Why you should not go to medical school • Hacker News Board

Re: Why you should not go to medical school

#111

Post by shawnjan8 » Sat, Sep 24, 2011, 6:00 PM UTC

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...

Does anyone have any idea if this would be similar to becoming a doctor in Canada? My girlfriend is doing her undergrad and plans to do med school, I'm not sure if I should show her this article or not... If this really only pertains to becoming a doctor in the USA, then there isn't a point in shower her this. Any advice/info is appreciated :)

Re: Why you should not go to medical school

#112

Post by roentgen » Sat, Sep 24, 2011, 6:10 PM UTC

giardini wrote: post #107

pradocchia wrote: post #82

Earlier quoted context omitted.

> 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.

The median salary for experienced radiologists is $300k-400k. And increasingly radiology has been outsourced overseas with mostly technicians required stateside (scan during the day, radiologist in India examines at night, results available the next morning). But roentgen claims to be a businessman as well as a radiologist. If so, most of his income would be from several radiology businesses. In that case the 800k/ye…

If you read my other comments, I state that I make twice the average salary, because I read twice as many films.

> increasingly radiology has been outsourced overseas with mostly technicians required stateside (scan during the day, radiologist in India examines at night, results available the next morning).

This is not true. Some "preliminary reads" are read overseas at night, but the doctors reading the studies are trained and certified in the USA. "Final reads", the CT scan report that counts, cannot be read elsewhere.

Re: Why you should not go to medical school

#113

Post by roentgen » Sat, Sep 24, 2011, 6:15 PM UTC

kenjackson wrote: post #106

roentgen wrote: post #98

Earlier quoted context omitted.

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 requi…

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. All you've said is that some tests aren't being passed. Can you correlate them with improved medical care? Again, in…

You make some good points.

Of course, I cannot prove that the tests insure quality. In fact, this is not what the radiology board exam does.

The board exam is designed to weed out dangerous doctors, which is probably the best we can hope for. So, I guess you can take my word for it or not, but dropping the bar at all would let dangerous people practice, which I see as a mistake. The people that I know who failed the exam should not be working in Radiology.

Re: Why you should not go to medical school

#114

Post by roentgen » Sat, Sep 24, 2011, 6:18 PM UTC

true_religion wrote: post #109

roentgen wrote: post #97

Earlier quoted context omitted.

> 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 s…

Characterizing it as a "short cut" is disingenuous. The argument here is that medical boards are too rigorous, and test things that do not matter practically. To give a ridiculous example, if a medical school required you to climb Mount Everest before becoming a doctor that might result in only 1 person becoming a doctor per year. However that scarcity isn't proof that climbing Mount Everest is needed to become a doc…

In fact, the medical licensing exams and board exams are too lenient. The general quality of people going to medical school in the US has been dropping for a generation. The standards are sliding, to our detriment.

Re: Why you should not go to medical school

#115

Post by timr » Sat, Sep 24, 2011, 6:19 PM UTC

roentgen wrote: post #98

kenjackson wrote: post #95

Earlier quoted context omitted.

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 requi…

"Radiology is a very difficult field to get into after medical school, something like 2/3 of American grads who apply get turned away."

I don't agree with kenjackson that the field can be self-taught, but saying that most people don't get into Radiology residencies tells me only that there aren't enough Radiology residencies to go around. The 1/3 board failure rate notwithstanding, my intuition is that there are far more people capable of practicing radiology than are currently allowed to try to get into the field. The intelligence level of medical students does not exceed that of PhD students in engineering, math, chemistry, etc., but the medical profession puts up much, much higher economic barriers to entry.

If the government decided to tax radiology providers and use the profits to increase the number of radiology residencies by 10 or 100-fold, I find it hard to believe that the lucrative profit margins of your industry wouldn't decline. Medicare reimbursement rates would go down as the number of providers increased.

Re: Why you should not go to medical school

#116

Post by roentgen » Sat, Sep 24, 2011, 6:20 PM UTC

kyro wrote: post #100

roentgen wrote: post #99

Earlier quoted context omitted.

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?

I don't know any secrets. It's hard to get a radiology residency. You need good grades. I don't think research experience matters. It also helps to be somewhat normal. The people interviewing you for residency have to be willing to sit next to you for four years, so if you're a "closet case" they might pass on you, even if you look good on paper.

Re: Why you should not go to medical school

#117

Post by larrys » Sat, Sep 24, 2011, 6:36 PM UTC

kyro wrote: post #100

roentgen wrote: post #99

Earlier quoted context omitted.

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?

"and ultimately own imaging centers"

Contact the MD here for advice:

http://upper-dublin-mri.com/aboutus.aspx

A nice guy, he was glad to help when I was thinking of starting up an imaging center. (The upshot from the meeting is that you have to have a tie in with a hospital and be aware that the hospital could end up doing the same in house etc. He's a businessman and a MD and would have profited from the association so I believe the advice was honest. Of course it's only one data point out of many you will collect.)

Re: Why you should not go to medical school

#118

Post by arohner » Sat, Sep 24, 2011, 6:42 PM UTC

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…

>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.

Thanks for the comments in this thread, they've been very informative.

I'm happy there are certifications, and I believe you that the bar should be raised, but given the huge demand for doctors, why aren't we increasing the number of medical schools?

If we have a supply problem, and we don't want to lower the bar, it seems like the answer is to let more people in at the front end, and let the filter do its job.

Re: Why you should not go to medical school

#119

Post by larrys » Sat, Sep 24, 2011, 6:43 PM UTC

nandemo wrote: post #103

roentgen wrote: post #99

Earlier quoted context omitted.

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…

Meta-comment: how is it possible that 2 reasonable, informative comments from roentgen are being downvoted?

I didn't down vote it but I suspect that it's

"Medical school was easy"

"went out drinking"

"partying two or three nights a week"

"did well with the ladies"

"get by on four hours of sleep"

"nurses were much more responsive to my advances"

"busy but always had time for each other"

"make over 800k a year".

"ultimate job security"

"tremendous resource for my family"

"easy to get screwed by the medical system...won't happen to me or mine"

"not a risk taker".

Did I miss anything?

Re: Why you should not go to medical school

#120

Post by carbocation » Sat, Sep 24, 2011, 6:48 PM UTC

startupcomment wrote: post #93

sp332 wrote: post #68

Earlier quoted context omitted.

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 student…

Right idea, but wrong bottleneck. Admitting more students to medical school would enlarge the pool of applicants to Rads residency, but it would by no means force Rads programs to admit more applicants.