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What you are describing is literally how medical training works. Residency IS on-the-job training. Medical school provides the foundation to then learn on-the

by riahi 8y ago

What you are describing is literally how medical training works. Residency IS on-the-job training. Medical school provides the foundation to then learn on-the-job; residency transitions them with graded responsibilities to independent practice. As far as your targeted questions, yes, I do think I would pass a cellular biology test from medical school. I wouldn't get 95%+ but I would expect myself to get at least 80% correct. I'd estimate the overwhelming majority of practicing physicians would pass the USMLE if they took it cold. They probably wouldn't do as well as they did after many weeks of dedicated study, but they would be above the minimum threshold.

treis 8y ago
>What you are describing is literally how medical training works. Residency IS on-the-job training. Medical school provides the foundation to then learn on-the-job; residency transitions them with graded responsibilities to independent practice. It's not because you can't start on the path without going to medical school. And you don't need medical school to start learning radiology. I messed up my elbow in high school. They showed me the x-ray and said this is a fracture, this is a chip, etc. It wasn't difficult to understand and with enough time and practice I'd be able to see them in other x-rays. I don't see where something like Organic Chemistry comes into play. >As far as your targeted questions, yes, I do think I would pass a cellular biology test from medical school. I wouldn't get 95%+ but I would expect myself to get at least 80% correct. So ~20% of what you learned in cellular biology isn't needed as a radiologist assuming you only remember what you've actually needed.
- rscho 8y ago
  There are a thousand reasons why your theories make absolutely no sense at all in the real world. You also make baseless and downright false assumptions due to your complete ignorance. People like you are part of the issues that make the job harder than it should be. Maybe you could take a break and re evaluate whether you have the elements to make judgement calls? Or enter med school and see if your theories hold water?
- riahi 8y ago
  You “could” teach a high school student all aspects of medicine, but it’s going to take so long for them to build the groundwork that by the time they can meaningfully contribute, you’d never make the return on investment. This is actually how medical training was done in the years prior to the Flexner report. From what I can tell in this exchange is that you have an innate distrust of credentialing, because you think because there is some excess therefore the entire system is wasteful. I’d argue that this is the DunningKruger effect in action. And claiming that 20% of cellular bio is unnecessary is a silly metric when in the US 70% is passing... I don’t think that logical conclusion applies. Yes we have more tools to look up information that we have forgotten, but as another poster here says “we aren’t bootstrapping the search each time”. If there’s something we’ve forgotten, it’s much more effective knowing where to start the search. I agree there’s a lot wrong with our current training paradigm; the cost of medical school education is #1 with several terrible downstream effects. However, there are no shortcuts. You have to put in the time to master the material, else you are doing your patients a disservice.
  - treis 8y ago
    >From what I can tell in this exchange is that you have an innate distrust of credentialing, because you think because there is some excess therefore the entire system is wasteful. I’d argue that this is the DunningKruger effect in action. >And claiming that 20% of cellular bio is unnecessary is a silly metric when in the US 70% is passing... I don’t think that logical conclusion applies. You're saying that you don't know 20% of cellular biology that they teach in med school. You are a practicing radiologist. Therefore, 20% of the cellular biology they teach is not necessary to be a radiologist. I have certifications in my field. Developer, Senior Developer, and Lead Developer. If I were to retake the tests, I'd get a 100% on the Developer and Senior one without studying for a minute. Those are good tests. They reflect what you need to know to be effective. The Lead one isn't. I'd probably not pass if I took it today even though I've worked several years as a lead developer since I passed it. So despite actually working in the field and becoming a better developer I'd do worse on the test. That means it is a bad test. So when you say that the overwhelming majority "wouldn't do as well as they did after many weeks of dedicated study" that makes it a bad test. It means that a good chunk of it is meaningless hoop jumping irrelevant to practicing physicians. A competent practicing physician should breeze through a well designed certification exam. >I agree there’s a lot wrong with our current training paradigm; the cost of medical school education is #1 with several terrible downstream effects. >However, there are no shortcuts. You have to put in the time to master the material, else you are doing your patients a disservice. If someone who wants to be a geriatric doctor skips pediatrics I don't see the disservice. Or take someone like a registered Nurse Midwife. Someone with 20 years experience delivering babies. The only way for them to become competent to prescribe pitocin, antibiotics, or use forceps is 4 years and $200k worth of school? It doesn't pass the smell test.

