Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Why you should not go to medical school

blogs.law.harvard.edu

Post reply on HN
Print view View original

91–100 of 186 posts

Re: Why you should not go to medical school

#91

Post by kenjackson »

sp332 wrote: post #85
kenjackson wrote: post #84

Earlier quoted context omitted.

So going to school for a long time to learn an unusual skill well means that your services are more valuable. It's only a rare skill because of licensing/board requirements. I'm fairly certain if you told other people they could make $250k as a radiologist, they could self-teach. The same thing could be said of programming if the only people that could practice had to be certified.

I really, really don't think that's true. Most people are not able to do this, and most of those few who could don't want to put themselves through it. And then separately, how many people would trust a self-taught diagnostician?

Most people are not able to do this, and most of those few who could don't want to put themselves through it.

Most people don't have to be able to do it, just more than are allowed to do it now, but a factor of say 10.

Furthermore, I don't think people would necessarily need to go through med school and residency.

It's like building a website. There's probably some parallel universe where programming requires certification and only a handful of schools have it. It requires doing MITs SICP as the intro course. Requires compiler construction courses, algorithms, theory of computation and complexity, etc... And then a 4 year apprenticeship with other programmers. And then you can start building webpages, if that's what you want to do.

But we live in a world where it is open and so there's instruction available at many different levels. Would you let someone without a PhD in CS build your website? Of course you would.

And then separately, how many people would trust a self-taught diagnostician?

I trust my car mechanics diagnosis despite the fact I have no idea what level of education he has. But I'm fairly certain he's not an ME from MIT or Berkeley. With good self-study tools, I think that one can self-teach in specialized areas and achieve good mastery rather efficiently. I could imagine Khan Academy for Radiology taught by JHU and Harvard professors to be quite good.

Re: Why you should not go to medical school

#92

Post by reason »

pradocchia wrote: post #82
roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

> I make over 800k a year, and take 14 weeks of vacation. I, for one, am disheartened by this gross misallocation of resources, but good work on the vacation time.

He's running a business; what's not to get? He sits higher up on the ladder with a bigger net than most doctors. The doctor that reads your x-ray at the local community hospital and this guy are in two different positions. One is an employee, the other is a business founder. The amount of money that you and the insurance companies pay to both are no different.

Re: Why you should not go to medical school

#93

Post by startupcomment »

sp332 wrote: post #68
patrickgzill wrote: post #57

Earlier quoted context omitted.

Thank you for your honesty. May I ask, what exactly do you do that you feel justifies your 800k per year? It seems to me that your career is ripe for disruption.

Generally, rare goods - and skills - are valuable. So going to school for a long time to learn an unusual skill well means that your services are more valuable. Also, providing a large amount of value in a small amount of time (like accurately interpreting the results of a scan) leads to providing huge amounts of value over the course of a year. Part of the explanation is the sheer volume of individuals he can give a…

Wouldn't radiological and physician services, in general, be less "rare" if medical schools started to train more physicians (admit more students)? I have read studies that suggest that in certain markets and certain practice specialties we are and will face shortages of physicians in part because medical schools are training too few physicians. When I ask academic physicians they seem to think admitting more students would erode the quality of students. In other words, scarcity is a public good in this case as it helps to ensure that the "most talented" will ultimately become practitioners. I don't know how this view squares with the large number of foreign-trained residents in some residency programs.

Re: Why you should not go to medical school

#94

Post by pavel_lishin »

michaelochurch wrote: post #64
codexon wrote: post #26

The reason why it is so hard to become a doctor is because the AMA restricts the number of applicants and schools that can create doctors so wages can remain artificially high. http://www.forbes.com/2009/08/25/american-medical-associatio... http://gregmankiw.blogspot.com/2009/06/physicians-incomes-an...

That post should go straight to the top. This is also why residents have to suffer ridiculous hours. With the severe limitations on the number of people who can become doctors, the profession is characterized by an extreme workload. It's seriously wrong. I, for one, would not want to be operated on by a surgeon who'd been working for 21 hours straight. Commercial pilots are limited to 40 flight hours per month, and w…

So, effectively pilots are only working 1/4th of the time that I work? Or is there non-flight-time work that eats up 120 more hours a month?

Re: Why you should not go to medical school

#95

Post by kenjackson »

roentgen wrote: post #90
kenjackson wrote: post #84

Earlier quoted context omitted.

So going to school for a long time to learn an unusual skill well means that your services are more valuable. It's only a rare skill because of licensing/board requirements. I'm fairly certain if you told other people they could make $250k as a radiologist, they could self-teach. The same thing could be said of programming if the only people that could practice had to be certified.

I'm going to respectfully disagree. This may be possible in some medical fields (I doubt it), but not radiology. There is simply too much to learn. I completed 4 years of medical school followed by a 5 year residency. Some radiologists go through additional sub-specialty training. I've been practicing for 5+ years, and I'm still learning everyday. I am a doctor's doctor, meaning my customers are doctors from every sp…

This may be possible in some medical fields (I doubt it), but not radiology. There is simply too much to learn. I completed 4 years of medical school followed by a 5 year residency. Some radiologists go through additional sub-specialty training. I've been practicing for 5+ years, and I'm still learning everyday.

But what can you say that about? I did 4 years undergrad in CS, followed by 5 years for a PhD. Followed by more than a decade in industry. And I still learn everyday too.

The notion that someone could self-teach what I know seems impossible.

