[DieBruderBauer]

discriminatory MCATs, brutal STEPS, insane Pre-Med curriculum, and more nonsense designed to cater to white elites who gamed the educational system and less to those who are genuinely trying to help the disenfranchised, unremembered, diverse and more.

Hopefully one day, we'll make it as easy to become a doctor as it is to -- say -- become an Engineer.

[trustingtrust]

I hope it’s not as easy to make a doctor as it is to make an engineer.

I am an engineer dating a surgical resident who has to go through so much training that an engineer would never even come close to an engineer. The room for error is quite small. If it was as easy to make a doctor as an engineer I would lose faith in the medical system and would never want such a doctor opening me up.

[killjoywashere]

I'm a physician, pathologist specifically. But also did a surgical internship. My dad is an engineer, my undergrad is in Physics and I spent years on ships in engineering and weapons departments.

Yes, the room for error can be incredibly small. A surgeon might cut out a breast cancer that's 5 to 10 cm on a side. The margin, the distance between the cancer and the edge of the surgeon's incision, might be negative by 1 cell. The cancer might be 1 cell away from having been left in the patient's body. The room for error in medicine is in some ways disturbingly small, in others it is incredibly large. Factor of 10 errors are so common they are a standard outcome measure in trainee fatigue studies. Ask your SO about ACDF. Imagine driving screws essentially blindly, without tapped holes, a few millimeters away from a spinal nerve root, with an 8" torx driver. On 3 hours sleep, after standing on your feet for the last 7 hours. An engineer, hell, a carpenter, would have measured the system extensively, set up a jig, and spec'd the entire process, soup to nuts.

From that perspective the margins for error, in absolute terms can be, and often are, enormous. Which is what lets them run on 3 hours of sleep for months. In that setting, sleep-deprived, no exercise, terrible food, compounded by relentless moral injury, yes, it seems like the margins are miniscule. But a good cabinet maker, electrician, or pharmacist takes more care in many aspects of their work, in absolute terms.

[SkyPuncher]

I’m married to a doctor. My opinion is training level generally needs to correlate to the level of acuity.

Surgeons will always need to be extremely highly trained because they do not have the ability to hesitate. Most of healthcare simply isn’t anywhere near the acuity level of surgery.

By far, the biggest need is primary care. The exact opposite of acute. The rigor, effort, and expense of medical school simply doesn’t match modern primary care. Either the system needs to change to accommodate that or physicians are in for a reckoning.

Physician lobbies have a golden opportunity to ensure even higher pay and better product by building better care models. Instead they simple say “fuck your I got mine”

[the_d3f4ult]

Physician lobbies are notorious for not actually aligning with physicians' interests and, rather, being in the pockets of the hospital industry. The AMA is the worst for this. Most physicians feel that they do not have a voice anymore.

[HyperSane]

If being a doctor is so incredibly hard then why are they allowed to practice after not sleeping for so long?

[feraloink]

You're right. It's been noticed. There are regulatory initiatives (in the U.S.) to address that for doctors. Also for pilots of passenger aircraft.

[HyperSane]

No, it really hasn't. In 2016 the ACGME increased the consecutive hour limit from a bad 16 to a completely ridiculous 28. The difference between rest requirements for truckers and pilots compared to doctors is just absurd. And it is even worse because doctors should know better than most how sleep deprivation affects people.

[Falkon1313]

Well it's not that hard, or that important, they're not truck drivers.

[carabiner]

You're only referring to SWE, right? I've noticed that there are no bootcamps for becoming an aerospace engineer and getting a job at Boeing.

[fma]

And actual engineering disciplines you can't do jack squat unless someone w/ a PE license signs off on it and becomes legally liable. Meanwhile Tesla deploys OTA at will... Oh yeah - and why be a medical doctor, or a Professional Engineer when you can make more money with less debt without the legal liable...

[wwweston]

I agree we want medical personnel who are very well trained, certainly better than software engineers.

I'm less clear about which aspects of the current medical education system produce effective training and which are more of a hazing run selecting for the privilege and determination to survive it.

[brutusborn]

It’s not that medicine should be _easier_ or _as easy_ as engineering, it just needs to be easier than the status quo.

This is theoretically an easy change, since most complaints are about the unnecessary bureaucracy and not the pedagogy itself. Doesn’t matter how simple the solution is, it’s practically hard because the bureaucracy has so many incentives to make the process harder.

[poly_morphis]

I wanted to become a doctor. But I also wanted to study engineering. I didn’t want to do some relatively useless degree path like biology simply to fill all the required prerequisites for med school. And then I learned about all of this other stuff, like the MCAT, and how you essentially get abused during residency. I don’t think I’d be able to function on the sleep you’d get anyways.

It shouldn’t be easy to become a doctor, but man the bar right now is so high.

[feraloink]

>... less to those who are genuinely trying to help the disenfranchised, unremembered, diverse and more.

There are many government and philanthropic institution-sponsored programs in the U.S. that repay 100% of medical school, dental school, or medical specialty tuition and expenses, in return for committing to five to 10 years of medical service, on site, to remote or under-served communities.

'Remote' can be rural communities in Appalachia. They can be 'under-served' and very remote, e.g. for American indigenous people who live on their sovereign nation's land.

Under-served communities can also be in economically devastated cities (usually due to offshoring of manufacturing) in the Midwest or East Coast where people of color and white people lack access to medical care that is within walking distance or public transport.

[hammock]

Too many white doctors? Have you been to a doctor in the last 15 years?

[ytschfs]

Medical school and residency are incredibly hard things. So you could make getting admitted to them easier sure but you’d be setting people up to fail if they can’t pull 80 hour weeks and manage information overload when they get there.

[0cf8612b2e1e]

I think what parent was referencing are the “tricks” required to get into med school. Applications are incredibly competitive, and students have every incentive to do anything they can to make the cut. Easier classes, begging for grades, leaning on connections, charity work (dependent on financial resources), etc. Leet code grinding, med school edition. Perfectly good potential doctors are passed over because they are missing X.

[rayiner]

What’s discriminatory about MCATs?

[barry-cotter]

If there are differences in outcomes between demographic groups some groups, like the SCOTUS, assume malice unless proven otherwise. See disparate impact or Griggs vs. Duke Power. Obviously the writers of the MCAT worked very hard to ensure Asians would get higher scores than any other group on them. The US is a country built in Asian supremacy.

[pknomad]

> Obviously the writers of the MCAT worked very hard to ensure Asians would get higher scores than any other group on them.

I am not sure how you are coming to that conclusion. Look at the latest metrics on scoring. Sure, Asians overall tend to score higher on average on standardized exams (which really ought to be split into different sub-ethnic groups because there is a disparity there too) and I'm not seeing the average MCAT score for Asians being disparately higher than the average score of Black Americans that would warrant such a statement.

https://www.aamc.org/media/6066/download

[rayiner]

MCAT scores range from 472-528. 514 is 88th percentile, and 505 is 61st percentile.