Posted on 10/16/2002 5:10:33 PM PDT by RJCogburn
It's conventional wisdom in academia that a bad economy is good for higher education. That's why yet another drop in medical school applications seems especially telling.
When the economy hits the skids, as it has recently, people often flock to colleges and universities. Some are hoping to make themselves more attractive to employers in a tightening job market. Recent undergraduates apply to graduate school in hopes that by the time they emerge, the economy will have improved. Others return to school to learn a new profession -- one they hope will be recession-proof.
The health care field has long been considered such an opportunity.
Indeed, the institutions that educate people to work in certain sectors of health care have experienced an application boom since the economy began slowing in late 2001. Nursing and pharmacy made the list of programs seeing application increases.
Medical schools, however, did not. Their absence is made even more conspicuous by the fact that several professional schools outside the health care sector also made the list.
Here's a look at application trends as reported by The Chronicle of Higher Education in February 2002.
Law -- up 21% from the same time in 2001. Business -- 65% of the MBA programs surveyed by the Graduate Management Admission Council said applications were up. Engineering -- many schools are reporting double-digit application increases. Nursing -- the American Assn. of Colleges of Nursing reported a 4% increase in enrollment in baccalaureate programs, and applications appear to be up as well. Pharmacy -- PharmD programs reported an 8% increase. Now, a look at medicine's numbers.
According to a study published in the Sept. 4 issue of JAMA, the number of medical school applications for the class of 2001 was down 6% from 2000 and nearly 10% from 1999. It's the fifth straight year of decline, a sign that a career in medicine is slowly losing much of its luster.
Experts cite several reasons for the fading attraction of medicine, including concern about the status of medicine, loss of physician autonomy in the managed care era, government regulation and litigation woes. It shouldn't be surprising that these difficulties, all too familiar to practicing physicians, are poisoning the well for medicine's future.
The fact that medical students now finish their education with an average debt of $100,000 isn't helping either.
The decline in applicants has not yet translated into medical school slots going unfilled. There are still two applicants for every open slot.
But that does not minimize the trend's troubling implications. The profession of medicine prides itself on its selective nature, and patients deserve care provided by the most capable individuals the system has to offer. The reality has long been that only the best and the brightest college graduates get into medical school. But a continued decline in applications, with the prospect that many of the best and brightest students will seek careers in less problem-prone fields, most certainly threatens that reality.
Indeed, it would seem the practice of medicine is in danger of becoming entangled in a classic vicious circle. The more damage done to the profession's reputation as a solid career choice, the fewer the number of college graduates interested in it. And the fewer the number of college students who choose it, the greater the chance the profession's reputation will start to suffer under a perception of mediocrity.
Some experts believe the application decline may have bottomed out with the class of 2002. Let's hope that's the case. The future well-being of patients, and of the medical profession, depends on keeping medicine a field that our best still strive to enter.
While being the best and brightest does not necessarily mean the individual will be an excellent physician, when I need care I would generally prefer my doc to have been relatively bright.
Medical malpractice or tort lawyer -- THAT'S the ticket to the big time. As Al Pacino's character said in "Devil's Advocate," it's the ultimate back-stage pass. Lawyers are in EVERYTHING. Perhaps they can cross-train into medicine. That way, they can sue themselves and cut out the middle-man.
So next time you need to visit the old ER, hope the place has enough lawyers on staff -- cause, thanks to the growing hoardes of ambulance chasers, there probably won't be any doctors there.
Hell, if a few more OB/GYNs throw in the towel, there may not be any PEOPLE in a few years.
You're expected to be superhuman, infallible, and perfect in every way. As the population continues to age you will increasingly have to deal with hysterical, selfish Baby Boomer A**HOLES who devoutly believe (because they have been raised to believe) they are the center of the universe and the one human being in the history of the universe who shouldn't have to die. Oh, and by the way, you're also the bad guy who wants them to give up their fattening treats and their self-destructive habits. You literally couldn't pay me enough to put up with what the average doc has to. To all medical FReepers, my sincere salute and thanks.
People who want to bitch about how much doctors make are usually ignorant f**kheads who wouldn't make it through the first DAY of med school and have no idea of what the job actually entails. "Doctor? Dem's de ones dat gotta coat and makesuh tunna munny! Dey just play-uh da golf and get dat munny! Zackly! Zackly!"
"Best and brightest" -- what does that mean? Reminds of the old "Coke is Love" slogan .... meaningless. When I was at huge state university early-70's it meant that grades were viciously bell-curved to eliminate by percentile -- but not by knowldege or wisdom is the bell curve. You can make a test that will pick out 5% out of any group, but that test says little of knowledge or the ability to use it. Med students were the most focused and vicious cheats I ever saw. In those days no med student went to college to learn -- they could not afford that indulgence. They went to pass the pre med curricula in the topmost percent they can beg borrow or cheat to.
