5 ms·

Medical schools require a lot of volunteering and things like 'slinging hot dogs to pay tuition' don't count unless you grew up without clothes surviving on rab

Medical schools require a lot of volunteering and things like 'slinging hot dogs to pay tuition' don't count unless you grew up without clothes surviving on rabid dogs in the holler of W Virginia working the coal mines from age 8. We all know who has time to volunteer or do minimum wage healthcare instead of work the best paying shitty side job they can get: the rich. It's set up heavily tilted so you have to be rich, or dirt poor enough for a sob story, or a desired minority. Even if you do volunteer a lot and are middle class, you probably didnt know anyone that could help you into the most prestigious positions. A middle class person of equal aptitude would likely go into something like engineering or law which have fewer class-signalling non-academic purity tests.

alistairSH 6mo ago
That gating on medical training has always been there (at least for 40 years, if not more). But the number of doctors from doctor families has increased. And just generally, socioeconomic mobility has decreased in the US across the population.
- mothballed 6mo ago
  Always been gated. But the slider has been dragged even further in the purity test direction. The intelligent un-pure now tend to become NP or PA, those programs still let you practice independently and slide more towards academics and less at whether a rich person set you up to be taken care of while you play mother Teresa until the switch flips the day you are accepted.
triceratops 6mo ago
> Medical schools require a lot of volunteering But...why? Why not just let in the applicants that have the best grades?
- Plasmoid 6mo ago
  Because there are so many applicants that have good grades. A more cynical view is that the governing boards want a way to pick and choose who they let in. So they create "holistic" application systems to get "360 degree view of the candidate".
  - triceratops 6mo ago
    > Because there are so many applicants that have good grades. So train more doctors.
    - waterhouse 6mo ago
      That would increase competition and thus depress wages for existing doctors, who are the ones who make the decisions here. I heard, from a medical school attendee, that she overheard some doctors discussing whether it would be a good idea to require a fifth year of medical school to become a general practitioner (luckily, they were like, "Eh... nah"). It did not seem like it bothered them that this would make it even harder for civilians to get medical care.
      - triceratops 6mo ago
        I thought lawmakers made the decisions. Silly me! :-D
        waterhouse 6mo ago
        Theoretically yes. But I think at least part of the decision they've made is to delegate a chunk of the decisionmaking to doctors' guilds. Which—on the one hand, they are experts of a sort, but on the other hand, they have an obvious conflict of interest. https://en.wikipedia.org/wiki/American_Medical_Association#Restrictions_on_physician_supply https://en.wikipedia.org/wiki/American_Medical_Association#R... Wow. 1997: https://www.baltimoresun.com/1997/03/01/ama-seeks-limit-on-residents-to-prevent-glut-of-new-doctors-shortage-of-physicians-in-inner-cities-continues/ https://www.baltimoresun.com/1997/03/01/ama-seeks-limit-on-r... > “The United States is on the verge of a serious oversupply of physicians,” the AMA and five other medical groups said in a joint statement. “The current rate of physician supply — the number of physicians entering the work force each year — is clearly excessive.” > The groups, representing a large segment of the medical establishment, proposed limits on the number of doctors who become residents each year. > The number of medical residents, now 25,000, should be much lower, the groups said. While they did not endorse a specific number, they suggested that 18,700 might be appropriate.
- andrew_lettuce 6mo ago
  Because everybody has the same gamified, inflated high grades

alistairSH 6mo ago

That gating on medical training has always been there (at least for 40 years, if not more). But the number of doctors from doctor families has increased. And just generally, socioeconomic mobility has decreased in the US across the population.

mothballed 6mo ago
Always been gated. But the slider has been dragged even further in the purity test direction. The intelligent un-pure now tend to become NP or PA, those programs still let you practice independently and slide more towards academics and less at whether a rich person set you up to be taken care of while you play mother Teresa until the switch flips the day you are accepted.

triceratops 6mo ago

> Medical schools require a lot of volunteering But...why? Why not just let in the applicants that have the best grades?

Plasmoid 6mo ago
Because there are so many applicants that have good grades. A more cynical view is that the governing boards want a way to pick and choose who they let in. So they create "holistic" application systems to get "360 degree view of the candidate".
- triceratops 6mo ago
  > Because there are so many applicants that have good grades. So train more doctors.
  - waterhouse 6mo ago
    That would increase competition and thus depress wages for existing doctors, who are the ones who make the decisions here. I heard, from a medical school attendee, that she overheard some doctors discussing whether it would be a good idea to require a fifth year of medical school to become a general practitioner (luckily, they were like, "Eh... nah"). It did not seem like it bothered them that this would make it even harder for civilians to get medical care.
    - triceratops 6mo ago
      I thought lawmakers made the decisions. Silly me! :-D
      - waterhouse 6mo ago
        Theoretically yes. But I think at least part of the decision they've made is to delegate a chunk of the decisionmaking to doctors' guilds. Which—on the one hand, they are experts of a sort, but on the other hand, they have an obvious conflict of interest. https://en.wikipedia.org/wiki/American_Medical_Association#Restrictions_on_physician_supply https://en.wikipedia.org/wiki/American_Medical_Association#R... Wow. 1997: https://www.baltimoresun.com/1997/03/01/ama-seeks-limit-on-residents-to-prevent-glut-of-new-doctors-shortage-of-physicians-in-inner-cities-continues/ https://www.baltimoresun.com/1997/03/01/ama-seeks-limit-on-r... > “The United States is on the verge of a serious oversupply of physicians,” the AMA and five other medical groups said in a joint statement. “The current rate of physician supply — the number of physicians entering the work force each year — is clearly excessive.” > The groups, representing a large segment of the medical establishment, proposed limits on the number of doctors who become residents each year. > The number of medical residents, now 25,000, should be much lower, the groups said. While they did not endorse a specific number, they suggested that 18,700 might be appropriate.
andrew_lettuce 6mo ago
Because everybody has the same gamified, inflated high grades