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The medical school in the city I grew up in had a policy of taking the students with the highest marks in last year school exams. That was it, no other judgeme

• Clewza313 5y ago
  "What do you call the person that finishes last in medical school? Doctor." Somewhat less snarkily, I was under the impression that medical schools hate not graduating their students, so once you're in, basically anybody who can physically survive the grind will become a doctor. Is this incorrect?
  • nradov 5y ago
    In reality the person who finishes last in medical school is at serious risk of not being matched to a residency slot. So technically they're a doctor, but not able to practice medicine. Those people tend to go to work in related fields like pharmaceutical sales or hospital administration.
    • ThePadawan 5y ago
      I'm not from the US, so this comes from curiosity and lack of knowledge of the system: Doesn't that suck for everyone? In Germany, there is a (apparently) large generation gap of countryside doctors. The old ones retire, but no one young shows up to replace them, even though they are very well paid. But what 30 year old would want to live and work in a village of 5000? Is that scenario not applicable in the US, or are the jobs you mentioned simply still considered a better deal.
      • chrisseaton 5y ago
        > But what 30 year old would want to live and work in a village of 5000? Married with kids and want to move to the country to settle down. Isn’t that what a lot of 30-year-olds do? Especially middle class people like doctors.
        • ThePadawan 5y ago
          Well, there's probably no work for your wife, and the daycare or school are probably miles away. That kind of moves it from "settling down in the countryside" to "getting away from civilization entirely" territory. (That's speaking in broad generalizations, of course. This isn't the usual case, but there are broad parts of (especially Eastern) Germany that are depopulating rapidly since there are so few job opportunities)
          • chrisseaton 5y ago
            I guess that problem just went away with work-from-home though?
            • ThePadawan 5y ago
              I personally don't know, but I also can't imagine - German internet speeds outside of metropolitan areas is notoriously somewhere between non-existant and absolute garbage. https://breitbandmessung.de/kartenansicht https://breitbandmessung.de/kartenansicht has a scrollable map, but it doesn't say from when the measurements are, nor if "no coverage" means that there is no coverage, or if they have performed no measurements there. But you're probably lucky to get into the double digits of Mbps. Note how the whole map tops out at ">= 50Mbps".
              • pedrosorio 5y ago
                Good thing starlink service was made available in Germany earlier this year.
    • OrvalWintermute 5y ago
      Being last-ranked is not a guarantee not to interfere with a residency slot. There are many more factors that go into matching. Being picky on specialty, or location, is going to make a match more difficult. A Competitive specialty like Ortho, Radiology, or Radiation Oncology trying for a big city that is popular would be a hard fit. Due to how few Radiation Oncology programs there are, even a class valedictorian may not get in - there are just not that many slots. A less desirable specialty like family practice or internal medicine would be a much easier fit for a lower ranked candidate.
• tzs 5y ago
  > These days the medical schools try very hard to make the population of graduating doctors look like the population they are going to treat. I recall reading about some researchers that studied patients at a large walk-in clinic in a low income area. Both the set of patients and the set of doctors were diverse. Patients were randomly assigned to doctors. What they found was that patients were significantly more likely to follow the doctor's instructions after the visit (such as getting prescriptions filled, following the doctor's home care instructions, or coming back for follow ups) if the doctor was the same race/ethnic group as the patient.
  • pella 5y ago
    "Study Finds Patients Prefer Doctors Who Share Their Same Race/Ethnicity ; In an analysis of more than 100,000 patient surveys, Penn researchers found that patient-provider race concordance led to higher odds of receiving maximum patient experience scores" https://www.pennmedicine.org/news/news-releases/2020/november/study-finds-patients-prefer-doctors-who-share-their-same-race-ethnicity https://www.pennmedicine.org/news/news-releases/2020/novembe... https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2772682 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
    • docdocgoose 5y ago
      An important 2012 study found that higher patient satisfaction is correlated with higher costs and death. This is not counter intuitive if one has practiced medicine. Point being that healthcare isn’t a classic consumer product and social experiments like patient/provider concordance have complex effects. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1108766 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
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• rablackburn 5y ago
  > The results are not achieved by different standards for graduation, but by different standards for admission. This is the key callout I think. It allows you to address representation problems while sidestepping opposing arguments about graduate quality. Do it in rounds, unfilled spots open up to anyone. If your child really wants to be a doctor but can’t get a spot, well, I’m sure that increased demand for medical spots means you’re willing to pay more, and the University can use that to expand their medical program. Or you can send them to another university. This seems like a reasonable approach to improving systemic inequalities without causing systemic harm.
  • babesh 5y ago
    If there is a positive correlation between admission standards and graduate ability, what you have done is lowered the average but left it above the bar (assuming that the bar isn't curved). There is still the question as to whether certain admission standards are actually correlated with graduate ability. I wonder if there is a way to find out?
