Do med schools reject great doctors?

You may have seen Hisashi T Fujinaka’s list of rejections and read his pessimistic conclusion:

“Just because they’ve always told you that hard work will get you your heart’s desires doesn’t mean it’s true. There’s a lot of luck involved in life and I’m kind of tapped out right now.”

That’s what he wrote back in 2003.  He acknowledged his failure, and the insults trolls hurled at him; but look at his blog and you’ll see that Hisashi is not a failure.  He only posts occasionally, but his updates show evidence of a full and varied life.

That’s not to say that medical students are just lucky.  When Robert F. Wail advises high school grads to reject medical training for high school graduates, he acknowledges that it is extremely difficult to get in.  (You need to have better grades than 98% of your class. If it’s a class of fifty people, you have to be the best student.)

There is a lot of work involved, which leaves no time for social life, and inadequate time for sleep.  When you’ve graduated, you face a qualifying exam that is statistically about 25% harder to pass than the bar exam that lawyers take.  Not only that, but this exam must be retaken and passed again every ten years, if you want to keep your job (and lawyers don’t have to do that to keep their jobs.)

And, if you do get into med school, pass the exams, get the job, and keep the job, your problems are far from over.  Long hours continue, massive debts, high suicide rates, and the stress of patients who refuse to pay make the practice of medicine a career that Wail wouldn’t recommend.

“Unless things change dramatically […] the best and brightest students will, and most definitely should, choose alternative careers.

There are plenty of other ways to help people without killing yourself while doing so.”  (more at Penn Live.)

The question is not, however, whether academically inclined students are giving up on med school, but whether medical schools are rejecting too many potential doctors.

Great doctors excel in many areas.  When breaking the bad news or interviewing a patient about past behavior, doctors need great interpersonal skills as well.  Some form of treatments involve physical skills that we may attribute more to welders and master painters than to academics.  While a knowledge of maths and chemistry can be useful, it’s not really what doctors deal with on a day-to-day basis.

No doubt, many great doctors do come out of medical school.  I’m sure you’ve met a few.  But many never make it there.

Long hours studying bookish and theoretical subjects may not prepare doctors for the social and physical reality of the job.  You may think that med school rejects with vital soft skills could just become nurses.  However, nurses training is becoming increasingly academic.

With a global shortage of doctors, and many excellent would-be-doctors who don’t get through, perhaps we should look at a non-academic route to qualification.

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