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Wait a minute... Im a doctor and I disagree with this. > They put the students through hell because that's what they had to go through... True. But the reason

Wait a minute... Im a doctor and I disagree with this. > They put the students through hell because that's what they had to go through... True. But the reason is that it toughens you up and winnows the wheat from the proverbial chaff. The forced marches through the wards at 2am in the morning prepare the budding doctor for the real world where he can be called upon as say, the sole doctor for miles in a rural area to attend to a mass casualty event. >In most other countries, doctors don't have an accreditation board. ... I do not know of any country that does not have an accreditation board. The difference between countries is the process of accreditation. Sometimes it is direct: the student takes centralized a board exam; sometimes indirect: the student takes a uni exam approved/supervised by the board. > it doesn't require years of school to set a bone or put in some stitches Maybe. But it requires erudition and experience to anticipate that a poorly set bone can heal with complications(malunion, non-union,infection etc.) Fun fact: when Admiral Nelson was wounded in the battle of Santa Cruz de Tenerife in 1797 field surgeons had his arm amputated but mistakenly trapped his nerve in a ligature that caused him great pain until the mistake was corrected ) > it doesn't require years of school ...(to) diagnose the flu or pneumonia That pov is exactly how people get misdiagnosed and killed (by quacks). There are many different diseases that present alike and even subgroups of the same diseases that have different management regimes. While it may seem obvious for instance, that a patient has pneumonia, one would also do well to ask what kind of pneumonia he has, why he has it (immunocompromise?, zoonosis?) and what the alternatives could be( the differential diagnosis). More than once has "ordinary pneumonia" been found to be lung cancer. It takes years of post graduate training and practice to become proficient enough to identify different disease conditions and manage them with confidence. Medical school hazing is not done because the seniors are sadists. Some aspects of the process could be improved but the rigor works and makes for good doctors.

jimmywanger 10y ago
> The forced marches through the wards at 2am in the morning prepare the budding doctor for the real world where he can be called upon as say, the sole doctor for miles in a rural area to attend to a mass casualty event. When has that happened to you, or anybody you've known? > There are many different diseases that present alike and even subgroups of the same diseases that have different management regimes. Sure, how frequent is that? My point is that we're training doctors like they have to be Navy Seals, equipped and prepared for every situation, whereas in real life, a grunt with 3 months paramedic training would be up for the task.
- ejstronge 10y ago
  I'm not sure how you can prove what you're saying. It sounds a lot like someone seeing an app/website and thinking, "I could do that in no time." The scope of what a paramedic does and what a doctor does are totally different. The way medical care is organized capitalizes on each person's training: paramedics stabilize and transport patients; nurses carry out treatment plans; and doctors create treatment plans. It sounds like you're saying, just because we don't always need to use an efficient algorithm all the time, we should never be trained to use efficient algorithms. This could make sense in the context of the next Rails app, but, when your life is at stake, the extra training matters. > When has that happened to you, or anybody you've known? In the state I grew up in, there were only three pediatric psychiatrists for multiple millions of citizens. If a doctor's training confers the ability to affect hundreds of children's lives, I definitely want them to be as knowledgeable of their area of practice as possible.
- Lordarminius 10y ago
  > When has that happened to you, or anybody you've known? Are you kidding me? I practiced medicine until 8 months ago when I burned out and had to take a break. One of the cases I recall having on an offshore medical center, involved 4 victims who had suffered burns(in one case over 80% of his body surface area), on a night when I had 2 other patients on admission. It easily took my team of four 5 hours to stabilize the patients and have them evacuated by helicopter. In 2014, the oil company we subcontracted for had an incident where over 90 people suffered acute food poisoning from eating dinner at the staff canteen. This was a bacillus cereus infection with vomitting and stooling. Dont attempt to imagine that number of sick patients. There were only 2 doctors and five nurses initially to manage the incident. I could tell you war stories all day so could many other doctors.
  - jimmywanger 10y ago
    In these incidents, how many times did you have to reach on your advanced medical training instead of the basic ones to treat burn wounds and fix food poisoning? How was any aspect of your job improved by your years of medical school, your years of residency? Would you rather have more less trained doctors, or fewer elite doctors in those circumstances?
viraptor 10y ago
> the sole doctor for miles in a rural area to attend to a mass casualty event. Seems like the issue is not a lot of doctors in the area. While we can't test this easily, wouldn't reducing the forced marches give more people incentive to join the profession? Then you have more doctors, better coverage and people scheduled to be on call for this. Essentially, where's the balance between few superheroes who survived and a large number of doctors who are just pretty good. > but the rigor works and makes for good doctors. You're commenting on an article which talks about medical students being suicidal. And I know of 2 local doctors actually going through with that. That's not my definition of "good".

jimmywanger 10y ago

> The forced marches through the wards at 2am in the morning prepare the budding doctor for the real world where he can be called upon as say, the sole doctor for miles in a rural area to attend to a mass casualty event. When has that happened to you, or anybody you've known? > There are many different diseases that present alike and even subgroups of the same diseases that have different management regimes. Sure, how frequent is that? My point is that we're training doctors like they have to be Navy Seals, equipped and prepared for every situation, whereas in real life, a grunt with 3 months paramedic training would be up for the task.

ejstronge 10y ago
I'm not sure how you can prove what you're saying. It sounds a lot like someone seeing an app/website and thinking, "I could do that in no time." The scope of what a paramedic does and what a doctor does are totally different. The way medical care is organized capitalizes on each person's training: paramedics stabilize and transport patients; nurses carry out treatment plans; and doctors create treatment plans. It sounds like you're saying, just because we don't always need to use an efficient algorithm all the time, we should never be trained to use efficient algorithms. This could make sense in the context of the next Rails app, but, when your life is at stake, the extra training matters. > When has that happened to you, or anybody you've known? In the state I grew up in, there were only three pediatric psychiatrists for multiple millions of citizens. If a doctor's training confers the ability to affect hundreds of children's lives, I definitely want them to be as knowledgeable of their area of practice as possible.
Lordarminius 10y ago
> When has that happened to you, or anybody you've known? Are you kidding me? I practiced medicine until 8 months ago when I burned out and had to take a break. One of the cases I recall having on an offshore medical center, involved 4 victims who had suffered burns(in one case over 80% of his body surface area), on a night when I had 2 other patients on admission. It easily took my team of four 5 hours to stabilize the patients and have them evacuated by helicopter. In 2014, the oil company we subcontracted for had an incident where over 90 people suffered acute food poisoning from eating dinner at the staff canteen. This was a bacillus cereus infection with vomitting and stooling. Dont attempt to imagine that number of sick patients. There were only 2 doctors and five nurses initially to manage the incident. I could tell you war stories all day so could many other doctors.
- jimmywanger 10y ago
  In these incidents, how many times did you have to reach on your advanced medical training instead of the basic ones to treat burn wounds and fix food poisoning? How was any aspect of your job improved by your years of medical school, your years of residency? Would you rather have more less trained doctors, or fewer elite doctors in those circumstances?

viraptor 10y ago

> the sole doctor for miles in a rural area to attend to a mass casualty event. Seems like the issue is not a lot of doctors in the area. While we can't test this easily, wouldn't reducing the forced marches give more people incentive to join the profession? Then you have more doctors, better coverage and people scheduled to be on call for this. Essentially, where's the balance between few superheroes who survived and a large number of doctors who are just pretty good. > but the rigor works and makes for good doctors. You're commenting on an article which talks about medical students being suicidal. And I know of 2 local doctors actually going through with that. That's not my definition of "good".