I am one that thinks most colleges and universities are in failure, not just the med schools.

@GregoryMPetersMD

Ай бұрын

Yes. This.

@vitkucera1116

Ай бұрын

But from med school you get good paper :D

@chanceceee3659

29 күн бұрын

I agree. Only about 30% of what you learn/apply teaches you to think critically on the information presented to you. The rest is simply a test of your memory

Of all industries, I am most concerned about the future of the Medical Industry in the US.

@sl4983

Ай бұрын

And in my opinion the quality of people going in

@dedetudor.

Ай бұрын

​@@sl4983Dr Suneel Dhand describes it perfectly on his ch. I really wish all Dr's could be like him.

@dedetudor.

Ай бұрын

​@@sl4983Dr. Suneel Dhand describes it perfectly on his ch. I wish all Drs could be like him.

Internship is always the way to learn. Just look at the difference between diploma nurses and Bachelor Nurses. As a Bachelor Nurse the feeling was we had superior education, but when I worked with diploma nurses, oh my gosh, they knew their stuff. I knew how to look things up, while they knew everything. Our whole society has bought the lie that college education was superior. It's definitely not. By the way, in other countries people dont have to get a BS before applying to medical school. They train foe 7 years and can then take their exams.

Yup. I probably forgot 90% of the things I learned in medical school *because* they were useless.

@joannabusinessaccount7293

Ай бұрын

Medical school is a joke. Useless, esoterica to be memorised. Listening hours of professors who can’t teach. A waste of young people’s mind and brains and youth. So many problems in medicine - how are you going to cover it all?!?

I worked in doctors' offices for my entire adult life, on the paper-pushing side of medicine. I've worked phones, front desk, filing, billing, transcription, pretty much everything that does not involve direct patient care. Over the decades my co-workers and I were unanimous that at least a semester of all things on the administrative end of medicine should be required for all medical students.

@nancienordwick4169

Ай бұрын

Or don't require doctors to do paperwork. Hire others to be patient advocates for medical business interface and scribes. Let doctors use their knowledge where it's most needed.

Coming from a current 4th year med student, there is SO a much truth to this! You just described my very existence.

Med school training is in dire need of updated, relevant, and career useful information. Thanks for bringing this discussion up, hopeful changes will be made.

Lets get back to the basics. How about doctors learn how fix underlying problems instead prescribing drugs for symptoms.

@marilyntaylor8652

Ай бұрын

Because most people don't want to fix their lifestyle, they want a fix for their symptoms so they can return to their lifestyle

@WeighedWilson

Ай бұрын

You forget that treating the symptoms caused by prescribed medications is the bread and butter of medicine.

@edwarda9403

Ай бұрын

Because most people can't fix their obesity or diabetes

@OmarAbdulMalikDHEdMPASPACPAPro

Ай бұрын

​@@marilyntaylor8652 YES! I work in internal medicine, in the inner-city. I tell patients that much of what they have is manageable or preventable, with lifestyle changes. However, the lifestyle changes and, the patience that goes with them, are exceedingly difficult for MANY of them. I've even been threatened for not Rxing meds ("You need to give me something!"😠👊....😮). 👋🏽👨🏽‍⚕️

I saw this ‘fake sick’ being praised on a junior Drs reddit forum in the UK. I pointed out that this was terrible because it put huge stress on colleagues who were under the same work stress but would be expected to cover the absentee’s work, and the ethical solution was to approach seniors and HR and admit they weren’t coping. I was inundated with trolls saying this would be detrimental to the OP’s career. Here we have the problem.

@sunriselotus

Ай бұрын

There is also the flip side where I needed time off and I was bullied when I came back as they were wanting to remove me. And I also covered every single one of everyone’s sick days and days off when needed prior.

@lulabellegnostic8402

Ай бұрын

@@sunriselotus So you documented all the extra work you covered in excess of what your colleagues have covered for you, then went to complain about them to HR?

As an old nurse I have seen these changes in residents.

