Questions to Ask Medical School Deans

[xchrom]

http://www.dailyyonder.com/questions-ask-medical-school-deans/2012/02/15/3766


***snip

I have a few quibbles. The real issue in American medical education is geographic distribution and specialty distribution. It doesn't matter how many doctors you have if they are of the wrong kinds and are in the wrong places — as they have been throughout my 50 years of medical school watching.

Most of the allopathic (i.e., M.D. degree granting) schools deny responsibility for their alumni's careers, though exceptional schools like the University of Minnesota School of Medicine at Duluth show how remarkably effective a school can be at admitting and preparing students for rural careers even with limited curricular time and resources.

From 1975 until 1998, I reported directly to medical school deans in a succession of schools. My work involved liaison with legislators in five different states, and included such tasks as setting up legislative hearings, gathering data and drafting reports for legislators on, for example, how many students from state A were practicing medicine in state A.

I worked for eight different deans in three different medical schools. At one point I drafted a report for a regional legislative conference of state legislators that might have been called, "How to Tell When Your Medical School Dean is Presenting Deceptive Information and What Follow Up Questions to Ask."

[cbayer]

1. A large part of the maldistribution in high need areas and specialities is economically driven.

The best and brightest tend to go into the specialties of dermatology, radiology and ophthalmology. These are highly sought after residencies that lead to lucrative practices with better lifestyles.

Rural or intercity physicians in the areas of primary care are the lowest paid and have the most demands in terms of being on-call.

Until these inequities are addressed, it will continue to be difficult to recruit medical students in primary care residencies and high need practices.

Particularly since most medical students are coming out of school with debt in the six figures and they are already about 30 years old.

State legislatures could play a significant role in changing this if they provide incentives for students to pursue primary care practices.

The federal government could play a significant role if they radically overhauled the payment schedules for specialties. And, of course, a single payer, universal access system could solve the problem entirely.

[exboyfil]

2. You are not going to pay a brain surgeon the same as

a GP even under a single player plan. The investment in additional training and the skill level required is greater for a brain surgeon.. That is not to say that GPs should not make more dollars, but many states and communities already compensate GPs by forgiving loans etc. Radiology and ophthalmology also require an exceptional skill set.

My daughter is leaning towards general surgery. I think it has something to do with her getting her appendix out when she was five. She is only an 8th grader, but she has been thinking this way for a very long time. She is taking 9th grade Physical Science and has already completed 10th grade Biology with two As. She has to work very hard to get the math, but she is currently in Honors Algebra and making an A.

I am truly amazed at what it takes to get into medical school. My daughter is already planning to do volunteer work in a nursing home this summer, and she is planning to become a CNA in 10th grade. She would next look to become a phlebotomists and receive some level of EMT training sufficient to do at least volunteer work in that area.

Doing this while trying to maintain a 4.0 and preparing for the MCAT is very difficult. Not to mention the nearly $300K for an in state medical degree (this is assuming public university for four years and the state medical school).

[cbayer]

3. I don't disagree that someone who has invested more time and money in training and is performing

more highly specialized procedures or skills should be paid more. This is true for a neurosurgeon, not so much for a radiologist or ophthalmologist.

Best of luck to your daughter. It's a very tough road and the rewards have been diminishing dramatically over the past 10- 15 years. As a result, medical school applications have been decreasing and there are some studies showing that the overall quality of the students has gone down as a result.

MCAT is far down the road for her, but it sounds like she is really serious. Best thing is to get into a good college and take it very seriously.

The financial burden has gotten to the point of total lunacy, imo. There are primary care physicians who are barely making their bottom line. It can take up to 20 years or more to repay the debt. It's a festering problem that will explode when there is mandated universal coverage. A lot of the uninsured are just trying to hold on until they can get insurance, and the demands on the system are going to be explosive.