    • rablackburn 5y ago
      You mean if there is a positive causation ;) But yeah, I think the difficulty of sociology makes it tough to reason about these issues in a comprehensive, logical way. And it's so hard to experimentally prove _anything_ when proving the counterfactual is "well, we'd need to split reality into two and wait 50 years".
• babesh 5y ago
  Aren't there already lowered standards for graduation for many Ivy leagues? https://www.theodysseyonline.com/ivy-leagues-grade-inflation-problem https://www.theodysseyonline.com/ivy-leagues-grade-inflation... I guess the other possibilities are that the students have gotten better or have optimized for the system? This author says that the students were complaining and not because they were getting better. https://qz.com/157579/confession-of-an-ivy-league-teaching-assistant-heres-why-i-inflated-grades/ https://qz.com/157579/confession-of-an-ivy-league-teaching-a... This article says that the students haven't gotten better either. https://uvachemistry.com/2014/12/13/the-causes-and-consequences-of-grade-inflation/ https://uvachemistry.com/2014/12/13/the-causes-and-consequen...
• actually_a_dog 5y ago
  > So the policy was abandoned for a more rounded approach. This was the exact pretext used by Harvard in the early 20th century to reduce the number of Jews in attendance. > As the sociologist Jerome Karabel writes in “The Chosen” (Houghton Mifflin; $28), his remarkable history of the admissions process at Harvard, Yale, and Princeton, that meritocratic spirit soon led to a crisis. The enrollment of Jews began to rise dramatically. By 1922, they made up more than a fifth of Harvard’s freshman class. The administration and alumni were up in arms. Jews were thought to be sickly and grasping, grade-grubbing and insular. They displaced the sons of wealthy Wasp alumni, which did not bode well for fund-raising. A. Lawrence Lowell, Harvard’s president in the nineteen-twenties, stated flatly that too many Jews would destroy the school: “The summer hotel that is ruined by admitting Jews meets its fate . . . because they drive away the Gentiles, and then after the Gentiles have left, they leave also.” > The difficult part, however, was coming up with a way of keeping Jews out, because as a group they were academically superior to everyone else. Lowell’s first idea—a quota limiting Jews to fifteen per cent of the student body—was roundly criticized. Lowell tried restricting the number of scholarships given to Jewish students, and made an effort to bring in students from public schools in the West, where there were fewer Jews. Neither strategy worked. Finally, Lowell—and his counterparts at Yale and Princeton—realized that if a definition of merit based on academic prowess was leading to the wrong kind of student, the solution was to change the definition of merit. Karabel argues that it was at this moment that the history and nature of the Ivy League took a significant turn. > The admissions office at Harvard became much more interested in the details of an applicant’s personal life. Lowell told his admissions officers to elicit information about the “character” of candidates from “persons who know the applicants well,” and so the letter of reference became mandatory. Harvard started asking applicants to provide a photograph. Candidates had to write personal essays, demonstrating their aptitude for leadership, and list their extracurricular activities. https://www.newyorker.com/magazine/2005/10/10/getting-in https://www.newyorker.com/magazine/2005/10/10/getting-in https://archive.is/qrLqE#selection-689.0-727.785 https://archive.is/qrLqE#selection-689.0-727.785
• usaar333 5y ago
  It's so nice to be in tech where comparatively we let the free market figure out how to properly evaluate candidates; many companies have moved away from pure algorithm problems (the equivalent of testing) because relying solely on them misses a lot of important factors. The fundamental problem with medicine that creates these dynamics is artificial supply constraints created by licensing regimes (I've yet to figure out how or why a MD is so much better than a PA for family medicine). Absent that, the market would just figure things out. There's no particular reason to believe high test scores are 100% correlated with future doctor quality given that lots of other factors go into being a doctor - and yet medical schools have historically relied on this. On the other hand, there's also no particular reason to believe the best doctors will be equally distributed across whatever splicing and dicing of the population you perform.
• satellite2 5y ago
  > These days the medical schools try very hard to make the population of graduating doctors look like the population they are going to treat So > 70 yo graduates?
  • williamtwild 5y ago
    Are you being serious? Did you not know they meant the ethnic diversity of the class?
    • satellite2 5y ago
      They didn't mean that you need diabetes to get your diploma?
      • K5EiS 5y ago
        You need diabetes type 1 and 2!
• 908B64B197 5y ago
  > So the policy was abandoned for a more rounded approach. These days the medical schools try very hard to make the population of graduating doctors look like the population they are going to treat. So you know that the bar was lowered if they aren't from ethnicity X. Interesting. Is that the doctor you want for you, or your loved ones? > The results are not achieved by different standards for graduation, but by different standards for admission. That's debatable.
  • worik 5y ago
    No, not debatable. Unless you debate with alternative facts