@ericjohnson5617

Ай бұрын

As an old nurse back in school, HS grad w LPN license, it's no different in nursing.

@fixthebrain

Ай бұрын

⁠​⁠​⁠​⁠@@ericjohnson5617: another old nurse here who has experienced a decline in multiple aspects of nursing and medicine.

@dedetudor.

Ай бұрын

Uncaring....Why are they even in the field?

@sliglusamelius8578

Ай бұрын

The hazing and the grind have been whittled down to students having all the power. It's pathetic.

Studying for boards right now and I’ve felt this huge sense of disconnect between my exams and what I saw day-to-day in the hospital and clinic. I feel like I need to take time to get in the head space for answering exam questions because I have to rework my mind from how I approached problems in a clinical setting. It’s such a different thought process to answer exams vs treating patients, even though the NBME and NBOME act like they’re the same and can complement each other.

Capital of Turkey is Ankara lol. Istanbul is biggest city. lol former Geo Bee school champ But yeah the random shit is a bit much. And I blame the board exams. It is getting better with research and epidemiology integration, but the BS factoids are tanking it. And yeah USMLE is a pain. I’m currently playing the clerkship appeasement- random memorization- research arms race game as an M3

@donaldlewis567

Ай бұрын

Came here to say that...yet he said it was a fact he actually needed to know :) Great catch!

@alfredopampanga9356

Ай бұрын

@@donaldlewis567not really. But it does show that a really smart guy can be sure and yet be wrong

I got my PhD, and when I learned what my friends in med school learned, and interacted with doctors afterwards, it really became apparent to me both that they don't know enough about the most common medical issues (like nutrition) or about how to read and interpret scientific papers. I would go further, though, and say they aren't learning a theory of medicine/evolutionary principles. Doctors still seem to think that humans are flawed at baseline and need fixing, not that identifying and removing something causing a difference from evolved conditions is the main necessary functionality of modern medicine. Glad you're pointing some of this out, though.

@Robin-xe4yz

Ай бұрын

Doctors are being relegated from scientists to technicians carrying out insurer treatment guidelines developed by people who are not clinicians, IMO. Training them to follow a script.

@pmberkeley

Ай бұрын

@@Robin-xe4yz doctors were never generally scientists, but otherwise, I agree.

@orhbo0

27 күн бұрын

Yup, it’s all about the insurance & the fear of.

@querist1377

26 күн бұрын

@@pmberkeley Academic medicine requires a lot of attendings to be scientists. Also, if you read cancer’s history, doctors were truly the scientists who lead all the discoveries and treatments such as chemo

@pmberkeley

26 күн бұрын

@@querist1377 do you know what the word "generally" means?

Regarding useless factoids, Im afraid this might be a problem across disciplines, at least in engineering this is also happening,

Unfortunately, most of what you say here is true of nearly every profession. I'm a CPA - schooling and CPA exam very much rely on how much you've memorized and not on how to do it. The schooling is nearly irrelevant in the actual work. My son is in law school - he feels the same way and same about the Bar exam. We seem to have forgotten what schooling and learning are actually for.

Applicants for Pilot training have to undergo psychological testing. High time this was introduced to med school applicants. As a retired hospital Dr and University panel member for applicants as well as an examiner, i could tell who would make it and the hot house flowers from the application. Passing exams is p*ss easy compared to the grind of the actual job. Selecting students on the basis of their ability to pass exams is why medical education is failing.

@dedetudor.

Ай бұрын

I perceive if you go into medical school as a caring individual, you are taught not to be.

@WeighedWilson

Ай бұрын

You just described one of the biggest problems of our entire education system.

In 1910, the Flexner Report was an exhaustive analysis of the dismal state of medical education at that time and made substantive recommendations to modernize and standardize medical education. Perhaps it’s time for a re- analysis.

