Similarly: What do you call the person who graduates last in his medical school class?
Doctor
Likewise, it’s disconcerting when medical types tell me how hard organic chemistry was. Please, I don’t want to know. We teach that shit to teenagers.
And predictive of whether a doctor can put a patient at ease and get them to spill what is really wrong with them and their concerns. Intellect alone isn’t enough.
I only have limited experience with it but I did take some real medical school classes in graduate school (neuroanatomy in particular). They weren’t easy at all but it was mainly a memory game. For example, for neuroanatomy, we had to memorize roughly 700 brain areas, some of which were tiny, and the final exam consisted of going to stations with real human brains and identifying the various pins stuck in them. Some of the lectures covered functions but I got the impression they were going to leave most of that to future specialists. They were just trying to give foundational knowledge. Most people could pass it given enough time and guidance.
My uncle, a retired psychiatrist, is very smart but not unusually so. He describes medical school as an endurance and memory stunt. The hardest part is getting in at least up to that point. Very few people flunk out once they get to that point and there is help for people that are struggling. The potential supply of doctors in the U.S. is much larger than it is now because medical school slots are artificially limited because of the costs of building new medical schools among many other things. There are lots of people that could be a great physician but aren’t allowed to because they got a B in undergraduate organic chemistry or something else that practicing physicians rarely use.
Like many things, I don’t think the limiting factor is raw mental ability beyond a certain point. It is more about perseverance and mental toughness. The whole process all the way through the insane residency hours is basically just a long hazing stunt to see if someone can take the worst things that they will ever have to deal with.
That brings us to the old joke:
What do you call the person that graduated last in the class from the worst medical school in the country?
Doctor!
I think one thing that most people don’t realize is that the majority of doctors have little scientific training. Medicine is science-based, but doctors have so much factual knowledge to absorb that there seems to be little time devoted to teaching them to think like scientists. (Of course, some do go on to become research-oriented scientists, “MD-PhDs” in the US.)
I find that some doctors tend to be surprisingly lacking in the training that scientists receive to try to check our natural cognitive biases. And medicine is particularly susceptible to these biases. For example: “Patient X presented with complaint Y. Treatment A didn’t work, but after treatment B she got better. So now I’m just giving B right away to all my future patients with complaint Y, that’s obviously the one that works!”
Of course, most doctors do know better in principle, and an established and documented medical “standard of care” based on the most current research helps doctors practice medicine scientifically without having to read dozens of research papers every night.
The correct answer is Post 21.
Doctors are lousy with stats. I had a doctor try to prescribe me med because it might prevent a heart attack by 1-2%. I had to explain random variation and statistical relevance. Then the surgeon who told me my cancer had a 95% cure rate, and I had to explain that was a population measure useful for planning and comparing treatment A with treatment B. I had what I had and living and dying didn’t have anything to do with stats.
I’m a doctor. I would say that the vast majority of the doctors I know are at least a little brighter than the average person, but most of us aren’t extraordinary geniuses. Being a somewhat above average bright person with a good memory and a good work ethic is enough to succeed in medicine for the most part.
Now that being said, I do not doubt that Dr. Ben Carson and Dr. Oz are intelligent people. An idiot would not succeed in a highly competitive specialty like neurosurgery or cardiothoracic surgery.
However, intelligent people are not immune to having wacky beliefs, and being very knowledgeable about the one area of medicine you specialized in doesn’t make you an expert on any other topic.
For that matter, when I was on my surgery rotations, I really didn’t have TIME to do much reading on any topic that didn’t relate to surgery - so it is quite plausible to me that Dr. Carson and Dr. Oz are truly smart people who are very well informed on their given specialties, but don’t know a lot about other topics they’ve decided to talk about.
I’m a lawyer. My parents are doctors. I know a depressing number of stupid lawyers (though law school and the bar exam are very difficulty). I don’t know any stupid doctors, although I have less day-to-day contact with American-trained physicians than I do lawyers (I knew lots and lots of Indian- and UK-trained physicians growing up). I also don’t know any doctors who I’d call brilliant; even the neurosurgeons I know don’t come across as particularly brainy.
I don’t really follow you. Why was your surgeon wrong to tell you that there is a 95% probability that you would be cured? You seem to be saying that the statistic was correct and applicable to your diagnosis, but that he was wrong to tell you? I don’t understand - did you not want to know the probability that you would be cured?
Actually, I would argue that this was an example of a doctor being not particularly smart or wise. A smart doctor would know that bronchitis is a viral infection in almost all cases and that antibiotics are not useful. A wise doctor would know that taking the time to explain this (and the fact that bronchitis can take up to 3 weeks to resolve-so a patient must be patient rather than just taking the easy route of prescribing antibiotics knowing that by the time the patient finished them the symptoms would likely be better anyway) would help prevent the explosive growth in multidrug resistant bacteria that is a direct result of overprescription of antibiotics.