I should be clear, as the term is ambiguous, they'd likely learn from experts, but not by going to a board approved medical school. But through things like online schools, programs, books, etc... It wouldn't be someone trying to recreate a curriculum from scratch.

There are licensing and board requirements, but conspiracy theories aside they are not designed to create artificial scarcity, they're supposed to keep dangerously ignorant doctors from practicing.

Given the lack of policing after becoming a doctor I'm skeptical of this claim. At the college level I'd like to see a wider swath let in to medical school, and then a more rigorous approach to filterning, based on not only medical proficiency, but ethics. The big problem I see with doctors isn't in expertise or proficiency, but in ethics.

And given the data on sleep deprivation and learning, I think loosening the requirements even a tad would result in less scarcity and better prepared doctors on average.

Re: Why you should not go to medical school

#96

Post by ender7 »

roentgen wrote: post #48
arn wrote: post #4

So, surprisingly, this rant is more or less accurate, imo. (I went to med school, residency, fellowship) I mean some things stronger than others, but it hits on the major negatives as you go through training. I know a lot of these rants tend to romanticize how hard people's own professions are in a "no one else has it this hard" type stance. We see similar "how hard it is to be a programmer" type rants as well. But,…

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

If you are still in radiology, I'm not surprised by this. Radiology is one of the few times that you can be a doctor and expect to work something like a 9-5 day.

There are other ways to have a decently normal life as a doctor, but on average it's a pretty hard life.

Re: Why you should not go to medical school

#97

Post by roentgen »

kenjackson wrote: post #91
sp332 wrote: post #85

Earlier quoted context omitted.

I really, really don't think that's true. Most people are not able to do this, and most of those few who could don't want to put themselves through it. And then separately, how many people would trust a self-taught diagnostician?

Most people are not able to do this, and most of those few who could don't want to put themselves through it. Most people don't have to be able to do it, just more than are allowed to do it now, but a factor of say 10. Furthermore, I don't think people would necessarily need to go through med school and residency. It's like building a website. There's probably some parallel universe where programming requires certifi…

> I could imagine Khan Academy for Radiology taught by JHU and Harvard professors to be quite good.

You have got to be kidding me. How would this work for surgery? There are no short cuts to medical competency.

Sure, some of what I do is self-taught, I read books and articles, attend conferences, and complete Continuing Medical Education requirements. But I am able to do this because I attended medical school, then spent five years sitting less than a foot from experienced radiologists while they worked and answered every question I had.

Re: Why you should not go to medical school

#98

Post by roentgen »

kenjackson wrote: post #95
roentgen wrote: post #90

Earlier quoted context omitted.

I'm going to respectfully disagree. This may be possible in some medical fields (I doubt it), but not radiology. There is simply too much to learn. I completed 4 years of medical school followed by a 5 year residency. Some radiologists go through additional sub-specialty training. I've been practicing for 5+ years, and I'm still learning everyday. I am a doctor's doctor, meaning my customers are doctors from every sp…

This may be possible in some medical fields (I doubt it), but not radiology. There is simply too much to learn. I completed 4 years of medical school followed by a 5 year residency. Some radiologists go through additional sub-specialty training. I've been practicing for 5+ years, and I'm still learning everyday. But what can you say that about? I did 4 years undergrad in CS, followed by 5 years for a PhD. Followed by…

We see things differently.

Radiology is a very difficult field to get into after medical school, something like 2/3 of American grads who apply get turned away. Additionally, for those who get in, up to 1/3 never pass all the board exams. It almost seems like you want to lower the bar, and I'm telling you it needs to be raised.

My guess is that if your system was developed and worked, the intelligence and drive required to complete it, the time spent studying and working to become competent in radiology would end up being no different than the current system. There are no short cuts.

Re: Why you should not go to medical school

#99

Post by roentgen »

ender7 wrote: post #96
roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

If you are still in radiology, I'm not surprised by this. Radiology is one of the few times that you can be a doctor and expect to work something like a 9-5 day. There are other ways to have a decently normal life as a doctor, but on average it's a pretty hard life.

True, but I knew about the lifestyle when I picked radiology, and it is a very hard residency to get. There are others with a similar lifestyle, like Dermatology, Ophthalmology, and Radiation Oncology. Guess what? They are the hardest residencies to get into when you finish medical school.

I should make clear why I'm replying in this thread. The world needs good doctors, and I want bright and ambitious readers of this site to know that there is a potential upside.

Re: Why you should not go to medical school

#100

Post by kyro »

roentgen wrote: post #99
ender7 wrote: post #96

Earlier quoted context omitted.

If you are still in radiology, I'm not surprised by this. Radiology is one of the few times that you can be a doctor and expect to work something like a 9-5 day. There are other ways to have a decently normal life as a doctor, but on average it's a pretty hard life.

True, but I knew about the lifestyle when I picked radiology, and it is a very hard residency to get. There are others with a similar lifestyle, like Dermatology, Ophthalmology, and Radiation Oncology. Guess what? They are the hardest residencies to get into when you finish medical school. I should make clear why I'm replying in this thread. The world needs good doctors, and I want bright and ambitious readers of thi…

I know this is off-topic, but I figured I'd take the opportunity to ask:

As a medical student who aspires to enter radiology and ultimately own imaging centers, like you, what advice can you offer that'd help me and other HN-med students position ourselves to be appealing candidates for a radiology residency?

Post reply on HN