My last rotation as a med student was ophthalmology. The attending asked about my career plans (FP) so she pulled me in to see things I'd need to recognize or treat, then I'd read about the condition (while she did routine exams/visits) and we'd discuss it later. I learned useful information without standing uselessly, no put downs, no BS. A fond memory. I won't discuss most other clerkships. As far as the preclinical mandatory trivia, a pathology professor had a thing for the fact that spider webs are chemotactic for neutrophils (on the final).

You are doing a terrific job Dr Prasad! ❤ - could also be, hypothesis: could this lack of mental energy be caused by poor diet or, the result of covid infections and vaccine injuries? Something is definitely wrong with younger people myself included, been not feeling good since 2020 and i used to be a ball of energy and joy and proactive,… no longer. Some days i feel so down, brain fog, low energy, pains… 😢

@maxwellkrem2779

Ай бұрын

It started perhaps 7-10 years before Covid. It's cultural, likely r/t a change in parenting patterns.

@orhbo0

27 күн бұрын

You mean like after Obama & Obamacare ? 🤔

Our lectures for neuro were 5 years old. A lot of what I learned in the first two years of medical school was wrong when I looked at my own patient care experience. It's not about the information, it's just a hoop to jump through.

The source of the problem is not just the trainers but the schools that train the teacher/trainers. Many have been ideologically captured and no longer have the knowledge base needed to make good teachers.

@paulbarclay4114

Ай бұрын

the source of the problem is the entire system is a regulatory captured clownshow and nothing actually works except for some surgeries

Wow!! I got dinged really badly for leaving for 24 hours to get my dad off life support!! And I handed off my pager and got coverage. This was a loooong time ago and the standards were high. We also worked up to 120 hours/week.

As a PharmD teaching MSU medical students at our community-teaching hospital in Kalamazoo 1980-1995 I am the faculty that taught them how to evaluate the medical literature. Sad

Being in the medical field for 25 years I have seen this progression (or I should say regression) in actually how to treat patients and care for them. I think it started when they limited resident training to no more than 40 hours a week (only for MD/DO providers and not PA/NP providers). Stay healthy my friends because you never know who will be treating you if they can even perform their skills effectively.

As a fellow physician (UCLA graduate 1995) I totally agree! Totally irrelevant information

@paulbarclay4114

Ай бұрын

entire system is a regulatory captured clownshow and nothing actually works except for some surgeries and many of those could be avoided by treatments that do work but arent permitted

Dr. Prasad thank you for all your work. It's a pleasure to listen to your views even as a layman. Besides being knowledgeable about many subjects, I think you're a conscientious Dr./human. Wishing you good fortune. And your humorous critical commentary is delightful. Thanks, again.

Current practice, ask patient problem, look up on Google right in front of them which drug to give them. Prescribe.

I'm in Infectious Diseases - fungal hyphae branching at 45 degrees is something that has never helped me clinically, but is something the pathologist needs to know when analyzing a sample/biopsy. It came up many, many times on my board exams.

The issue is that there is no pot of gold at the end of the rainbow. The vast majority of these students and residents will be wage slaves to a large organization. Playing the game in these large organizations either means doing the bare minimum or being a sycophant to try to get into administration. Being an excellent, safe and caring doctor is the sure way to burnout. Calling in sick is a way to take advantage of the entitlement that they have been given. The sad fact is that the patient suffers. But then again, the patients have the satisfaction questionnaire to take it out on those who actually show up.

Physicians are there to sell medical products, med school teaches them their product catalog.

Some patients with serious health conditions have been waiting for months for their appointments and doctors are calling out "fake sick"? Come on now 😓

Ankara is the capital of Turkey.

@mednerd6777

Ай бұрын

I was gonna type this ..omg 😂

@lindawolfe2885

Ай бұрын

Well, Istanbul was Turkey’s capital until it became the Turkish Republic in 1923.

I thought of bringing back the oral board. Once upon a time (my grandpa's generation, doctors have to pass the oral board). Given the coddling environment universities created for their students and attendings now are forced to be very nice to students, oral board is probably make sense these days....

