[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.