The US really needs to reform the path to becoming a doctor. 4 years undergrad + 6 years medical school is far too much school. First of all, only rich kids become doctors, as normal kids cannot afford the cost of medical school and lost income. Even then, the opportunity cost is too great for most people. Most gifted people with neutral ideology will go to finance or consulting and make like a million dollars in the time that it takes to graduate from medical school.
Much of the time that pre-meds spend in undergraduate programs is wasted. Since they need high GPAs for medical school admissions, they take easy classes to boost their grades. Much of the material is already covered in high school. Most of the pre-med students I know also took community college classes during the summer, as these count towards their graduation and they are virtually guaranteed to get As or A+s. Any additional time is spend cramming for MCAT, or doing pseudo community service for application purposes.
I don’t blame the individual students - they are only optimizing their chances to get into medical school. However, the system is messed up. It encourages undergraduate pre-meds to waste years doing meaningless work. The system also discourages most people from even considering medical school. Instead, the norm needs to be a “fast track” program, where you skip traditional undergraduate programs and spend 5 years just becoming a doctor. Most other countries do it this way.
I don’t agree with this at all, from what I’ve seen medicine gets some of the most gifted, hardworking, and committed students. I don’t mean just the students that work hard, but some of the most naturally gifted ones as well. I don’t think finance or consulting compares. FYI I know a ton of medical students/wannabes (Indian).
Again from what I’ve seen, I think pure sciences get the best talent and the second tier seem to funnel into finance and consulting. (Although many in the second tier do like to think of themselves as exceptionally gifted).
I don’t think the path is that long or that arduous to becoming a doctor. I think going through 4 years of college really separates the ones who want that career from the ones who’re simply interested in the “idea” of being a doctor.
Clearly, you need to be smart and hardworking in the US to get into medical school. However, a higher proportion of smart and hardworking people in other countries aspire to attend medical school compared to the US. In the US, desirability of medical school among the brightest students is clearly lower than in other countries. I applied to universities in the UK in addition to the US. My UK applications were all for medical school. It was the same for almost all students in the top 5% or so of my school (and probably in the country). In the US, it was just not worth it. We would be fools to think that all the best students in the US want to go to medical school. The cost is just too great.
When over 35% of Harvard graduates go work in finance, you know that non-medical fields can have very compelling incentives, to which the best students are not immune.
That doesn’t really mean anything… By the time my friends in medical school graduate, finish their residency, etc. many of my non-doctor peers will be millionaires (or are already millionaires). The non-doctors could definitely have gotten into medical school. However, becoming rich quickly is very compelling. There is no doubt that the high cost and long duration of medical school discourages many people from becoming doctors. In the US, more than most other countries, bright students are drawn away from the medical field and into finance, consulting, tech startups, or other fields.
Spending four years in undergrad figuring out if you want to become a doctor is the only good reason for the 4+6 system. However, the cost of a full undergrad education on top of medical school is still too great. Plus, I doubt that those 4 years really give you a good picture of medical school anyway. The undergraduate experience as a pre-med is not the same as medical school (or so I hear). Pre-meds who drop out are typically disillusioned with the bullshit pre-med preparations. They still have no idea what it is like to attend medical school, or to be a doctor.
Just because more people are covered doesn’t mean more people will get sick. People get sick at similar rates when they are covered and when they are not. The only difference is that soceity as a whole covers the uninsured and rather than the individual.
Uncovered people tend to get medical treatment anyway. If you are going to die, will you refuse to go to the hospital because it is expensive? Also, insurance encourages you to get preventive care, which reduces the chance of (more expensive) emergency treatment later.
Of course, Obamacare includes a lot of subsidies that are paid for by certain groups of people, but that’s a different matter…
Also, it doesn’t address another important healthcare problem - it’s too expensive to begin with. If the US does not reform doctor supply and malpractice law, we’re stuck paying 18% of GDP on healthcare, despite the manner in which the cost is spread out between insurance companies and taxpayers. 18% will become a bigger number in the future, as US people get older and fatter.
That makes no sense. The goal of everybody who gets into medical school is not to become a millionaire, apparently some are truly interested in the medical career. (why do people even bother with 10 yr MD/PhD programs? Those are far more competitive than MD programs and anything in finance and they won’t be millionaires). Furthermore, by comparing college grads who became “millionaires” 6 years out of college you’re comparing the most successful college grads to a wider body of medical students. Apples to oranges.