When I was in medical school I used to joke with my classmates that we were paying a huge amount of money to get a piece of paper to have proof that we taught ourselves medicine and succeeded in spite of our medical school… class of 2009. Residency and fellowship were far more useful and helpful but medical school was basically 100% self taught. The faculty staff and administrators make your job as a medical student harder not easier. I was so happy I pushed through because it got so much better in residency and as an attending when you get to apply your skills and help people. We had many quit during those dark med school years and never made it to the other side, wish they had stuck with it because med school experience is 5% representative of what it means do be a doctor, just another hurdle. You take very little from it into internship residency fellowship and being an attending… just have to survive it. Then it gets so much better.

You have an amazing voice.

While I agree with a lot of your points, I think some of it is unrealistic. Specifically regarding more one on one education. You're right, it would require paying academic physicians a lot more. But it isn't always a matter of schools taking money from students and spending it on dumb stuff. I went to the 2nd most inexpensive med school in the country (at the time), graduated 7 years ago, and my tuition was about 15k/year. And, I had actually had really good preceptors on clerkships. It's largely got to do with the culture at the school/hospital you're at. I like teaching, and will sometimes have students with me currently. There are days when I do a great job teaching, and there are other days where I'm slammed and struggling to just avoid going home 4 hours late. Medicine is a sinking ship right now, with mid-levels taking over, reimbursement going down, more and more work with less and less resources to do it with. A lot needs to be fixed on the back end, before you'll see academic medicine improve on the front end. But yeah, a lot of waste needs to be cut in academics as well.

truth! So much wasted time memorizing stupid nonsense and taking classes like structural biochemistry. Zero use in real life.

The capital of Turkey is not Istanbul… it’s Ankara…

As a rising M2 I also think preclinical is largely a waste of time. Could not agree more about these useless factoids of which the one you mentioned I also have memorized for Step1 lol

As a medical student I agree with all of this. I am the class president and I brought up so many of these issues and more at my med school, but was met with deaf ears and quite frankly ridicule. So many clerkship weeks I was completely ignored by residents and when some residents did bother to teach, they didn’t know much (how could they?). Some residents were great but overall they were too stressed and busy to teach anyway. For some clerkships our subjective performance was 60% of our total grade. Infuriating.

Medical school has been flawed for a long time. Lot of attendings and residents are not interested in teaching - has been the case for a long time. They have a lot of other priorities over the students. There is also a lot a wasted of time for students waiting around. how many hours do students spend waiting in the hospital on call or waiting for the attendings to round? how about the wasted hours in the OR just sitting there? These days at least students can see more now that many procedures are minimally invasive so the screen is visible to them. Many schools don't let students even write notes anymore b/c they are more concerned about billing issues. My feeling on teaching is that one should teach the student, even the ones that are considered "bad", as if that student will be taking care of your loved one in the future.

Wonderful points, as always, VP. While your essay and video focus on Medical school, many of the problems you describe are problems within the education system more broadly. As our society attempts to scale many industries like education and medicine to keep up with demand, there is a noticeable tradeoff between quantity and quality. Consequently, over time these industries turn the credentialing process into little more than a box checking exercise rather than offering training that serves to make the individual better (as defined by positive outcomes per $) at their chosen career. While there is a case to be made for the prioritization of material constraints (e.g. $), the profit motive (particularly as applied in service industries) seems to be a devil's bargain as it leverages personal interest (including greed) to increase productivity. Therefore, it's not all that surprising we're seeing the gamification of the medical system (e.g. how to code/bill for the most procedures regardless of help to the patient, how to pump out MDs even if their training is inadequate, etc.). Increasingly, trusted institutions seem to prioritize metrics over outcomes as funding is often tied more to the metrics/data than to the perceived benefit or outcome. I.e. institutions are incentivized to make it APPEAR (through dodgy metrics) that the status of the industry is ever improving, despite declining outcome measures (i.e. education is happy to pump out more degrees (many educational institutions are partially funded by how many degrees are awarded) even if employers are reporting that these degrees haven't resulted in the necessary and desired job skills). I had naively hoped that medicine and education would avoid this market corrupting effect (i.e. sometimes markets can corrupt the good/service being exchanged. Ex: a market for organs, scalping free tickets to a community event, etc.) but here we are.

