I think communication skills, negotiation etc is a huge thing to look for!
I feel as a primary care doc basically my day is negotiation- with patients, insurance, other docs/ specialists etc etc. trying to get the best care we can figure out for each individual person.
You HAVE to be able to communicate and many more of this younger generation who have never had a job in the “real world” (ie not a lab) have not learned this skill, although many older specialists seem to not have it either, to be honest. I have many patients that will make appt with me after they see the specialist so I can translate the medical-speak and try to answer their questions.
I concur on the level that working in retail (particularly the specialty running store where I worked) was more useful as a preparation for medicine than doing research or volunteering.
I don't know how you assess ethics, but maybe the more tangible thing is civics. Whatever tests we use for entry into medical school could test content on how licensing and malpractice and insurance and such work, because a surprising number of doctors do not actually know very much about their own profession. And I don't know how you even frame an ethical question without understanding that medicine is a legal construct and we all operate within it.
Another great video. Agree that more needs to be done to promote critical thinking skills in medical students and develop further during training. The entire system selects for and promotes obedience and compliance, creating a medical profession that is too susceptible to propaganda and manipulation. I was fortunate to train in a time and in places where challenging the diagnoses and opinions of others, even those more senior, was encouraged.
Vinay, I agree that research should not be a prerequisite for medical school, but having directed the research of many fine undergraduate students, I think that there is great value in having them wrestle with experiments that do not work, beat their heads against the wall and then troubleshoot their way to success. It teaches them persistence, patience, and critical thinking. Then interacting with data and presenting their work at scientific meetings helps them cultivate poise, careful thought, and the humility to say, “I don’t know,” or “that’s a great idea, I hadn’t thought about that.” So while research should not be required, good research, well done should be given some positive consideration.
Confused about “economic opportunities.” Are you saying you would score up someone who had less? If someone comes from a two parent home where those parents worked very hard to give that child a good education, and pay for it in full, why should that student be penalized? Also-elephant in the room-big elephant is race, gender, underrepresented minorities.
One of your “obvious” statements about dumb research, the one about daily shower, may not be so cut-and-dried as you think. In fact, questioning it is the point of this article:
I have two sons. One got into medical school. The other did not and became a nurse. Different people and I think life often turns out ok for individuals as time goes on. Our physician son, however, a head and neck surgery resident works incredibly hard covering three hospitals at night for a week at a time. I think kids going into medicine need to understand the demands on their stamina and that there is little free family time. His brother has a more relaxed and predictable life.
Well said, so true. Ultra-processed medicine is like ultra-processed food—many essential qualities you mentioned (humility, curiosity, service) get milled out in the selection and making. Too many doctors come out of the pipeline ready to plug a healthcare machine following brain dead consensus policies corrupted by cash. The final product is mediocre, expensive, and very unhealthy in many cases.
It is extremely difficult for one who trained 1974-1982 to understand the affinity of younger colleagues for “guidelines”, affinity so strong that they will advocate for doing the wrong thing because someone wrote it down.
I could listen to you all day. So logical, Intelligent, informed, experienced and willing to challenge what needs to be challenged for the improvement of medicine. So rare today. Thank you.
I vote for: problem solving abilities, curiosity and affinity and affection for their fellow humans. I also “like” well roundedness. These are challenging to measure objectively but you recognize when you see it.
But the superficial bogus activism being encouraged these days from premed and med students was never a thing in my day. We see mindless activism now in the form of outright radical baseless resolutions being put forth in organized medicine, in large part from the med students who don't have a day of caring for patients under their belts. Meaningless, silly things that take up time and resources, with doctors having to debate these things. What's worse is that a percentage of these resolutions make it to the voting body of organized medicine and end up being passed as policy. Crazy stuff that does nothing to help patients but harms the fabric of medicine, some which we know may in fact harm patients. Thanks for shedding light.
I think communication skills, negotiation etc is a huge thing to look for!
I feel as a primary care doc basically my day is negotiation- with patients, insurance, other docs/ specialists etc etc. trying to get the best care we can figure out for each individual person.