Which brings me to the OP. You have to look at what it takes to become a doctor in order to determine how the selection criteria weeds out certain applicants. Much of the selection is actually self-selection in who is willing to put in the work to satisfy the admissions criteria.
In order to be admitted to medical school, a candidate has to have good grades and test scores in order to meet a certain predetermined minimum standard. This probably requires a certain baseline level of intelligence but more importantly, rewards the ability to take standardized tests more than critical thinking. In order to make it through medical school and training, the candidate has to have the ability to work hard and to delay gratification. Note that above a certain baseline standard (the ability to get a decent grade in Organic Chemistry or to pass basic physics, for example) additional intelligence does not actually make it any easier to either get into or succeed in medical school. In fact, what I remarked on when meeting my medical school class initially, was not their intelligence (although all were reasonably bright) but that most of them seemed to have above average charisma. I have never met a more personable, pleasant charismatic group of people. Whether this is true of other medical schools I can’t tell, but it certainly seemed to be a selection criterion at mine. No idea how I slipped through that net.
(Anybody wanting more ranting about the unfairness of medical school admissions is welcome to my college senior paper in my Medical Anthropology course titled “An Anthropological view of the American Medical School Admissions Process”, otherwise known as *Psychobunny unleashes all of her pent-up frustration at the medical school admissions process and yet somehow still gets an A, thereby truly pissing off all of the actual anthropology students in the class. *)
To experience this phenomena first-hand, become a Medicare (or, even better, Medicaid) patient and sign up with the local Med School.
I have several things going on, one of which is kidney failure.
It takes a large operation to have beginners in Nephrology - but a big teaching clinic can find them.
I don’t know why they even print business cards - these people are gone after 6 months to a year.
I have had at least 4 since 2009. The current one spent 5-10 minutes trying to bring up my record without admitting he did not know my name.
I pulled out the old “credit-card” type ID the clinic used before everything was online and placed it next to his keyboard.
I lived in SF for approx. 30 years. I do well with various accents.
But this clinic is pushing it. The Hindi was thick enough to cut with a saw; this Russian is improving fast, but that first appointment was almost comical.
Thank you. I was debating whether to tackle this but you said it much better than I would have. There are a couple of urgent cares around here that hand out z-pack prescriptions to anyone with a cough and it drives me nuts.
That actually sounds like an entertaining read.
As others have said it takes a certain level of intelligence to retain the amount of information thrown at you in medical school but the amount of time you’re willing to put in studying is at least as important as how smart you are.
My daughter is n a small major in the biology dept. of a major university. It’s MCDB (Molecular, Cellular, and Developmental Biology) This is where the Med School students come from. About 80% of Med School admissions come from MCDB and 20% from pre-med. Iv’e met her classnates and I haven’t met a one that wasn’t sharp as a tack.
it’s got on of the highest dropout rates of any major in the school. along wit aerospace engineering
I worked for a major medical school just a few years ago and met (and interacted with) hundreds of first year med students.
None were ‘stupid’ but many were very sheltered and what I would describe as ‘clueless’. The majority were very good at studying and memorizing facts, as has already been described by other posters. But I think most organized people with average intelligence and a BS degree from a four year college could pass med school.
I think she is saying that the 95% figure is essentially abstract since her prognosis is totally independent of the other people who make up the sample.
Maybe, nut if they didn’t have the self-discipline as an undergrad, they’re probably not going to be a good student in Med School. I don’t really care what my Dr. knows about art or politics as long as they know medicine.
What exactly do you mean by the words “abstract” and “independent”? The statistics of a sample of people with the same condition is the only way to provide an accurate prognosis. Her prognosis is the diametric opposite of “independent” of that statistic.
Is this some kind of “I’m not just a statistic” argument? If so, it’s a strange example to cite in support of the notion that doctors are “lousy with stats”.
If you just want a doctor to hold your hand and tell you everything will turn out fine, that’s up to you. But personally, if I’m diagnosed with cancer, the first thing I want to know is the probability distribution of my life expectancy. The only way to give a meaningful answer to that question is to look at the statistics of a sample of people similar to me with a similar diagnosis.
The problem is that simply saying “x% of people who come in with that problem are cured” ignores any mitigating factors. I don’t know if that’s their issue with it, but, from where I stand, it can easily be seen as a possible apples and oranges comparison.
Age, relative health, timing of the diagnosis, etc. all play a role–if those aren’t taken into account, the stat is fairly meaningless.
Yes, of course. It would make a lot more sense if that’s what was meant in that post - the surgeon was just doing statistics poorly. But it’s still statistics - you don’t know what a mitigating factor is without statistics. Effectively, that’s just saying that if there is a more precisely matched sub-sample (say, females with a certain genotype and in a particular age range) rather than all patients, then that’s the better statistic to use. So statistics is still the only way to provide a prognosis. Maybe that’s what she meant, but the post didn’t seem to read like that, that’s why I queried it.