You are really on a roll now thanks!

Im a m4 now and I agree with this need for apprenticeship. The rotations in which I learned the most as a ms3 and even now are those in which a resident or attending pulls me aside and says directly “THIS is how you improve at X,Y,Z.” We feel a bit rudderless as students because we are at the mercy of the randomness of whether we get good residents or teaching attendings

My son is finishing his first year residency, during which he was called in many times to cover a shift for some one who called in sick. He worked sick or not, refused to do the same. I think residency is way too much work for very little pay. The hours my son put in is ridiculous compared to his salary.

@orhbo0

27 күн бұрын

Residents were “residents” in the past because they actually lived at the hospital. That’s the point of the low pay.

@fidesedquivide3486

27 күн бұрын

@@orhbo0 I know. My mom did hers in the hospital, literally.

@orhbo0

26 күн бұрын

@@fidesedquivide3486 So there’s nothing to complain about

Insane that the standard in med school is that you shouldn’t take days off when you’re not physically sick because “think about the patient! are you saying that their health is less important than yours?” completely ignoring that if someone is stressed out and mentally unwell that will affect the care they give their patient. Med is so exploitative

@teresabenson3385

Ай бұрын

You think the person having to unexpectedly cover for them won't also be stressed out?

@khun9237

Ай бұрын

@@teresabenson3385 Yes, but there is stress from both angles. There needs to be reform for both staff and patients.

@teresabenson3385

Ай бұрын

@@khun9237 Reform, yes. Calling in "fake sick" without an ounce of care about your colleagues and patients, no.

@khun9237

25 күн бұрын

@@teresabenson3385 If they call in sick to take a “mental health” day, they are most likely genuinely stressed out. Despite the narrative that older doctors love to push, residents are not ‘lazy’ and skimping out on their responsibilities because they “just don’t feel like it”. These people still care about their coworkers and patients.

This would never happen in my residency/fellowship. Speaks to a much larger social issue.

I can relate to every single thing you say. Yes I had a chief who would show us dozens of KUB films from about 6-8:30 pm every night just to torture us. Then round.

But remembering useless facts has always been the case yet it seems medical students are getting worse. I'm afraid that society in general is going in a different direction and we've decided to leave even the good values behind.

Students of medical university here were always the most substance abusers, especially weed.

Thank you for this. I feel this way about some board exams as well.

I felt my "job" in medical school was to be a 'scut monkey". I was harassed when I discovered a UTI that the resident and intern missed. Nobody likes being showed up by the lowly med student who is supposed to keep his mouth shut!

really helpful video as someone applying this cycle

Ankara is the capitol of Turkey. Istanbul was Constantinople, the capitol of Byzantium/Eastern Roman Empire.

so sad...I have a coworker who has been an RN for two years, during which time she took the MCAT three times...gets no credit in her applications for being an ICU nurse...My own daughter has changed her mind from wanting to be an MD to going to nursing school because of the BS involved in the quest for candidacy for medical school...My spouse , who is an MD Anesthesia, says he would not recommend the field without big changes to education and to current oversight by non medical administrators...

If I took a shot for every time I heard a variation of, “you need to know this for boards”, I’d spend most of the day inebriated.

Hi. I agree with you. I didn't know what can be done to change the culture, though. There is also hazing of young, eager students who are on their rotations, on the part of chief residents. This "beats" the humanity out some students. It's very sad to experience and watch.

Actually someone does have the guts. I’ve now joined the ABIM Question Writing Task Force to add more EBM RCT based questions on metabolic syndrome and nutrition (eg Diabetes Prevention Program, Look AHEAD, VITAL etc) for the massive hole of lack re behavior modification for disease prevention - which is just as much primary care’s realm as disease treatment.

True factoid: Ankara is the capital of Turkey.

