Monday, March 02, 2009

So, you want to be a Doctor?

Some days I just don’t understand people.

I find myself asking good friends odd, rather basic questions, to see if the way I approach and think about things is way outside the norm. The answer is often yes. Often enough, the norm is simply incomprehensible to me.

I recently was interviewing prospective students for a very advanced, accelerated program that ideally takes kids who just graduated from high school and pops them out as newly minted MDs in 6 years. I teach Genetics, which is required for the program.

(Yes, yes, I know many people say “graduate high school” but as no student I know finishes their education by measuring and marking the institution that was conferring a degree upon them.)

In any case, these were high school kids who have been very successful students, with high GPAs, high test scores, and great recommendations. They claim that they want to be doctors. They claim to ready to dive into year-round classes with high workloads and potentially go 200,000 in debt over 10 years (you have to add on internship and residency in the timeline) to end up licensed to practice medicine. Even in the accelerated program this is a long time and a lot of money. No one should go into it unless this is what they really, really want. I know several people who left the program, already in debt, either realizing that medical school or being a practicing physician was not for them. I have interacted with even more who I would never want to be my doctor because they have little interest in the well-being of people, and even less in truly finding out how to be a good doctor. There are many outstanding students, of course, who will end up fine physicians, but not as high of a percentage as I would like.

Our Medical School’s goal, which is stated frequently, is to produce general practitioners, ideally for rural and urban under-served areas.

I was tired of the same old questions and the typical pat answers.

"Why do you want to be a doctor?"
"Because my (mom, favorite uncle, best friend's dad, or beloved grandparent) got sick (and maybe died) when I was (5, 7, 11, 14). I spent lots of time in the hospital and saw that doctors really help people so I want to be one"
or "My father is my role-model and he is a doctor and I want to be just like him"

"What would you do if your best friend in college was cheating?"
"I would tell her that she shouldn't, it's wrong, and turn her in"

"What are your strengths and weaknesses?"
"I'm caring and smart but I can be impatient, or I need more confidence, or I can be too serious"

"Why did you apply to this accelerated progeram?"
"Because I really want to get done and be a doctor and help people as soon as possible" or "Because this is the main way to get into you wonderful high -ranking med school!" (which is bull, we do not rank high)


So, what did I do? I made the mistake of thinking about how I was as a high school student. I wanted to end up a professor of Genetics before I even entered high school. There was no life-changing event, or great teacher, or geneticist parent to inspire me to do this. Rather, I read a lot, I read the newspaper, the information that I ran across about genetics fascinated me. I looked up more things. I read “The Double Helix” by James Watson when I was a Sophomore in high school if I remember right.. I followed news on the topic, I looked up all kinds of things in the library. I knew how political candidates stood on issues of Biology, and the Environment, and Education, and yes, even health care.

I never had a great Biology class. In fact I think I had ONE biology class total in Jr. High and high school combined. It was experimental. It didn’t work well. It didn’t matter. My heart was already in it. I also played in orchestras, drew and painted, swam on a swim team,and had fun writing in AP English, but Biology degrees and Genetics was where I was going.

So I asked these candidates questions to determine whether they were devoted to their area or not, such as:

1. What do you think of the various health care plans that the Presidential Candidates presented before the last election?

2. What problems face health care in the U.S. now?

3. Do you know what the rough rank U.S. health care holds in terms of cost and infant mortality among developed countries?

4. Why do you think the U.S. has the most expensive per capita health care and yet the highest infant mortality rate amongst “advanced” countries? (this one added when clearly no student had a clue about the last one)

5. What do you think general practitioners could do to help the health care status of individuals in their communities?

Answers?
1. “I don’t follow politics”
2. “Ummmmm”
3. “I don’t know… we are pretty good, right?”
4. “Ummmmm”. Finally, after being pressed two of the batch that we interviewed (two interviewers and one student at a time) said “Welll, I guess Americans eat too much junk food, and some people really don’t take care of themselves.”
5. “Ummmmm.” One finally said “Maybe doctors could spend more time with their patients.


After this debacle we started asking whether everyone in the U.S. had good access to health care. The answer “Yes!” and then on seeing our faces said, “Well I guess some people might live a long way from hospitals”

Of the eight, six had fathers who were doctors. How can they know NOTHING about issues in area in which they want to work?

I also asked questions about medical news to no avail.

*sighs*

What are we doing? What are THEY doing?

I asked several people if I was being unreasonable. Some said that high school kids don't read newspapers and should not really be expected to know much about the area in which they plan to eventually work.

But I did!

3 comments:

TitleTroubles said...

A) Weirdo.

B) Keep in mind that the vast majority of students trying to get into this program are doing so because they were told to, not necessarily because they want to.

C) Children of physicians are among the fluffiest snowflakes alive.

H said...

*Laughs*

Emano said...

So, I'm guessing that for many it is not the passion for health care that drives them into the medical profession.

I once had a special needs student who wanted to be a nurse because her deceased mother had been a nurse. Academically, it was not ever going to happen. Just as important, however, was the way she screamed whenever anyone even said the word "blood."