7 ms·

> For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world Rest of the world, yes. Rest of the deve

by rscho 5y ago

> For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world Rest of the world, yes. Rest of the developed world, not at all. The major difference is that becoming a doc in the US is much more expensive than pretty much anywhere else. You could also argue it's proportionally harder because of the more numerous competitors. But on an absolute level of knowledge and capability no, it's not harder than say, in western european countries.

whiddershins 5y ago
I believe it takes longer in the US, when all is said and done. It’s hard to casually verify this because each country uses different terms and has a different track but I think, when you include the various phases of training, starting from the bachelors degree, the US one is more total years. Edit: So for example the UK and France don’t appear to require any sort of bachelor’s degree as a prerequisite for medical. Which saves you 4 years on average. So their tracks may be longer but you can start sooner.
- jimnotgym 5y ago
  Citation definitely needed here And just to be sure, I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine. I note this Wikipedia article that suggests 4 years messed school plus 1 year internship could get me a license in the US. That sounds like Western Europe to me. Or India... https://en.m.wikipedia.org/wiki/Medical_education_in_the_United_States https://en.m.wikipedia.org/wiki/Medical_education_in_the_Uni...
  - triceratops 5y ago
    > I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine. Why? An apples-to-apples comparison would be to see how long it takes to become a general physician after completing secondary school. In the UK or India it's something like 5.5-6 years.[1] In the US it's 3-4 years of "pre-med", then 4 years of med school. That's from the article you referred. 1. https://en.wikipedia.org/wiki/Medical_school_in_the_United_Kingdom https://en.wikipedia.org/wiki/Medical_school_in_the_United_K...
    - bialpio 5y ago
      > Why? An apples-to-apples comparison would be to see how long it takes to become a general physician after completing secondary school. Because if the requirement in the US is indeed "bachelor's degree required, any will do", then it exists solely for gate-keeping and says nothing about the standards of education. Edit: looking at wiki, the requirements are actually a bit more reasonable, but it does seem strange that they are not just rolled into the first year (or two) of medical degree. Why force people to finish undergrad studies if only a few courses are relevant?
      - kaesar14 5y ago
        Of the people who attempt the pre-med track not all will make it. Forcing students to get an actual Bachelor's degree gives students some fallback. I think really it's just the system was built this way and nobody's going to change it now.
        bialpio 5y ago
        > Forcing students to get an actual Bachelor's degree gives students some fallback. That may be one reason, but seems to me that it doesn't really raise the standard of education. So it doesn't really help with proving that "US > the world" in this aspect. I imagine you could still fall-back from medical college to undergrad & get credit for the completed coursework that is relevant towards the Bachelor's degree you fall-back to. This way, you don't incur unnecessary costs on folks who succeed. > I think really it's just the system was built this way and nobody's going to change it now. Channeling my inner cynic: nothing's going to change given that the decision-makers benefit financially from the system being set up like this.
        gowld 5y ago
        They can switch to a Bachelors when they transfer off the med track.
      - ameister14 5y ago
        Some universities in the US offer a 7 year undergrad and medical degree. Those usually have an extremely high GPA requirement but it's possible to do just that.
- trosi 5y ago
  I'll bring an example for the sake of comparison. In Italy the path to becoming a physician involves a six year degree focused entirely on medicine (so not a bachelor), followed by a specialized degree of variable length (4-6 years depending on the chosen specialty) during which you practice in a hospital and study for exams at the same time, mostly the former. Entrance exams are required at both levels and acceptance rates are very low. Also, many students end up needing 1-2 extra years to complete it all.
- rscho 5y ago
  Well, I can answer that very clearly from personal experience: you are wrong. Medical education is much shorter in the US compared to most western countries. You have to understand that in medicine, school years are not all there is to it. The real issue is when do you get to truly practice without supervision, and that's much earlier in the US. Basically, a short residency and 1-2 years of fellowship and... done! In Europe, you're still a junior at 35.
  - triceratops 5y ago
    > The real issue is when do you get to truly practice without supervision, and that's much earlier in the US. Is it? If a doctor in the UK can graduate from medical school and practice as a GP 6 years out of secondary school, but for a US doctor it takes 8-9 years, it's not really "earlier". What you're talking about is status within the profession.
    - rscho 5y ago
      For GPs, it may be true. I admit I was speaking from the POV of a specialist.
HDMI_Cable 5y ago
It really is harder in the US. The standards are much higher in the US than anywhere else. The US only accepts doctors who went to Canadian or American medical schools. And then on top of that, it is much harder to get into a medical school here in NA than practically anywhere else, except maybe India. I know that in the UK you can go directly from high school, meanwhile in the US & Canada you need a 515 MCAT, 3.7 GPA, and lab time to even get in to a mid-range school.
- alistairSH 5y ago
  The US only accepts doctors who went to Canadian or American medical schools. That's absolutely not true. Foreign medical graduates do have to take the US board exams, complete a US-based residency, and possibly take additional courses to fill educational gaps, but they absolutely can practice in the US with a foreign medical degree.
  - signal11 5y ago
    Here's an article that describes the pathway by which foreign doctors can get a medical license in the US: https://www.voanews.com/student-union/how-indian-doctors-get-medical-license-us https://www.voanews.com/student-union/how-indian-doctors-get... In brief, they have to sit the MLE (medical licensing exams), but the real hurdle is getting into a US-based residency program beforehand. In practice, this means only the best candidates tend to make it.
  - JamesBarney 5y ago
    -> complete a US-based residency This is the kicker. There are incredibly difficult to get, they are incredibly stressful, and it's another 3-5 years of your life. If you allowed any non-us developers to practice in the US but you made them work a 5 year 80hr/week internship for 1/6th of what professional developers made first, that basically bans non-us developers from writing code in the U.S.
    - alistairSH 5y ago
      Absolutely. And that's due to AMA lobbying in the 90s. It doesn't have anything much to do with stringency of US medical licensing or ensuring quality and everything to do with existing MDs protecting their lucrative practices.
KptMarchewa 5y ago
Isn't the problem that US requires having bachelor's degree before you even can start studying medicine, which effectively makes people start 4 years later?
- rscho 5y ago
  The question is not "when do you leave school?" it's actually "when are you employable as an independent practitioner?". In my personal experience, it's _much_ easier to get an attending/private practice position in the US at a younger age. Just because the country is huge and lots of places lack docs, probably. Of course, that's my experience and I could be wrong.
  - opo 5y ago
    Just because there is a Dr shortage in the US due to having a limited number of medical schools, there are still thousands of students who get their degree and can't find a residency: >.... The matching challenge comes as the U.S. faces a physician shortage. The nation could be short as many as 139,000 physicians by 2033, according to the Times, which cites Association of American Medical Colleges data. Despite this shortage, thousands of medical school graduates are consistently rejected from residency experience, rendering their MD or DO "virtually useless," according to the report. https://www.beckershospitalreview.com/hospital-physician-relationships/thousands-of-physicians-can-t-get-into-residency-programs-4-things-to-know.html https://www.beckershospitalreview.com/hospital-physician-rel...
    - phobosanomaly 5y ago
      That must be understood in the context of the number of applicants to U.S. residency programs from Caribbean medical schools (which are well-known to be a little predatory). From that article you cited: International medical graduates in particular have low match rates for residency programs. American medical students have a 94 percent match rate, according to the Times, which cites information from the National Resident Matching Program. However, Americans who study at international medical schools have a match rate of 61 percent." Kids from the U.S. get sold on a Caribbean M.D. school, and spend thousands and thousands of dollars only to find out that things get really complicated when it comes time to do clerkship rotations or apply to residency. An M.D. or a D.O. from a school on U.S. soil is definitely not useless, and your chances at matching a residency are extremely high, as cited above.