by riahi 8y ago

treis 8y ago

>What you are describing is literally how medical training works. Residency IS on-the-job training. Medical school provides the foundation to then learn on-the-job; residency transitions them with graded responsibilities to independent practice. It's not because you can't start on the path without going to medical school. And you don't need medical school to start learning radiology. I messed up my elbow in high school. They showed me the x-ray and said this is a fracture, this is a chip, etc. It wasn't difficult to understand and with enough time and practice I'd be able to see them in other x-rays. I don't see where something like Organic Chemistry comes into play. >As far as your targeted questions, yes, I do think I would pass a cellular biology test from medical school. I wouldn't get 95%+ but I would expect myself to get at least 80% correct. So ~20% of what you learned in cellular biology isn't needed as a radiologist assuming you only remember what you've actually needed.

rscho 8y ago
There are a thousand reasons why your theories make absolutely no sense at all in the real world. You also make baseless and downright false assumptions due to your complete ignorance. People like you are part of the issues that make the job harder than it should be. Maybe you could take a break and re evaluate whether you have the elements to make judgement calls? Or enter med school and see if your theories hold water?
riahi 8y ago
You “could” teach a high school student all aspects of medicine, but it’s going to take so long for them to build the groundwork that by the time they can meaningfully contribute, you’d never make the return on investment. This is actually how medical training was done in the years prior to the Flexner report. From what I can tell in this exchange is that you have an innate distrust of credentialing, because you think because there is some excess therefore the entire system is wasteful. I’d argue that this is the DunningKruger effect in action. And claiming that 20% of cellular bio is unnecessary is a silly metric when in the US 70% is passing... I don’t think that logical conclusion applies. Yes we have more tools to look up information that we have forgotten, but as another poster here says “we aren’t bootstrapping the search each time”. If there’s something we’ve forgotten, it’s much more effective knowing where to start the search. I agree there’s a lot wrong with our current training paradigm; the cost of medical school education is #1 with several terrible downstream effects. However, there are no shortcuts. You have to put in the time to master the material, else you are doing your patients a disservice.
- treis 8y ago
  >From what I can tell in this exchange is that you have an innate distrust of credentialing, because you think because there is some excess therefore the entire system is wasteful. I’d argue that this is the DunningKruger effect in action. >And claiming that 20% of cellular bio is unnecessary is a silly metric when in the US 70% is passing... I don’t think that logical conclusion applies. You're saying that you don't know 20% of cellular biology that they teach in med school. You are a practicing radiologist. Therefore, 20% of the cellular biology they teach is not necessary to be a radiologist. I have certifications in my field. Developer, Senior Developer, and Lead Developer. If I were to retake the tests, I'd get a 100% on the Developer and Senior one without studying for a minute. Those are good tests. They reflect what you need to know to be effective. The Lead one isn't. I'd probably not pass if I took it today even though I've worked several years as a lead developer since I passed it. So despite actually working in the field and becoming a better developer I'd do worse on the test. That means it is a bad test. So when you say that the overwhelming majority "wouldn't do as well as they did after many weeks of dedicated study" that makes it a bad test. It means that a good chunk of it is meaningless hoop jumping irrelevant to practicing physicians. A competent practicing physician should breeze through a well designed certification exam. >I agree there’s a lot wrong with our current training paradigm; the cost of medical school education is #1 with several terrible downstream effects. >However, there are no shortcuts. You have to put in the time to master the material, else you are doing your patients a disservice. If someone who wants to be a geriatric doctor skips pediatrics I don't see the disservice. Or take someone like a registered Nurse Midwife. Someone with 20 years experience delivering babies. The only way for them to become competent to prescribe pitocin, antibiotics, or use forceps is 4 years and $200k worth of school? It doesn't pass the smell test.