God Given Right to Superiority

This article from the New York Times is a source of endless amusement.  The New York schools are highly upset that some excellent clinical spots are being taken up by the graduates of Caribbean medical schools.

‘Clinicals’ are an integral part of medical education, consisting of rotations through various specialties in medicine where students can learn side by side with physicians.  This process goes on for two years before students pick a residency and their specialties.  It gives students exposure to a variety of specialties and increases their overall knowledge about medicine.  It is also the time they start applying all the things they’ve learned during the first two years to a real life situation.

So these spots are highly important, and New York schools are crying that a Caribbean school took the spots from them.  For reference, a third of new physicians in the US have gone to medical schools not in the US.  Why?  Well, because of the medical schools themselves.

The problem is that it’s their fault that the Caribbean schools even exist. In order to inflate demand, the AMA and the schools kept market really tight for doctors by severely limiting enrollment.  Those were obviously not enough, so they kept admitting thousands of FMG’s while denying seats to potential American students.  And to justify their actions, they kept on blowing smoke up people’s rear end by warning of an impending ‘physician oversupply’.

When they couldn’t keep saying that with a straight face anymore, they finally relented and admitted there was a chronic under supply and that all schools should increase enrollment. You force US students to go elsewhere, and then you complain that they are infringing on your God Given Right to get the best clinical spots? Tough ****, as far as I’m concerned.  These are US students that went to the Caribbean because your short-sighted and greedy policies forced them to.  I’d rather have more US graduates becoming doctors than importing graduates from other countries.

It is even more galling that schools like NYU complain about physicians in New York City hospitals, considering most of NYU graduates (just like all US medical graduates) tend to go into high paying specialties, leaving the much needed jobs in primary care medicine to graduates from foreign countries and the Caribbean.  So not only are the Caribbean schools a product of their own short-sightedness, I can argue that they provide a bigger service to the health of the US population than the New York schools do.  Specialists are nice, but the US really needs primary care doctors.  Grads from NYU and Albert Einstein aren’t going into Family Medicine, so give the spots to people who actually might be.

Spot that pre-med!

It’s a game I like to play while on campus, and I’ve gotten pretty good at it over the years. In other sciences, such as math or physics, the students often realize how little they know and how far they need to go. Pre-meds can be spotted by the flaunting of knowledge on the simple-folk, because as they often remind us, they are ‘pretty much doctors already.’ After all, I learned today that mitochondria are the ‘powerhouse of the cell ‘. Call me into surgery now – because the rest is just minutia.

Why do I see such behavior from only the biology majors (many of whom are pre-meds, even though 80% end up switching), and not from others? It’s pretty simple really – they believe that only the smartest people have the honor of being doctors and because they are certainly about to become one, they get the right to lord their infinitely higher intellect over everyone else. Coming from a different field, this is obviously untrue – the “smartest” people (if such a term can be objectively defined) that I’ve met were in my previous major and job (math and engineering). Really, if you can do an upper level math or engineering course at my school, there is no biology course that comes close in undergrad, in terms of remotely reaching the same level of complexity and application of knowledge. Memorizing the Krebs Cycle does not make you smart buddy – it just means you’ve memorized the Krebs Cycle.

Another interesting aspect of a pre-med is the level of backstabbing that goes on and the gunners that roam the hallways. Enter an introductory biology course, and you’d think that you’re playing political espionage in the court of a medieval Tsar. In classes that are graded on a curve, I’ve seen students pour exceptional energies into sabotaging the grade of their fellow classmates. Joining a study group and giving out incorrect answers? Messing up the labs of others? Refusing to ask questions in public so the rest of the class won’t hear the answers? I’ve seen it all. You’d think that if they put half that time into studying, they wouldn’t need to sabotage everyone else.

Obviously, now you are asking, “Why bust on all the pre-meds? How do you reconcile all this hatred with the fact that you are now one of them?” My answer is – go fuck yourself. Don’t you know that I now possess complete knowledge of the cell after learning about the mitochondrion, the powerhouse of the cell?

In other news, I really hope that I get into a PBL school because my motto is simple – One word, two syllables: intimidation.

The rituals of a pre-med

One of the standard rituals that all pre-med students go through is the padding up of your application by cramming as many useless extracurricular activities as possible. I am sure it was once a useful idea, as you would ideally do things depending on your interests and demonstrate your well roundedness as an applicant. Unfortunately, now you need to pass out condoms or teach inner city kids English just to fit in to the applicant pool, and not doing it opens up a red flag. You are interested in something else? Too bad – feign sympathy and go help out that drug addict/inner city kid/old lady. Obviously, you will be so moved by this act of selflessness that you will devote at least two paragraphs of your personal statement describing how medicine is a calling and how you snub your nose at the selfish bastards in healthcare industry who are not in it solely out of the purity of their hearts.

Then, you have to file papers in the Emergency Department at a local hospital and pretend that such an act showed you how residents and attendings really feel and you are going into the career with the full knowledge of what it will be like. Obviously, you didn’t actually talk to anyone while you’re there and played Tetris on your cell phone, but at least you were thinking about the patients while doing it. Then you shadow a doctor in a specialty you care nothing about and feign excitement as he performs routine tasks. After sufficient amount of sucking up, he writes you a letter of recommendation, knowing that you were always in it for the letter, but because he did the same thing as a pre-med, he just writes it anyway. Finally, you pretend you want to practice rural family medicine in Podunk, Kansas because you really care about the under-served population, when everyone in the world knows you’ll end up in a major metro with more doctors than patients.

Ah well. Time to go to the Emergency Department.