Even in the case of the surgeon, I think you’d be surprised.
I was based at a neurological hospital for a year, and contrary to the popular image, brain surgery is not supposed to be about throwing around complex conceptual ideas and thinking outside the box. It needs to be as standardized as possible.
Heck, we’d love it to be routine, but every hemisphere is different and tech and understanding is progressing all the time, so it won’t be that for a long time.
But I didn’t, for example, see anything in the work that I thought someone with an average IQ would struggle to grasp. They work damn hard, and I hold them in the highest of esteem, but I do think a reasonable proportion of the population, sufficiently motivated, could do the job.
What’s the difference between 99% and 99.65%? The smarter one may have a slightly lower GPA because he was busy doing a side project or practising for the Olympics. Or, he was so smart he was bored silly even in challenging classes. Or she went to a college that marked slightly harder, or had a cold while taking the standardized tests (or it was that time of the month). The difference in judging of less than 1% is probably as much noise as anything.
My experience in science classes too, was that high marks indicated some smarts, but the correlation between marks and demonstrable smarts was less than perfect. Some people are just realy good at book learning, but fail at real-world analysis.
My friends in med school said too that people who found the curriculum challenging were given plenty of second chances and could even repeat a year - once they had gotten past the entrance criteria. The fact that it happened indicates something. Also, read any catalog of malpractice suits and you will find that being “smart” enough to get into med school does not always translate into real-world capability either.
Actually, thinking about it further, we’re talking about surgeons. Not diagnosticians. Everyone that I know who programs robots could probably learn to be a surgeon. Oh, yeah, they actually have robot surgeons, now. Mechanical; not intellectual.
I work at a Dental School. We don’t have the space to add more students, we are at 116 for the Class of 2013, we had 2201 applicants for those spots. Our largest lecture halls holds 120, we have 2.
There is talk of building a new facility for us, but that is not going to happen for another 10-15 yrs. First and second year students spend a lot of time in the teaching labs and are already fighting for resources and time in the simulators. If you add more students and don’t add more resources, your students will be unhappy. Unhappy students will eventually lead to a decline in the quality of applicant, and so on… Administrators are keenly aware of what they can and can’t do with regards to student numbers.
Where I work, faculty already complain about their teaching load, imagine if they had to teach twice as many students or gasp teach their lectures twice to two different sections. Faculty at med school and dental school are vastly different than undergraduate faculty. Their primary focus is research, not teaching. You also have two sets, clinical and basic science. Clinical faculty see patients, teach and many do research as well. Basic science faculty teach and do research. Take a guess at what takes priority over teaching? Patients and research. (I am not saying that some faculty don’t enjoy teaching, but not one here has it as their main priority.)
If one teacher is teaching 120 students then in the long term there really shouldn’t be a problem getting enough teachers or teaching time (presuming that at least a handful of those 120 will be qualified to teach someday).
If it’s lack of investment then that’s another thing. I don’t know much about how medical teaching is funded in the US. Is it entirely from tuition fees?
I don’t dispute your claim but it reminded me of a discussion I had once with a friend who gave me an example of proof that the reverse is sometimes true.
He told me that his brother-in-law was a very sober individual because he was a heart surgeon who lost 75% of his patients soon after operating. The effect of so many people dying under his hands made it difficult for him to socialize on some days so he spent a lot of time alone reading or playing solitaire.
I commented to my friend that maybe his BIL should not be doing surgery if he was so bad at it.
His reply was something like, “No, you don’t understand. He’s such a good surgeon that he only performs the most difficult of surgeries that other surgeons won’t or can’t perform. In essence, he saves 1 in 4 people who are clearly medically marked for death.”
In university (science classes) it was a prof teaching 100 to 300 students with twice-weekly lectures. There were tutorial classes where graduate students would provide closer to 1-on-1 support, plus there would be help times when you could ask an attendant in a study hall. This provided jobs for graduate students to help them with tuition. In 1970’s the tutorial raio was about 1 to 12 or 15; by the 1980’s to save money this was up to about 1 in 50.
I’m not sure what medical schools do for lab technicians, surgeon training, or even tutorial help. I imagine they are less likely to opt for huge classes, at leat in labs; you don’t want people to squeak by not knowing the material, you want a good 2-way interaction to be sure the information is being understood.
So it’s not just classroom sizes. you need to hire 3 times as many anatomy techs who can watch students individually chop up their Uncle Fred’s body donated to science, and ensure the lesson is propery learned by asking eah one, “OK, show me the main blood vessels into the liver”. Where are you going to find and train those people? Unlike latin profs, to get doctors who will teach you have to compete with real-world salaries. Lab techs who are trained in cadaver dissecting is a pretty specialized field. The pharmacist dispensing restricted drugs for experiments, the materials they use, etc. all cost money.
Plus in Canada, and I’m sure in state schools in the USA, half or more of the cost of the university student is atually paid by the government rather than tuition. If you want to triple the med school, you have to convince the govenrment to spend a few billion a year more.
So the real question is, are we really that short of doctors, or just not making proper use of what we have?
My understanding is that, over the past few decades, more medical students have been electing to become specialists – it can pay better. My understanding is also that most medical doctors in the U.S. leave school with a mountain of debt from their med-school tuition, and spend a good portion of their careers paying that off.