I am of the age where my friends are sending kids to med school or kids are doing pre-med. Where should these kids go? Are they all bad? I am thinking they are.

I think the fact is memorized to explain the disease to a patient in a specific way, like potentially it gives a different route of connection with the patient

Hello! I'm an aspiring pathologist and current medical laboratory technologist working in a Microbiology department of my local hospital's pathology lab! I will admit, I've only worked in two hospitals (a medium sized community hospital and an academic medical center currently), and I mainly work in bacteriology, not mycology, so my knowledge is limited. Nonetheless, I also had to take a few medical school classes for my master's degree in Physiology, so I do have some understanding (though not a complete understanding) of what is being taught to M1's. Before I begin, I want to say, I agree with everything said here. I think it is important to teach more applicable information than the information that is taught for boards, and its frustrating that some of the material taught in medical school is information you will never use as a clinician. However, I did want to shed some light on the specific example of Aspergillus branching. While its branching pattern may not be used in clinical practice, fungal culture still remains the gold standard of fungal infection diagnosis currently, which is why I believe that fact is taught. In fact, I don't really know if there are many commercially available PCR systems that test for Aspergillus. That said, This recent paper (link.springer.com/article/10.1186/s12929-023-00926-2) states there are several multiplex PCR systems available for such testing. Nonetheless, for the commercially available PCR systems I have experience with, none of them actually test for Aspergillus to my knowledge. Even at the academic health center I work at currently, I do not believe we have an in-house PCR method for molds. Interestingly enough, however, one of the PCR systems I work with (the Roche Eplex system) does have a fungal panel. However, most of the species listed on the panel are yeasts, not molds. That said, Fusarium species is also in the panel, so it does make me wonder why we can't add Aspergillus to these commercial panels, especially since it is so common. Nonetheless, at my current hospital and at my old hospital, there is still a decent enough amount of manual fungal cultures performed to the point that there is a separate mycology room in the lab, so we definitely need to know the branching patterns. However, I don't know if this means Aspergillus branching patterns should still be taught to medical school students, as most medical students will not enter the field of pathology, and even of those studying pathology, only a fraction of them will decide to specialize in medical microbiology. This makes me wonder if we should have separate medical schools by specialty rather than one big medical school encompassing all specialties (or at least a separate pathology school, since a lot of applied pathology isn't really taught in medical school). For my master's degree, I took hematology with medical school students, and the microscopy portion was, in my opinion, quite lacking. We were never even taught what a reactive lymphocyte looks like, and that is something I came across quite often while reading peripheral blood smears when I was in medical laboratory school. I understand that the "average" doctor usually won't be reading peripheral blood smears, but as an aspiring pathologist, it makes me wonder if it would be more efficient to have a separate pathology school so that I would learn more of what I need to actually run a pathology laboratory in school rather than in residency. I think for these specialties that are not the "average" doctor, it is perhaps more beneficial to have them as separate schools since the skillset for these specialties is so different from what is taught in medical school. But what do y'all think? Would it be better to have separate medical schools by specialty so we can target information more specifically to fields that students want to learn?

@Alich79865

Ай бұрын

By your logic even medicine surgery eye care hospitalist all should have different schools and I agree that should be the case

Anyone have a link to the article discussed at the end of the video?

Finally someone talking a lot of sense and speaking the truth 🙌🏼

i graduated med school in 1995. House of God was an accurate representation of the state of training at that time. As bad as things are now it was much worse back then, not that there is any excuse for the top administrators who support the current crappy quality.

I hate to be that person but I think Ankara is the Capitol or Turkey

Vinay! The capital of Turkey is Ankara. Saying it's Istanbul is like saying New York City is the capital of the United States. Otherwise, as always, awesome clip and keep rockin'! You are an island of truth and sanity in an ocean of idiocy.

Our Pathology prof in med school always said "Boards are 3 years behind real life." I commonly say there's "Boards Medicine" and "Real Life Medicine." Sometimes they intersect....but only sometimes

The capitol of Turkey is ankara

Teachers learned how to teach from their own teachers... and we go back in time teaching the same way. How boring!!!

