4 ms·

There is a kernel of truth to this, disproportionate sure, but I think majority is a bit over the top. There are plenty in medicine aware of this, antisocial be

by bohner 3y ago

There is a kernel of truth to this, disproportionate sure, but I think majority is a bit over the top. There are plenty in medicine aware of this, antisocial behavior and toxicity in general, there’s a lot of crying that goes on from medical school throughout training. You can easily have a rich social life throughout training but the process doesn’t effectively filter out the trainwrecks either.

AmericanChopper 3y ago
> You can easily have a rich social life throughout training This is the complete opposite of my experience, and I’d be very surprised if there were any med schools where this was legitimately possible. When my wife was in med school she had about 40 hours of course work per week, and the curriculum was so dense that she spent nearly all the rest of her time studying. She worked (a job) 10 hours a week during med school and we’d be lucky to have a couple of hours of dedicated time together per week. Most of the time we spent together was when I’d help her with revising. During semester breaks she had mandatory placements to complete, and her school operated classes on all public holidays. It only eased for a couple of months between academic years (when she also had a non-trivial study workload to get through). During her residency this got worse when she had irregular 18+ hour shifts to get through, and just wanted to spend most of her time at home sleeping. This was the same experience that all of her peers had, so either you or my wife must have had an atypical academic experience, or you have a substantially different definition of “rich social life” than I do. > There are plenty in medicine aware of this, antisocial behavior and toxicity in general To be clear I’m not referring to toxicity necessarily, or antisocial as in being destructive or disruptive. I mean averse to social settings, and not capable of or interested in participating in normal pro social behaviour. Nearly all of her peers at med school had these characteristics, if somebody told me that 90% of doctors had some form of autism, I really wouldn’t have a hard time believing it. This is very similar to the experience I had in all of my maths, physics and comp sci papers at college, and to my subsequent experience working in software development. Granted it’s not quite as severe in that setting, but the poorly socialised software engineer stereotype didn’t just materialise out of thin air. People do find these highly contrived LLM outputs to be insightful for their “perspectives” on compassion or empathy, which is totally unrelatable for me, but this just seems like a reasonably plausible explanation.
- bohner 3y ago
  > This is the complete opposite of my experience, and I’d be very surprised if there were any med schools where this was legitimately possible. Well then your experience is limited. Most people don’t work a job in medical school, so that’s time right there. Also the format of US medical school has changed considerably in the last 20 years. There is plenty of free time in the preclinical years, very few attend lecture (preferring to use a number of commercial review/prep product), there are usually only a few hours a week of mandatory team based learning groups and some hours of labs, this format is overwhelmingly common now in the US. Time management is also a large factor, some are better prepared to deal with the gauntlet. Clinical years will have periods of intensity but usually for few week stretches, surgery clerkship might be intense, but psychiatry which is also at least 6 weeks will often be close to 9 to 5 with free weekends or even less. Time during residency training is extremely specialty and program dependent. Is your wife OB/GYN or general surgery, that’s very different than medicine, anesthesia or dermatology. > Nearly all of her peers at med school had these characteristics, if somebody told me that 90% of doctors had some form of autism, I really wouldn’t have a hard time believing it. Yeah whatever. There’s a lot of pricks and socially awkward people in medicine but a majority are primarily still interested in going into a service oriented industry working with people. Just because some idiot with something to sell posts an apocryphal story about ChatGPT doesn’t prove your point. Having worked in both tech and medicine your take is just selection bias and a limited view. Such a verbose response to say very little as well.
  - AmericanChopper 3y ago
    > Also the format of US medical school has changed considerably in the last 20 years. There is plenty of free time in the preclinical years You're right about that, it's gotten worse. The perspective you're offering here contradicts basically all documented perspectives on the intensity and time demands of medical training. > Concerns about excessive content and curricular overcrowding in medical education have existed for more than a century. In 1910, Abraham Flexner noted that the packed medical school curriculum would “tax the memory, not the intellect.”1 The Rappleye Commission Report on Medical Education published in 1932 stated that “the almost frantic attempts to put into the medical course teaching in all phases of scientific and medical knowledge, and the tenacity with which traditional features of teaching are retained have been responsible for great rigidity, overcrowding, and a lack of proper balance in the training.”2 Since then, periodic concerns have been raised about this ongoing problem, notably in the Association of American Medical Colleges' Panel on the General Professional Education of the Physician (GPEP report) in 1984 and the Assessing Change in Medical Education (ACME-TRI) report in 1993, among others.3-6 > The problem has only worsened in the years preceding the pandemic. New pharmaceutical agents seem to appear daily, while our understanding of pathophysiology of disease continues to expand. In addition, we have needed to consider new and vital subjects such as cultural competence, care of LGBTQ patients, teamwork and interprofessional care, health care quality and safety, medical humanities, narrative medicine, and even wellness curricula, that have added pressure to the preclerkship phase of medical school, as ever more content is added. And little has been removed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463236/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463236/ The relationship between empathy and burn out (especially in clinical practice) is also very well established. The whole system has a very strong selection against empathetic practitioners, whether through burning them out, or selecting a preference for their less empathetic peers.