by rscho 5y ago

whiddershins 5y ago

I believe it takes longer in the US, when all is said and done. It’s hard to casually verify this because each country uses different terms and has a different track but I think, when you include the various phases of training, starting from the bachelors degree, the US one is more total years. Edit: So for example the UK and France don’t appear to require any sort of bachelor’s degree as a prerequisite for medical. Which saves you 4 years on average. So their tracks may be longer but you can start sooner.

jimnotgym 5y ago
Citation definitely needed here And just to be sure, I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine. I note this Wikipedia article that suggests 4 years messed school plus 1 year internship could get me a license in the US. That sounds like Western Europe to me. Or India... https://en.m.wikipedia.org/wiki/Medical_education_in_the_United_States https://en.m.wikipedia.org/wiki/Medical_education_in_the_Uni...
- triceratops 5y ago
  > I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine. Why? An apples-to-apples comparison would be to see how long it takes to become a general physician after completing secondary school. In the UK or India it's something like 5.5-6 years.[1] In the US it's 3-4 years of "pre-med", then 4 years of med school. That's from the article you referred. 1. https://en.wikipedia.org/wiki/Medical_school_in_the_United_Kingdom https://en.wikipedia.org/wiki/Medical_school_in_the_United_K...
  - bialpio 5y ago
    > Why? An apples-to-apples comparison would be to see how long it takes to become a general physician after completing secondary school. Because if the requirement in the US is indeed "bachelor's degree required, any will do", then it exists solely for gate-keeping and says nothing about the standards of education. Edit: looking at wiki, the requirements are actually a bit more reasonable, but it does seem strange that they are not just rolled into the first year (or two) of medical degree. Why force people to finish undergrad studies if only a few courses are relevant?
    - kaesar14 5y ago
      Of the people who attempt the pre-med track not all will make it. Forcing students to get an actual Bachelor's degree gives students some fallback. I think really it's just the system was built this way and nobody's going to change it now.
      - bialpio 5y ago
        > Forcing students to get an actual Bachelor's degree gives students some fallback. That may be one reason, but seems to me that it doesn't really raise the standard of education. So it doesn't really help with proving that "US > the world" in this aspect. I imagine you could still fall-back from medical college to undergrad & get credit for the completed coursework that is relevant towards the Bachelor's degree you fall-back to. This way, you don't incur unnecessary costs on folks who succeed. > I think really it's just the system was built this way and nobody's going to change it now. Channeling my inner cynic: nothing's going to change given that the decision-makers benefit financially from the system being set up like this.
      - gowld 5y ago
        They can switch to a Bachelors when they transfer off the med track.
    - ameister14 5y ago
      Some universities in the US offer a 7 year undergrad and medical degree. Those usually have an extremely high GPA requirement but it's possible to do just that.
trosi 5y ago
I'll bring an example for the sake of comparison. In Italy the path to becoming a physician involves a six year degree focused entirely on medicine (so not a bachelor), followed by a specialized degree of variable length (4-6 years depending on the chosen specialty) during which you practice in a hospital and study for exams at the same time, mostly the former. Entrance exams are required at both levels and acceptance rates are very low. Also, many students end up needing 1-2 extra years to complete it all.
rscho 5y ago
Well, I can answer that very clearly from personal experience: you are wrong. Medical education is much shorter in the US compared to most western countries. You have to understand that in medicine, school years are not all there is to it. The real issue is when do you get to truly practice without supervision, and that's much earlier in the US. Basically, a short residency and 1-2 years of fellowship and... done! In Europe, you're still a junior at 35.
- triceratops 5y ago
  > The real issue is when do you get to truly practice without supervision, and that's much earlier in the US. Is it? If a doctor in the UK can graduate from medical school and practice as a GP 6 years out of secondary school, but for a US doctor it takes 8-9 years, it's not really "earlier". What you're talking about is status within the profession.
  - rscho 5y ago
    For GPs, it may be true. I admit I was speaking from the POV of a specialist.