You HAVE to be able to communicate and many more of this younger generation who have never had a job in the “real world” (ie not a lab) have not learned this skill, although many older specialists seem to not have it either, to be honest. I have many patients that will make appt with me after they see the specialist so I can translate the medical-speak and try to answer their questions.
I concur on the level that working in retail (particularly the specialty running store where I worked) was more useful as a preparation for medicine than doing research or volunteering.
I don't know how you assess ethics, but maybe the more tangible thing is civics. Whatever tests we use for entry into medical school could test content on how licensing and malpractice and insurance and such work, because a surprising number of doctors do not actually know very much about their own profession. And I don't know how you even frame an ethical question without understanding that medicine is a legal construct and we all operate within it.
Another great video. Agree that more needs to be done to promote critical thinking skills in medical students and develop further during training. The entire system selects for and promotes obedience and compliance, creating a medical profession that is too susceptible to propaganda and manipulation. I was fortunate to train in a time and in places where challenging the diagnoses and opinions of others, even those more senior, was encouraged.
Vinay, I agree that research should not be a prerequisite for medical school, but having directed the research of many fine undergraduate students, I think that there is great value in having them wrestle with experiments that do not work, beat their heads against the wall and then troubleshoot their way to success. It teaches them persistence, patience, and critical thinking. Then interacting with data and presenting their work at scientific meetings helps them cultivate poise, careful thought, and the humility to say, “I don’t know,” or “that’s a great idea, I hadn’t thought about that.” So while research should not be required, good research, well done should be given some positive consideration.
Confused about “economic opportunities.” Are you saying you would score up someone who had less? If someone comes from a two parent home where those parents worked very hard to give that child a good education, and pay for it in full, why should that student be penalized? Also-elephant in the room-big elephant is race, gender, underrepresented minorities.
One of your “obvious” statements about dumb research, the one about daily shower, may not be so cut-and-dried as you think. In fact, questioning it is the point of this article:
Showering daily -- is it necessary?
https://www.health.harvard.edu/blog/showering-daily-is-it-necessary-2019062617193
I have two sons. One got into medical school. The other did not and became a nurse. Different people and I think life often turns out ok for individuals as time goes on. Our physician son, however, a head and neck surgery resident works incredibly hard covering three hospitals at night for a week at a time. I think kids going into medicine need to understand the demands on their stamina and that there is little free family time. His brother has a more relaxed and predictable life.
Well said, so true. Ultra-processed medicine is like ultra-processed food—many essential qualities you mentioned (humility, curiosity, service) get milled out in the selection and making. Too many doctors come out of the pipeline ready to plug a healthcare machine following brain dead consensus policies corrupted by cash. The final product is mediocre, expensive, and very unhealthy in many cases.
I love "ultra-processed medicine". I think EMRs contribute to this too, not that they don't have value in other ways.
It is extremely difficult for one who trained 1974-1982 to understand the affinity of younger colleagues for “guidelines”, affinity so strong that they will advocate for doing the wrong thing because someone wrote it down.
Dr. Prasad,
I could listen to you all day. So logical, Intelligent, informed, experienced and willing to challenge what needs to be challenged for the improvement of medicine. So rare today. Thank you.
I vote for: problem solving abilities, curiosity and affinity and affection for their fellow humans. I also “like” well roundedness. These are challenging to measure objectively but you recognize when you see it.
Dr. Prasad,
Great video to start my day. Solid insight.
The pipetting has been around a long time.
But the superficial bogus activism being encouraged these days from premed and med students was never a thing in my day. We see mindless activism now in the form of outright radical baseless resolutions being put forth in organized medicine, in large part from the med students who don't have a day of caring for patients under their belts. Meaningless, silly things that take up time and resources, with doctors having to debate these things. What's worse is that a percentage of these resolutions make it to the voting body of organized medicine and end up being passed as policy. Crazy stuff that does nothing to help patients but harms the fabric of medicine, some which we know may in fact harm patients. Thanks for shedding light.