by bohner 3y ago

AmericanChopper 3y ago

> You can easily have a rich social life throughout training This is the complete opposite of my experience, and I’d be very surprised if there were any med schools where this was legitimately possible. When my wife was in med school she had about 40 hours of course work per week, and the curriculum was so dense that she spent nearly all the rest of her time studying. She worked (a job) 10 hours a week during med school and we’d be lucky to have a couple of hours of dedicated time together per week. Most of the time we spent together was when I’d help her with revising. During semester breaks she had mandatory placements to complete, and her school operated classes on all public holidays. It only eased for a couple of months between academic years (when she also had a non-trivial study workload to get through). During her residency this got worse when she had irregular 18+ hour shifts to get through, and just wanted to spend most of her time at home sleeping. This was the same experience that all of her peers had, so either you or my wife must have had an atypical academic experience, or you have a substantially different definition of “rich social life” than I do. > There are plenty in medicine aware of this, antisocial behavior and toxicity in general To be clear I’m not referring to toxicity necessarily, or antisocial as in being destructive or disruptive. I mean averse to social settings, and not capable of or interested in participating in normal pro social behaviour. Nearly all of her peers at med school had these characteristics, if somebody told me that 90% of doctors had some form of autism, I really wouldn’t have a hard time believing it. This is very similar to the experience I had in all of my maths, physics and comp sci papers at college, and to my subsequent experience working in software development. Granted it’s not quite as severe in that setting, but the poorly socialised software engineer stereotype didn’t just materialise out of thin air. People do find these highly contrived LLM outputs to be insightful for their “perspectives” on compassion or empathy, which is totally unrelatable for me, but this just seems like a reasonably plausible explanation.

bohner 3y ago
> This is the complete opposite of my experience, and I’d be very surprised if there were any med schools where this was legitimately possible. Well then your experience is limited. Most people don’t work a job in medical school, so that’s time right there. Also the format of US medical school has changed considerably in the last 20 years. There is plenty of free time in the preclinical years, very few attend lecture (preferring to use a number of commercial review/prep product), there are usually only a few hours a week of mandatory team based learning groups and some hours of labs, this format is overwhelmingly common now in the US. Time management is also a large factor, some are better prepared to deal with the gauntlet. Clinical years will have periods of intensity but usually for few week stretches, surgery clerkship might be intense, but psychiatry which is also at least 6 weeks will often be close to 9 to 5 with free weekends or even less. Time during residency training is extremely specialty and program dependent. Is your wife OB/GYN or general surgery, that’s very different than medicine, anesthesia or dermatology. > Nearly all of her peers at med school had these characteristics, if somebody told me that 90% of doctors had some form of autism, I really wouldn’t have a hard time believing it. Yeah whatever. There’s a lot of pricks and socially awkward people in medicine but a majority are primarily still interested in going into a service oriented industry working with people. Just because some idiot with something to sell posts an apocryphal story about ChatGPT doesn’t prove your point. Having worked in both tech and medicine your take is just selection bias and a limited view. Such a verbose response to say very little as well.
- AmericanChopper 3y ago
  > Also the format of US medical school has changed considerably in the last 20 years. There is plenty of free time in the preclinical years You're right about that, it's gotten worse. The perspective you're offering here contradicts basically all documented perspectives on the intensity and time demands of medical training. > Concerns about excessive content and curricular overcrowding in medical education have existed for more than a century. In 1910, Abraham Flexner noted that the packed medical school curriculum would “tax the memory, not the intellect.”1 The Rappleye Commission Report on Medical Education published in 1932 stated that “the almost frantic attempts to put into the medical course teaching in all phases of scientific and medical knowledge, and the tenacity with which traditional features of teaching are retained have been responsible for great rigidity, overcrowding, and a lack of proper balance in the training.”2 Since then, periodic concerns have been raised about this ongoing problem, notably in the Association of American Medical Colleges' Panel on the General Professional Education of the Physician (GPEP report) in 1984 and the Assessing Change in Medical Education (ACME-TRI) report in 1993, among others.3-6 > The problem has only worsened in the years preceding the pandemic. New pharmaceutical agents seem to appear daily, while our understanding of pathophysiology of disease continues to expand. In addition, we have needed to consider new and vital subjects such as cultural competence, care of LGBTQ patients, teamwork and interprofessional care, health care quality and safety, medical humanities, narrative medicine, and even wellness curricula, that have added pressure to the preclerkship phase of medical school, as ever more content is added. And little has been removed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463236/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463236/ The relationship between empathy and burn out (especially in clinical practice) is also very well established. The whole system has a very strong selection against empathetic practitioners, whether through burning them out, or selecting a preference for their less empathetic peers.