And there in that quoted paragraph is another bit of socialist poison "patients deserve care provided by the most capable individuals the system has to offer" -- indulgent socialist claptrap. "Patients deserve ..." Gee, golly molly -- let me be the choser of mine own physician in specific and in general, and not some elitist creeps narrowing the pack for me! The public is wise when let to be so, but the medical profession since the mid-1800's in the US has been a well-formed gang keeping out whoever they deem.
Aye! Now we are all to pay the piper... *Unless* we can open up the gates and let the free market work its wonders. You shouldn't need a license fallen off a very few poisoned trees to practise medicene and who may do what in medicene should be greatly more open and less "doctored" of a game!
I wouldn't reapply, even though I'd bet extravagant amounts of money that I'd be a shoo-in now. They didn't get me then, they ain't gettin' me nohow. I'm too old anyway.
The thing is, goodnesswins has a point. The whole application process is a game-- and the ones who have the best chances of winning are female minorities who've spent their summers doing coffee runs for AIDS researchers or some such bullsh!t. That is the bottom line. Excellent academic record? Outstanding work ethic? Huh.
There are easier ways to make a living.
I can attest to THAT...
Little off subject but did you see CA is going to let Mexican doctors practice with three year non renewable contracts. They will be assigned to underserved areas.
Actually, the best way to get into med school is to go to South Dakota and do a study on the rectal temperatures of an Indian tribe. Medical schools eat up that 'social' bullsh*t.
I know not all do it but did you see the one last week, doctor saw 160 patients in one day????? Of those 32 were dead. Medicare caught him but after "years" of cheating.
Oops...you're right. I can't believe that- and I happen to have a baccalaureate!
Yes you pretty much have to decide on becoming a doctor during your early college career- it's very hard to catch up, especially if you go to a top, high priced school where you must graduate in four years. Then there are the MCAT's-many in my freshman class (including myself) stated that they were pre-med; five years later few are in medical school. I think the dot com boom also attracted a lot of science minded kids who didn't want to spend four more years in school.
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That's unbelievably low. In the '50s it was many times that.
Wasn't there a program in, I believe, the Clinton years that paid medical schools in lieu of accepting students as there were too many applicants. Was it just discussed but never happened?
Also, this sounds to me like - hey we need to import more foreigners, we don't have enough doctors? I will confess, I see immigrants behind every bush - no pun intended.
I think it's just too hard to expect today's lazy, unmotivated, publik skool edjookated kids to put in sooo many hours and sooo much of their time to devote to medical school! Not when today's Kollege offers "funner" classes like "Pop Culture", "Latina Writing", "Friends of the Environment", "Lesbian Marxism" and "The Simpsons" How do you compete with that?
Jennifer Shubinski
El Paso Times
El Paso medical professionals and one of El Paso's state senators told the Texas insurance commissioner and his committee that a binational health coverage plan won't work and that Mexico's standard of care is not acceptable.
Jeannette Skinner, a nurse and director of case management at Del Sol Medical Center, told the committee she had seen many patients who had suffered medical complications or had died after receiving care in Mexico.
"It's an atrocity that you would send people to Mexico and expect us to clean up the mess," she said. "Answers (to health care) do not come from encouraging people to seek out care in a Third World country."
Texas Insurance Commissioner Jose Montemayor and other members of the Interim Committee on Binational Health Benefit Plan Coverage were in El Paso Tuesday to gather testimony from local medical providers and health officials about health insurance coverage for Texas residents in Mexican clinics.
House Bill 2498 was passed during the 77th Legislative Session. The bill ordered the Texas Department of Insurance to conduct hearings on the feasibility of letting Texas residents on U.S. insurance plans get services in Mexico.
State Sen. Eliot Shapleigh, D-El Paso, was one of the people who testified against the idea.
"What you have here is an insurance company's dream ... ," Shapleigh told the committee. "What this creates is a separate health-care system at lower costs and lower standards. This is not what Texas wants or needs."
Shapleigh said the proposal threatens standards for preventative care for children, for immunizations for children and for information as to what is and is not covered.
"The primary obligation under this plan is to the insurance company, not to the patient," he said.
Shapleigh told the committee that border communities, such as El Paso, need to market themselves as world-class health care centers to draw paying clients north of the border to increase the economic vitality of the area.
El Paso City-County Health and Environmental District Director Jorge Magaña told the committee that the plan "is not in the best interest of residents."
"We don't have any control over the type of services that are available over there," he said. "In America, doctors have high qualifications, and the quality of care is not a concern."
State Sen. Eddie Lucio Jr., D-Brownsville, said one thing was clear in Tuesday's testimony and in other hearings.
"We want to make sure qualifications and standards are kept at a high level, like anywhere else in the country," he said.
Lucio said the idea of binational health insurance is a "challenge that we may not be able to resolve this session."
Rep. Pat Haggerty, R-El Paso, author of the bill, was not at the hearing. A secretary in his El Paso office said Haggerty was in town Tuesday but was busy and had not received an invitation to the public hearing. The woman said Haggerty was not available Tuesday afternoon because he was on his way back to Austin.