HDMI_Cable 5y ago

It really is harder in the US. The standards are much higher in the US than anywhere else. The US only accepts doctors who went to Canadian or American medical schools. And then on top of that, it is much harder to get into a medical school here in NA than practically anywhere else, except maybe India. I know that in the UK you can go directly from high school, meanwhile in the US & Canada you need a 515 MCAT, 3.7 GPA, and lab time to even get in to a mid-range school.

alistairSH 5y ago
The US only accepts doctors who went to Canadian or American medical schools. That's absolutely not true. Foreign medical graduates do have to take the US board exams, complete a US-based residency, and possibly take additional courses to fill educational gaps, but they absolutely can practice in the US with a foreign medical degree.
- signal11 5y ago
  Here's an article that describes the pathway by which foreign doctors can get a medical license in the US: https://www.voanews.com/student-union/how-indian-doctors-get-medical-license-us https://www.voanews.com/student-union/how-indian-doctors-get... In brief, they have to sit the MLE (medical licensing exams), but the real hurdle is getting into a US-based residency program beforehand. In practice, this means only the best candidates tend to make it.
- JamesBarney 5y ago
  -> complete a US-based residency This is the kicker. There are incredibly difficult to get, they are incredibly stressful, and it's another 3-5 years of your life. If you allowed any non-us developers to practice in the US but you made them work a 5 year 80hr/week internship for 1/6th of what professional developers made first, that basically bans non-us developers from writing code in the U.S.
  - alistairSH 5y ago
    Absolutely. And that's due to AMA lobbying in the 90s. It doesn't have anything much to do with stringency of US medical licensing or ensuring quality and everything to do with existing MDs protecting their lucrative practices.

KptMarchewa 5y ago

Isn't the problem that US requires having bachelor's degree before you even can start studying medicine, which effectively makes people start 4 years later?

rscho 5y ago
The question is not "when do you leave school?" it's actually "when are you employable as an independent practitioner?". In my personal experience, it's _much_ easier to get an attending/private practice position in the US at a younger age. Just because the country is huge and lots of places lack docs, probably. Of course, that's my experience and I could be wrong.
- opo 5y ago
  Just because there is a Dr shortage in the US due to having a limited number of medical schools, there are still thousands of students who get their degree and can't find a residency: >.... The matching challenge comes as the U.S. faces a physician shortage. The nation could be short as many as 139,000 physicians by 2033, according to the Times, which cites Association of American Medical Colleges data. Despite this shortage, thousands of medical school graduates are consistently rejected from residency experience, rendering their MD or DO "virtually useless," according to the report. https://www.beckershospitalreview.com/hospital-physician-relationships/thousands-of-physicians-can-t-get-into-residency-programs-4-things-to-know.html https://www.beckershospitalreview.com/hospital-physician-rel...
  - phobosanomaly 5y ago
    That must be understood in the context of the number of applicants to U.S. residency programs from Caribbean medical schools (which are well-known to be a little predatory). From that article you cited: International medical graduates in particular have low match rates for residency programs. American medical students have a 94 percent match rate, according to the Times, which cites information from the National Resident Matching Program. However, Americans who study at international medical schools have a match rate of 61 percent." Kids from the U.S. get sold on a Caribbean M.D. school, and spend thousands and thousands of dollars only to find out that things get really complicated when it comes time to do clerkship rotations or apply to residency. An M.D. or a D.O. from a school on U.S. soil is definitely not useless, and your chances at matching a residency are extremely high, as cited above.