to a couple of brothers who lived several blocks away from my home and saying to the effect 'why can't you stop mucking around and just apply yourself like them'. (They were in different classes to me and a year's difference separated them. Trouble was my mother and theirs used to associate with each other (mother's club and all that stuff), so such comparisons were easy.)

It turned out later that it wasn't that they just had normal brains but with lost of application to study—but more. Some years later (perhaps a decade or so) I opened the pages of Scientific American and started reading a fascinating and informative article, it was then that I turned to the author's name only to realize that I knew that 'bastard'. Also a check of the references showed that he had a string of publications about the subject in other advanced publications.

As they say, that's life.

[cannaceo]

My experience in medical school is that your success is based on your ability to memorize large amounts of information that is of low conceptual difficulty in short periods of time. This isn't a trait that is selected for in passing ochem. Furthermore, ochem is the last time in your undergrad or medical school training where you'll be faced with that level of conceptual rigor.

You could just as easily ask all the undergrads to train for a marathon and see who has the discipline to follow through. It would probably be more relevant because at least its health-related.

I think overall we want our doctors to have high general intelligence so we'll continue to demand o-chem. We all have our biases against the kids who couldn't pass o-chem.

[hilbert42]

"We all have our biases against the kids who couldn't pass o-chem."

Do you think that really true? I know some people who struggled with it who took it (or had to take it) as a major. Others, found it easy because they were good at remembering many details, yet others loved its systematic order.

I love the subject but the amount of detail drives me batty at times (one only has to thumb through a copy of Merck to be overwhelmed by the number of processes, etc.)—and I don't have a photographic memory.

However, I don't see that as a major issue in the long run, for if one is heavily involved with some of its specialized threads/areas then it all makes sense at that level (well sort of for much—duh, some—of the time).

Unlike physics where the rules seem clearer and more straightforward, the detail in o-chem throws people (especially those who don't have a good memory for detail). From my experience, this can become an acute problem around exam time when other subjects are competing for attention. Some people do much better in that situation than others, it doesn't mean that they're not good students, or haven't tried hard enough—or that they even dislike the subject.

It seems to me it's the nature of the beast that is actually the real culprit. Perhaps that ought to be taken into account when teaching the subject (for instance, we could offset o-chem exams from others by scheduling them to be held at a different time of year).

Just a thought.

[hilbert42]

"It's a bit of academic hazing to wash out weaker pre-meds from the undergrad program"

In undergrad chemistry my lab partner was a med student whereas I was doing science and engineering. In essence, there were unavoidable common core threads for everyone.

I'm not saying that's good or bad but it was problem for my co chem student not because he was doing poorly but because he was overloaded (his workload was definitely much heavier than mine).

His experience is the reason why I'm not in favor of that approach because it also filters out good students who do badly for other reasons. For example, some students have family commitments and don't have as much time available for study. Others have less time because they have to travel long distances to lectures.

Take my situation, for a part of my studies I used to travel the better part of 200 miles round trip by train and bus each day. I'd leave home when it was dark and also arrive home when dark—that was nearly 6 hours traveling per day.

Making up time studying on the train wasn't an option as I'd just fall asleep. If I'd been doing medicine and that weeding out process adopted then I'd not have stood a chance.

Edit: at a different period when I eventually managed to get closer to uni my flatmate was also a med student and he too always had a much heavier workload than I did.

If I'd been a med student under those conditions, I reckon I'd have wanted to ditch organic chemistry if given half a chance.

[hintymad]

> "And how hard should organic chemistry be anyway?"

For christ's sake, Organic Chemistry has a mechanism that's solidly based on theory of chemical bond and structural chemistry(chirality and what not). And for the empirical part? We've got more than a hundred years of experience. How the fuck hard could it be for an undergrad-level course? What's wrong with the students?

[hilbert42]

That's how it was (and things were) when I was doing organic chemistry.

To answer your last question I could suggest some answers but they'd only be inflammatory. Here, the real problem is that it's not that my answers would be inflammatory but why they'd be considered such (as opposed to being just options or ideas, whether right or wrong, in a much wider rational debate).

The real issue is that illogical, unfounded and ill-informed opinion has stifled rational debate, it having the loudest voice—and that nowadays there's no longer any moderating mechanism that's able to pull it back into line.

[whywhywhydude]

Organic chem 1 and 2 are prerequisites for medical schools. A lot of colleges actually make the courses as hard as possible to make sure that the med school acceptance rate for their graduates is very high.

[forgetbook]

What connection do you see between the company hiring and the course content? I don't think there is a closed-loop there.

[hilbert42]

Tough question, but it boils down to the type of subject matter that's been taught.

I'll use myself as a illustration: I've done a wide range of subjects in my time and I'll use two instances. One was philosophy which included political philosophy the other electronics (which was separate from science, physics, chemistry, etc.).

Philosophy covers a vast field: analytic Phil./logic requires mathematical precision whereas political Phil. requires a different type of thinking altogether much of which is subjective in nature. If I were to be employed in this field an employer would be mainly looking for my ability to assess and judge situations, etc. but that would have had precious little to do with any course materials. Here, an employer is looking at the worldly skills Phil. has taught me which is very different to my electronics courses.

An employer who was employing me for my electronic skills would expect me to have perhaps basic but very specific skills as taught in the course. If given a spectrum analyzer or oscilloscope, my employer would expect me to know what they were and how to use them. If I'd not used those models previously, any reasonable employer would give me operations manuals and a little familiarization time then set me to work on some electronics project. Essentially, in electronics there are certain specific skills that one must be taught and be familiar with or one cannot do the work.

In essence, in some professions there's a very tight coupling between one's education and one's work, especially so in engineering, chemistry, etc. and less so in others.

[forgetbook]

So, it varies, and is loosely coupled at best, even looking from a macro-level.

The problem I see is that while students have enormous incentive to match a company's standard, companies have very little incentive to be a part of that process.

A student pursuing a degree in a larger pursuit of a career is faced with a founder's dilemma. They shoulder all of the risk of failure, and have no recourse. It isn't a company's problem if they aren't trained properly, nor is it a professor's. When starting a company founders are able to seek funding and declare bankruptcy, but students are expected to take out loans that cannot be defaulted on.

If the macro-level goal is a highly trained, highly effective workforce, then why aren't students supported in pursuing training by any of the institutionsthey interact with on that macro level?

[hilbert42]

The point you raise isn't unique to the medical profession (although it's likely at the sharp edge), but it's endemic in other professions too. It's a much bigger cultural issue involving employees' attitude to work, long term job security and employers' indifference, etc. Huge topic, too complex to make much sense of here.

A related problem is the continuing education issue/ongoing skills etc. It's always been a bit of a joke from a workforce-wide/global perspective. Again, the reason why that's so is also involved and complex.