My daughter is in medical school and she is studying for the STEP 1, and you are right. She complains about all the useless stuff she has to learn, and how little effort has been made to teach her so much of this. I was hoping her rotations would go better. 😔

Nice Neumann. I think you need a different technique for this mic.

Thanks again Doc

You can say the same thing about nursing school. They spend so much time worrying about getting the highest percentage of pass rates on the NCLEX but breeze past training actual skills. It’s scandalous.

With very few exceptions the way we do education in an incredible waste of human potential and inefficiencies.. and I would even argue, borderline child abuse in the younger years… It is so sad IMO😢

Capitol of Turkey is Ankara…not Istanbul ~

In other jobs, the "fake sick day" is simply called a "personal" day off. By the way, not to nitpick, but... the capital of Turkey is Ankara. ;-)

3:17 dude the capital of Turkey is not Instambul :))))

You are right!

Last time I was in college (40+ years ago), it became very clear to me that professors wanted students to be walking data banks, able to regurgitate their "facts" upon demand. There was no attempt to train them to use those "facts" and think for themselves. I repeatedly found myself questioning those "facts" with actual science-based facts. My arguments were quickly & summarily dismissed with ad hominem comments.

Crazy how it is a minority percentage who are willing to say, why are we doing this if there is no clear benefit?

I’ve been trying to hire a partner for my group for 2 years. >$500k/yr and I can’t find anyone. They all want to work from home working 4 days a week. I’ve personally been offered 3 positions at about 150% MY income, 4 days a week, 1 week each month off. Because other groups in the US can’t find anyone worthwhile in these ‘new doctors’ either. These groups are willing to headhunt known MDs just to get the work done.

Truth!

The same can be said about the new dentist and hygienist. Actual useful info to do their job, they don’t know much. It’s so sad. The work is complete crap. 15 yrs in

Sorry it's not Istanbul, it's Ankara

Med students are not trained to read papers. WHAT?!!!

I am quick to call minutia as garbage but nobody in power- nobody who writes the boards, nobody at the universities listens to my lessons.