Even if people are not solely motivated by money, a big pile of cash is a great incentive. If someone just got into Johns Hopkins Medical School and I offered them $10 million to drop out, I bet they will take it. That’s an extreme example, but it illustrates that the decision to go to medical school is sensitive to opportunity cost.
As for your “apples to oranges” example - since you made it a point to say that the most gifted people go to medical school (or other science fields), I thought it apt to compare these to the most gifted non-medical people, who can usually make a few million dollars by the time they are 30 or so (if they choose to).
Well… it will be cheaper for some people - poor people, people with pre-existing conditions, (some) women, unemployed early to mid 20s people, etc. For you, maybe it will not be cheaper.
Also, some people don’t buy insurance out of stupidity. For these people, maybe choice is not such a good thing…
Sure, if you give an (unpaid) guy in the Peace Corps 10M to drop out, he’d take it as well. Does that mean he couldn’t have gotten a well paying job somewhere else? Except in the real world these situations rarely arise.
Well then should we compare the most gifted science students to the broader financial workforce (Most who don’t make millions of dollars) just because you said that the best students go into finance? Could they get into top rate MD or PhD programs? It’s a dumb comparison.
FYI I do know people from your alma mater who are making megabucks out of college in finance. I see nothing that indicates that they as a group would be good enuf for the elite PhD/MD or MD/PhDprograms. Can some of them? Absolutely. As a group in total, yeah right.
Everybody I know in Med School is very smart (or at least always had very good grades.) I don’t think there’s really an issue with atracting talent. US med school accept under 10% of applicants. Top med schools here accept under 5%.
-The process is absurdly long. Maybe we could start with taking all the pre-med classes you need in a couple of years of college and then applying? Also a lot of people do community service or other things AFTER college just to get into Med School.
-Another huge issue is the number of residency slots. A large amount of residency positions are paid for by the Department of Health and the states. These openings aren’t keeping up with demand either, creating yet another bottleneck in the system.
Or alternatively, walk over to the PhD programs at your alma mater, and say with a straight face that those PhD students could not have made much more money going into finance.
Ok this is getting a bit mixed up. My general argument is that in the US, medical school is too time consuming and expensive. Few other countries make it as hard to become a doctor as the US. As a result, many US people don’t want to go to medical school. There is clearly an undersupply of medical services in the US, which contributes to the high cost. The other stuff is illustrative.
Funny you say that lower income students will be discouraged from going into medical school and prefer finance. If anything, the students whose goal is to get into the elite corners of finance tend to be from upper class or very wealthy backgrounds. Partly because middle and lower class people have little or no idea idea about that. (When I went to college, I thought finance meant being an accountant…)
Hmm. That residency thing is another issue that I seem to have forgotten. It’s basically a cartel. Plus, it’s really hard to get a US residency if you went to a foreign medical school. Imagine if the US poached all the best doctors from India and paid them the average of a US and India doctor’s salary.
I’d like to see someone who argues that “healthcare costs need to come down” provide an actual strategy for achieving this. Pay doctors less? Great idea, create less incentive for skilled people to enter the medical field. Cap prescription drug prices? Forget about breakthrough drugs if R&D becomes cost prohibitive. Not to mention it’s government overreach to increase Joe Schmo’s taxes but not if they intervene to decrease revenues to benefactors of health spending…
As other people have mentioned, this isn’t going to create chaos as 35 million people suddenly get health insurance and immediately run to the hospital, hospitals all along have been required to treat everyone, only now they will actually receive payment for those who previously didn’t have insurance - note the performance of hospital stocks today. The ACA certainly isn’t perfect, but it’s a step in the right direction.
I never said that lower income people go into finance. I’m just saying that not everyone can afford to go to medical school in the US. I could not afford to go to medical school in the US without taking out huge, life shattering loans. Most medical students have costs at least partially subsidized by their parents. Many parents cannot afford this. It’s hard to argue that the cost of medical school is not higher than the cost of non-medical school.
Doctors will work for less money if they don’t have to spend 10 years getting medical degrees. If we reform medical education, future doctors will happily accept less money. Are UK doctors worse than US doctors? UK doctors don’t need 10 years of tertiary education.
Also, reform malpractice laws so that many kinds of friviolous lawsuits are thrown out.