Very interesting, had not seen that one.
I did see the other day that health insurers are quietly telling their customers that they will pay for drugs bought in Mexico and Canada. I dont think anyone has "the answer". It is too late to get the governments out of medicine, like the 600 pound gorilla, they will never go away.
a teacher comes out of relatively easy schooling, works no weekends, no holidays, no summers, short days, gets terrific benefits including extra vacation and sick time during the year as well as "personal" time as if they needed more time off, guarenteed seniority, can set their own school year, and if not immediately, they can at least look forward to having a steadily rising income over the years...........................
so why would a young man or woman want to become a doctor?
I agree, but I still want a bright person to be my doc. And those who are determined to succeed are more likely, though clearly not guaranteed, to be the more skilled physicians, whether or not they have 'bedside manner'.
I don't think they plan to stop with Americans having to cross the border to use cheap Mexican clinics for their healthcare, next it'll be letting Mexican doctors practice in this country. Just like the Mexican trucks soon to take over our highways.
The undergraduate school was rated very selective by Cass and Bernbaum's Guide To American Colleges. Only the top 20% of high school classes would get in. In those days you were expected to know something to graduate from high school. As entering freshmen we were often told most of us didn't belong at the school and that we ought to go back home and Every attempt would be made to send you there. Your chances of graduating with a B. S. or B. A. overall was roughly equal to your percentile ranking on the entrance exam. Chance of making it through pre-med was about 1/4th that.
Grading was on the fang and claw system. Premed was a rough curriculum. Midway 5through the first semester 100 students would be washed out. By the end of the second stmester you had about 350 of the toughest sonofbitches imaginable to compete with. Pre-med there was nearly as roungh as medical school. If you graduated, you needed to compete against the best from four year and other colleges for acceptance to med school.
If you were accepted, when you signed up for class you were given a 600 page reading assignment to be tested upon on the first day of class. Flunk the exam and you could pack your bags for home. There was the traditional greeting at the introductory lecture on the first day of medical school. "Look to your left. Now look to your right. Don't fall in love with each other because one of you won't be here this time next year." I had a healthy acquaintance who lost 35 pounds during his first year of med school from strain. After making it through that year he came home for the summer and cried.
In the last 35 years I have been seeing Ph.Ds. who never would have graduated from undergraduate school when colleges and universities were selective and serious. Med schools have become a joke compared to what they were. In recent years people have been turned loose as graduates from colleges and universities like hughe flocks of blackbirds each spring. Very few of them have graduated from what I knew at college at any level.
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I've had people pleasantly bugging me. I have a complex study on economics coming out in a week. Zola and I don't agree on economic theory so it will be published on my own site. So far it's about 22 pages long. Send me a priviate email so I will notify you when it's done.
I passed that along just as info, not to rouse your ire. It made me sick that it took them "years" to catch the man.
Did you see my post about CA importing Mexican doctors under State contract?????
That's news to me.
I suppose the thinking is 'underserved' is worse than 'maybe served', but there is no reason for the state to be involved with 'contracts' in the first place.
I did, back in the day, because I knew the medical profession needed folks like me-- I don't have much in the way of bedside manner, but I had the integrity and the guts and the will to make something of myself and try to give some folks a break...
It held the promise of being one hell of a challenge, and there's nothing I like better to sink my teeth in...
Still bitter about being passed up for some coffee-fetching bimbo, I reckon, haha... Being in an academic environment, I see quite a few premeds come and go and a bunch of knockkneed grayfaced gradegrubbers I have yet to see the like...
Approx 6000 for 160 slots at the state Med Coll in my home town in 1996. 3000 for 55 slots at the out of state school the better half finally got in and graduated from last June.
VA is worse than most states. They average 40% out of state students, (most of whom are Arabs) compared to nationwide average of 12%.
We owe $240,000 compared to $36,000 had she been able to get an in-state school.
My late brother-in-law -- a cardiovascular surgeon in Ohio -- was a year from cashing in early when he passed at age 57. In addition to being subjected to meritless suits on an average of twice a year, he, too, was becoming fed up with the bureaucratic BS.
My niece -- his daughter -- is a 40 year-old OB/GYN who is phasing out of her practice and into teaching (if she can find any kids to TEACH!) for the same reasons.
You know, don't you, that Thomas Jefferson predicted what we have going on here. He warned that if the socialism then sweeping Europe ever came here, at least two things would occur: We would become an increasingly litigious and contentious people as we shouldered one another out of the way to get OURS from the public trough and the trough would soon be empty. Both have come to pass.
What might surprise Tom, however, is how that has spilled over into the private sector as the public trough emptied.
I HOPE you and your colleagues who are familiar with the process now destroying what once was an efficient and quality health care system become active in helping to find and implement common-sense and efficient ways to salvage it.
Hang in there, doc!
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