I have mixed reactions to your assessments. My thoughts: 1. You hit the nail on the head that when residents or medical students take unplanned leave for non-severe emotional stress. they end up putting greater stress on their colleagues. This makes the entire team’s mental fortitude take a hit. First of all, the patient is number 1. They (for the most part) didn’t ask to be in the hospital in the situation of being vulnerable and relying on another person to take care of them at risk of losing limb or life so to speak. A more appropriate alternative is to either confide in your colleagues that you need a little extra help at that given short time period while doing some basic functions, or go to the program director to request an official leave (indicating something more serious going on). 2. Esoteric knowledge. There’s two ways I think about the example you gave. Medical school to me was to break down presenting symptoms as what most commonly causes it and what are the rare don’t miss things. Your example of aspergillus while may not ring alarms for many should raise alarms in certain scenarios. Everyone recalls that mucor is highly aggressive in invasive fungal sinusitis. Aspergillus is one of the next leading entities that can be devastating in certain populations as well (diabetic, immunocompromised). I need to know this as an ENT, but also the hospitalist that consults me that cultured sinonasal secretions should also have alarm bells going off that ENT needs to be consulted stat rather than sit on it (this is a disease of hours, not days, ending up with cranial neuropathies, intracranial complications, and death). Besides making categories of most common and don’t miss, the practice of drinking from a firehose of knowledge is symbolic of what residency is in terms of workload. The idea is to mentally and physically push you to prepare for the next step. When you get called in the middle of the night after a long day, it’s those times that you or school pushed you to dig in and make informed decisions without having to refer to a textbook (or google). All of this combined prepares for how many private practices are. 3. I do agree with you on better preparing students on how to read literature. 4. Apprenticeship models are a better way to give personalized teaching in clerkship years. 5. Medical school may or may not be longer than it needs to be, but my experience the past 5 years (I was an intern when COVID hit), was taking away of protected hands-on learning of medical students. The same problem you discussed with young children that had masking during Covid is similar in principle to what is wrong with the medical students that have come out since Covid. They do not know how to interact with patients as well, their physical exam skills are lacking, they shy back to a shadowing role rather than an investigative role, and do not appear self motivated. I do think this falls on us as teachers to demonstrate as role models how to be a good doctor. So much information can be gathered from the combination of the history and the physical, and I feel like the latter has significantly gone by the way side because so many people are adverse to getting close to others physically. 6. If you insist on medical school being shortened, then I must insist on primary care, specialties being lengthen by one year. The amount of knowledge that I gained my fourth and fifth year of ENT residency is astronomically higher than the first three years. I will never understand why many primary care specialties are only three years long. I understand some of them offer cheap residency years and many subspecialties are in additional three years, but for the primary care specialties, including hospitalist, pediatrics, ED, and family medicine amongst others, there is no way you can adequately learn all to be able to practice immediately after graduating residency. I understand that you’re still a learner once you come in attending, but I believe the risks and mistakes would be much less problematic with that additional year of residency under the guidance of staff physicians. 5. I agree with your assessment on grading. I also feel like getting rid of arbitrary scores for USMLE exams might help with stress in some ways, but it takes away the motivation for self improvement. Maybe perhaps instead of giving arbitrary scores, we categorize into quintiles or quartiles. Ultimately I think the problem with medical students today is the same problem with all students today. Many give up with the slightest adversity, require high amounts of praise to stay motivated, and struggle to balance the selfish and selfless aspects of this career path. You should take care of yourself in order to take care of others, but letting those times of mild dissatisfaction or discomfort rule over the fact that someone is coming to you for your expertise is just antithetical to being a good doctor. The patient is first. As always, thanks for your insight into these subjects even if I disagree with them sometimes. It’s how the medical field as a whole will improve.

The capital of turkey is Ankara, but I feel like this helps prove the point even more 😆

I think the biggest way we fail patients is by selecting people by race instead of capabilities in medical school acceptance. For instance an African American with a very low GPA has a higher acceptance rate than an Asian person with a high GPA. Schools were more or less open about these affirmative action racial quotas, after the recent SCOTUS ruling, it's clear they will continue and just try to keep it a bit quieter.

YOU ARE 1,000% CORRECT!!! medical schools should have advanced better than this! you mean medicine has advanced BUT medical schools... HAVE NOT?

3:17 The Capital of Turkey is Ankara, actually - not Istanbul. Just saying... On topic - I've always felt the same way about med education and education in general, especially back in my high school/college days. I've since come to change my mind. Apparently useless information comes to be useful later in life, and having broader knowledge and culture makes better men. Pumping all that info in makes for lost time in preparing better experts and serves no purpose to that end - I must admit. So it's a trade-off. If I had to make a choice, I would vote with Vinay on this one, because the long term consequence is a skewered and crooked scale of values that ends up producing a class of "experts" with top credentials that in actuality are worthless theoreticians with high record/playback value and pretty much nothing else...

In the late '60's in college nursing school, we were traumatized by being forced to learn the Kreb's cycle. I am still waiting to use it. Mind you this is not med school, it was nursing school!

Can this video go viral, holy crap do they teach useless garbage in undergrad and med schools.

A while ago, a guest on your show said that medical students were told that half of what they learned would be invalid in five years. Oops. Too bad for their future customers.

I haven't read your article, perhaps you rehash it, but the accommodations also do a disservice to the students. Having some students have a different testing environment and a different time limit is straight-up cheating. It cannot be a "standardized test" if some get more time than others, especially if it can be influenced by how whiney and entitled they are (not all but some). Some of these attitudes could change if the schools were more interested in maintaining standards than "customer satisfaction."

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Everyone wants to be House and not giving shit that House helps 6 people per year.

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Sadly this ends a lot of careers..