tag:blogger.com,1999:blog-4968787219619380438.post1696136909405244630..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Changing pre-med requirements and med school curriculaSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger32125tag:blogger.com,1999:blog-4968787219619380438.post-42467881766698360702017-11-17T07:11:18.146-05:002017-11-17T07:11:18.146-05:00Brian, I believe we might be able to teach them to...Brian, I believe we might be able to teach them to think without calculus or physics. Law schools don't require pre-law students to take either of those courses even though practicing law requires some thinking to be done.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-81470734871969622102017-11-16T21:30:06.322-05:002017-11-16T21:30:06.322-05:00I'm not a doc or med student. I was a lawyer....I'm not a doc or med student. I was a lawyer. Calculus helped me, as did physics, not because of any bearing on my work, but because they told me how the world works, some ways that working might be described, and the habits of mind that go with learning these things. <br /><br />No matter what courses I took, and no matter what courses prospective physicians take, it will be the way minds are shaped by exposure to Shakespeare, Einstein and the calculus; the habits of mental acuity and flexibility that will well serve those who serve others. BrIan Buchbinderhttps://www.blogger.com/profile/12626502438267547254noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-67892184890743027452017-08-20T07:31:58.634-04:002017-08-20T07:31:58.634-04:00OnTheOtherSide, thanks for your comments. I agree....OnTheOtherSide, thanks for your comments. I agree. Teach them to think.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-509409679227530282017-08-19T15:23:50.518-04:002017-08-19T15:23:50.518-04:00I am not in the medical profession, but I have spe...I am not in the medical profession, but I have spent many years surrounded by it with two sick kiddos. SkepticalScalpel, I wholeheartedly agree with this post; I have seen MDs and surgeons who fall into both categories of "schooling". We lost our oldest at 3 1/2 because her surgeon looked at her symptoms and said "looks like X, so treat it like X". It was a mistake. Our youngest is now 4 and, while he struggles with his rare condition, he was diagnosed because HIS surgeon cared enough to look beyond the textbook/common assumptions of his case and spent 2 months digging deeper and deeper until she found answers. She has worked tirelessly for my son - sent pathology to labs all over the country, talks to surgeons in other countries about care tactics, talks with us and advocates for us. Yes, her skills are tremendous and she is one of the few surgeons I allow near my son, but I cannot tell you the number of battles I have fought with residents, floor doctors, interns, etc. about my son's care because what works for him sometimes does not make sense, and they want to change plans or question my care. NO. Take the time to learn that a textbook only tells you so much. As you said in an earlier response, it's the nuances that tell the story. Well, my son has about 1,000 muances to his case, and they change sometimes daily, so please, please, please look beyond "what you were taught" to the heart of what's in front of you. "Teaching medical students to THINK" - what a novel idea. OnTheOtherSidenoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-85483622975536055422017-08-06T19:09:43.883-04:002017-08-06T19:09:43.883-04:00Anon, you are the rare example of someone who foun...Anon, you are the rare example of someone who found organic chemistry and pharmacokinetics useful. It is a good thing you went to school when you did because those courses are dinosaurs.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-32067505560153937232017-08-06T08:02:24.899-04:002017-08-06T08:02:24.899-04:00I disagree with the idea that calculus, physics an...I disagree with the idea that calculus, physics and organic chemistry could be removed from pre-medical requirements. I may be an odd duck, but I use the principles I learned in those subjects to analyze clinical data, to shed light on statistics, and to understand the molecular workings of the human body. I built on what I learned in those courses to understand pharmacology, especially pharmacokinetics. I built on what I learned in organic chemistry to understand immunology. I built on what I learned in calculus to understand complex test algorithms. I used what I learned in a fluid hydraulics course to understand principles of circulation.<br /><br />So yeah, I use that "useless" stuff all the time. But then, I paid attention in every science course I ever took, and I learned the material. The material is useless if you just cram for the exam and brain-dump afterwards. If nothing else, all of those courses provided "hooks" I could hang new, more complex information on, allowing me to make better use of that information.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-6678796127633088502016-06-24T14:20:24.437-04:002016-06-24T14:20:24.437-04:00I'm not so sure. I think he's got some goo...I'm not so sure. I think he's got some good points especially about statistics for example.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-39134421119799575312016-06-24T12:31:15.467-04:002016-06-24T12:31:15.467-04:00I question anything the Obamacare architect has to...I question anything the Obamacare architect has to say. What a disaster. Anonymoushttps://www.blogger.com/profile/07932482638690832712noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-86068753296407133912016-06-21T07:50:45.688-04:002016-06-21T07:50:45.688-04:00Maybe you could screen them for lack of passion, b...Maybe you could screen them for lack of passion, but I wouldn't know how to do it.