In the US, many professional schools (health sciences, law school) have had part of the budgets they used to receive from the state and federal governments decreased, sometimes to a significant amount. When that happens tuition (already more expensive than undergraduate tuition) goes up. Students in many of those professional schools do not have the time to also have a primary outside job that can cover the expenses, as one would have in undergraduate studies. So many resort to student loans.
Even just taking out the bare minimum to cover the expenses and eke out a living, many students end up with six-figured student loans debt, on top of what they may have had for undergraduate studies.
Becoming a teacher for medical (or veterinary) students requires a PhD. in basic sciences, and depending on the course, the person also has to be a trained MD/DVM with boarded specialty. Those are years adding on to the studies, when many people just want to get out and start making a (semi) decent living to pay back the loans.
Again, with budget cuts, there are hiring freezes in many medical and professional schools. Those that have tenure or are on tenure track stay, but if someone retires, they may not immediately fill the position with someone new, and they definitely won’t open a new teaching position even if there are qualified candidates begging for one.
You’re mistaking entrance scores for skill as a doctor. If the entrance score were that predictive, we wouldn’t need medical school. Just look at the numbers and hand 'em a scalpel.
The fact is that the methods we use to determine entrance requirements (GPA, position in class, standardized tests, letters of recommendation) are way too coarse to accurately differentiate between the 99th percentile and above. They’re probably too coarse to differentiate between the 95th and the 99th, too.
Regarding computer science grads starting at $70,000+…
I went to grad school in 1999-2000, and some of my younger classmates were in touch with people still in undergrad. They claimed some were getting starting offers ivo $90,000. This was because of the artificially high demand for programmers to fix Y2K problems - there was a shortage of people who knew COBOL and other old languages.
That was a very different climate than today though.
Where do you live? Because this is completely untrue of any Medical school in the US.
Answer: What do you mean by qualified?
Answer: Admission to medical school isn’t capped due to future earnings potential, but they are capped, usually for one of three reasons:
[LIST=1]
[li] It is incredibly, incredibly expensive to educate medical students[/li][li] .[/li][/QUOTE]
I am curious: why is it so “incredibly, incredibly expensive” to train medical students, as opposed to say chemists or engineers?
In my days in both undergraduate and graduate school in both engineering and chemistry school we spent all kinds of hours in very expensively equipped labs, using some very expensive materials and equipment; all in addition to sitting in expensive lecture halls for days on end.
How is that different to medical students? Where is the expense differential?
My buddy in medical school at the time mentioned the gynecology class. One day they had a live subject - with a doctor supervising, they would poke around while the (trained) subject would help them along, “now you’re feeling the uterus, yes, that’s my right ovary…” I don’t know what they pay these people, but that’s just one class of many, and training is hard enough, let alone finding women who for any price are willing to provide running commentary while being groped by a group of 100 strangers. The supervising obgyn alone if he makes $200,000 a year (low?) is making $100/hr. - plus benefits.
Even with engineers, the complaint at my university towards the end of the 80’s was that equipment was outdated and the program was in danger of losing accreditation; the Engineering students’ union voluntarily agreed to a $1500 annual lab fee tuition hike to help modernize the equipment.
Expanding a medical school is not a simple matter of moving to a bigger lecture hall.
We may think medical costs are ridiculously high, but proportionately, very little is going into doctors’ pockets.
As a current 4th year medical student, I can offer some perspective on the differing costs of education between us and, say, somebody studying for their chemistry or biology PhD.
Medical education at most places is divided into two two-year divisions: pre-clinical and clinical. The pre-clinical is what most people are familiar with when they think of school. We sit in lecture halls, we study in the library, we take exams. For the most part, space wouldn’t be an issue. At my school lectures are recorded, so on any given lecture day there are only about 60% of the class in attendance. Space IS an issue with the anatomy labs and microbiology labs, however. Cadavers are very expensive to prepare and maintain throughout the months of gross anatomy. A ratio of 4-5 students per cadaver is optimum; more than this and it becomes too difficult to see and learn. There is some push toward “virtual” cadavers, but it’s still a definite minority.
The clinical years are when all the medical students start rotating through the hospitals. In my mind, this is probably where the bottleneck is. It is extremely expensive to have medical students in a hospital. There are extra costs for attending physicians (doctors who have already finished residency) to take the time to teach on top of their already busy days, extra costs for insurance for each student, extra costs in facilities such as basic office supplies, etc. Most hospitals are not equipped to handle 200-400 medical students rotating through every year.
It is not so simple as building a new lecture hall or hiring more professors. A basic infrastructure needs to be in place, and that infrastructure is not present everywhere in the country. That’s why there most schools are grouped around big cities, and some states may not even have a medical school.
As for the issue of the number of qualified applicants versus accepted applicants, I can tell you that not being accepted does not automatically mean you would be a terrible doctor. As others have said, a test score does not guarantee success, which is why there is so much emphasis also being placed on non-academic factors, such as volunteering experience, community service, and being well-rounded in general. However, the lack of spots means that a lot of potential physicians don’t get in, and may spend years reapplying or just give up and go into another field.
I hope that helps clarify some issues.
That, and who in their right mind was going to come out of undergrad in 1998-1999 and do COBOL, even for 90k, if there were a zillion relatively high paying conventional JAVA or C++ or website coding jobs out there that would still be useful after 12/31/1999?