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-27408497928023288682016-06-20T17:52:05.839-04:002016-06-20T17:52:05.839-04:00Passion is a little like pornography...difficult t...Passion is a little like pornography...difficult to describe, but easy to identify. There is no way to screen for it, but I think you can screen some out for their lack of it. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-44925650783052304922016-06-17T07:38:16.739-04:002016-06-17T07:38:16.739-04:00In my early days as a program director, I inherite...In my early days as a program director, I inherited residents that the previous PD had chosen. Many of them did extremely well on tests like USMLE and ABSITE, but couldn't take care of patients, lacked common sense, and had bad communication skills.<br /><br />I agree that it would be nice to match with only passionate applicants, but as I mentioned in the post about grit, identifying them is difficult--maybe impossible. <br /><br />How would you suggest we screen applicants for passion? It's not by interviewing. Anyone can talk the talk.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-32112167804623739962016-06-17T02:52:05.576-04:002016-06-17T02:52:05.576-04:00Thats true skeptical scalpel, but my point is we t...Thats true skeptical scalpel, but my point is we teach 18-21 yo to resume build to get admission into med school, law school, MBA school. Volunteer here, research here, but 19 yo johnny really has no passion for the volunteer work or the research or the trip to Africa teaching about Aids. This is all fake if its really not passion. Its just to say you did it, make yourself look good, and get admitted. Then once you are admitted all that fufu stuff from that resume you built all gone, why, you are already in! This is teaching fake character. This is why you have the chairman saying wow johnny was pretty good during interview and his resume, wow! Then when Johnny is an intern, hes doing shortcuts and not giving 100 percent, he's really not passionate about this, it was all a facade. Or as a fourth yr MS leaving rotation early, not reading during 4th yr, hey, I already matched.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-56806874903748812902016-06-16T08:14:44.875-04:002016-06-16T08:14:44.875-04:00Anon, thanks for commenting. Test scores do not di...Anon, thanks for commenting. Test scores do not directly correlate to physician quality, which is hard to measure anyway. The trend in the US has been to try not to focus on scores alone, but to consider other factors in deciding who gets admitted to med school. Right or wrong, that's where we are headed.<br /><br />Passion is great, but it is also hard to measure. [See: http://skepticalscalpel.blogspot.com/2014/08/true-grit.html]<br /><br />I don't have all the answers.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-80922560921709519862016-06-16T05:38:30.976-04:002016-06-16T05:38:30.976-04:00I am USA born and I am loyal to the red white blue...I am USA born and I am loyal to the red white blue, but my parents are from India. I have heard the stories about the indian admission system, which has been in scrutiny lately due to accusations of cheating. However, in the past the system was quite good overall. Everyone interested in medicine takes a test last year of high school to see how they compare to students nation wide. You get ranked nation wide and thats how you are granted admission. My worry about our system does not start with curriculum. My worry is in regards to who we are admitting. Over at University of Arizona in the past they have allowed navajo or native tribe decent admission with lower standards. I have seen favors pulled for people who know people. These are just examples, we can go on and on. Im not saying india is perfect, I know of the corruption that has occurred over the yrs, but the overall premise of scoring well on a logical exam and allowing only a certain amount of students into the system based on their rank seems better to me. Now i have heard the, well, we interview students judge their character yada yada. That is important, but I feel we let a lot of mediocre people into the system here in USA not based on scholastic merit. The admission process is quite a game, what research you did, did you travel to Africa to teach about Aids, etc. Look, I never understood the resume building we teach 19 year old kids. What happen to passion...Alright, I had more to say, got to go to rounds soon. Look, I feel our system might be fine as it as, we need more honest people who are dedicated to this. I have said for long time the 4th yr is a waste, students either already know their high usmle score will match them into ophtho, ortho, derm, etc. They dont take the 4th yr seriously, we need to discipline students, hold them accountable and start bringing in people who do not manipulate the system. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-39162707774299357362016-06-14T08:51:34.428-04:002016-06-14T08:51:34.428-04:00Anonymous Europe, I appreciate your faithful readi...Anonymous Europe, I appreciate your faithful reading of my posts, but I must disagree with you about math. Unless you have some understanding of statistics, you will not be able to properly evaluate research papers.<br /><br />You don't have to crunch the numbers, but you do need to be able to interpret them correctly. I think as time passes you will change your mind about this. I've written many posts about statistics and tried to keep them free of formulas and other distractions.<br /><br />On the right-hand side of this page is a list of my popular posts. Click on "statistics" and read a few of them. You will find it's less burdensome than you thought.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-2034351880426598052016-06-14T07:54:04.687-04:002016-06-14T07:54:04.687-04:00Anonymous Europe: This is interesting. I went to m...Anonymous Europe: This is interesting. I went to medschool in Europe, and I have the same notions about medical education here. Firstly, the curriculum is littered with irrelevant information, and you can practically finish medschool without ever giving an i.m. injection..... Besides what everyone forgets, -and the way I see it, is a huge problem with Generation Y- is growing up. You spend six-eight years of your life in a library and in the hospital, crunching data and working. By the time you come out you are just a teenager with a dangerous title. Growing up has shifted well into the early thirties which is bad for everyone. <br />I disagree with the statistics. I have always hated mathematics and have an inborn hatred for anything related. I prefer performing and assisting operations and working in the outpatient unit to crunching some boring numbers....Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-10848460958794696472016-06-10T10:12:36.199-04:002016-06-10T10:12:36.199-04:00nuance--I like that word. As a GP there are some d...nuance--I like that word. As a GP there are some days that all I deal with are nuances. Not one of which would have any meaning or even be incorporated into a multiple choice testEd Volpintestahttps://www.blogger.com/profile/02295480572501208764noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-68369230785320618002016-06-10T09:06:31.107-04:002016-06-10T09:06:31.107-04:00Anon-from June 9, I completely agree that students...Anon-from June 9, I completely agree that students and residents should be taught how to interpret the literature and that multiple-choice testing does not lend itself to nuances.<br /><br />Ed, it's true that some academicians are not aware of what goes on in real life.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-49172074819669113212016-06-09T20:07:35.736-04:002016-06-09T20:07:35.736-04:00yeah, anonymous, the academicians have a way of th...yeah, anonymous, the academicians have a way of thinking that medicine is not practiced on the ground but up in the rarefied air of the ivory tower.Ed Volpintestahttps://www.blogger.com/profile/02295480572501208764noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-17012507564188802052016-06-09T17:53:45.746-04:002016-06-09T17:53:45.746-04:00they need to teach how to read and interpret the l...they need to teach how to read and interpret the literature. this however would go against the multiple choice way of teaching in medical school. for example most medical students come out knowing that drug A is used to treat condition B. very few know that in 3/5 trials drug A showed a 20% improvement over placebo (which itself showed a 20% improvement) in patients with condition B who were between 40 and 75 years old, who did not also have condition C & D and who had not already failed drug D. Then they might not be so shocked as to why things in the real world don't work out the way that you were taught.<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-31614263295028594852016-06-09T07:52:20.980-04:002016-06-09T07:52:20.980-04:00Ed, anyone may comment here as long as the comment...Ed, anyone may comment here as long as the comment is relevant, not profane, and not a personal attack on someone else.<br /><br />Anon from June 8 11:44 pm, I've never (as far as I know) had an administrator resign because of me. I'm sure some have wanted to. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-41657398937629290442016-06-08T23:44:22.880-04:002016-06-08T23:44:22.880-04:00Do you have me beat? I have risk managers that res...Do you have me beat? I have risk managers that resign and won't talk to me (so far). That's one hospital only. <br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-87695564698159051182016-06-08T14:39:34.210-04:002016-06-08T14:39:34.210-04:00June 8, 2016
Skeptical Scalpel [response to anonym...June 8, 2016<br />Skeptical Scalpel [response to anonymous June 7, blog]<br />Probably the worst deterrent to physicians who want to express personal comments that are not mainstream medicine is the risk of being criticized by their colleagues. It can make one feel like a pariah.<br />It is easier and safer and more respectable to criticize one’s colleagues than to find fault with the way medicine is taught or practiced.<br />It is good that the Skeptical Scalpel allows physicians’ dissident voices to be heard.<br />Edward Volpintesta MD<br />Bethel, CT<br />Ed Volpintestahttps://www.blogger.com/profile/02295480572501208764noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-19070532336141863662016-06-08T13:40:32.156-04:002016-06-08T13:40:32.156-04:008:34 anon, my mission in life is to anger administ...8:34 anon, my mission in life is to anger administrators.<br /><br />Kor, you are welcome. Thanks for being a loyal reader.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-13396558215785724212016-06-08T12:15:47.148-04:002016-06-08T12:15:47.148-04:00Skeptical Scalpel; thanks for the links to your ea...Skeptical Scalpel; thanks for the links to your earlier posts.Korhommehttps://www.blogger.com/profile/05497111884933914657noreply@blogger.com