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Why you should not go to medical school

blogs.law.harvard.edu

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Re: Why you should not go to medical school

#171

Post by roentgen »

stevenbedrick wrote: post #151
Game_Ender wrote: post #123

Earlier quoted context omitted.

Do you worry about being replaced by computer software? You said you make $800k a year, and for that amount of money you could higher 2-3 PhDs in machine learning and computer vision for each radiologist. Do that maybe 5 times over and give them 5-10 years and productivity and costs for CT scan analysis will probably go way down. After all a radiologist armed with software that prescans each CT scan looking for inter…

I can assure that there are already an awful lot of PhDs in machine learning and computer vision working on the problem of automatically analyzing medical images, and there's been lots of progress over the last few years. There's a really long way to go, however- it's one of those areas where the problem is a lot harder than it seems. Working in the field has convinced me that radiologists earn every penny, and that…

> it's one of those areas where the problem is a lot harder than it seems.

Yes, exactly. To computer savvy people unfamiliar with radiology it looks like something a computer might be good at, but I suspect the best we can hope for is a computer to aid me in my work, not replace me.

Re: Why you should not go to medical school

#172

Post by roentgen »

carbocation wrote: post #143
roentgen wrote: post #140

Earlier quoted context omitted.

I don't have any hard evidence, but I insist that it is true. Bright and determined baby-boomers became doctors and lawyers and accountants. Today smart and determined people aren't even going to college. The HN demographic is a perfect example of this.

Intuitively, I think I get a different sense of the HN demographic. It's one thing to say that the brightest aren't going to medical school. It's another thing to say that the best and brightest aren't even going to college . I might argue that going to college is no longer necessary for the purpose of learning, because the material is so widely available. Even though I think that's true (for some fields), I still wo…

Have you seen a typical medical school class recently? The people getting in these days is almost shocking. I have a hard time believing that qualified people are being shut out of admission.

Re: Why you should not go to medical school

#173

Post by arethuza »

mahyarm wrote: post #150
gonehome wrote: post #102

Earlier quoted context omitted.

The long hours and over working is more a factor of a hospital trying to save money than having anything to do with supposed 'price controls' being purposefully set up by doctors. The price comes mostly as a factor of the extremely expensive education (both in cost and time) that is necessary. If you want talented people in any field, especially one with such a laboring path of entry, you have to pay them well.

If the kids had choices, they would not choose hospitals where shifts are 40 hours long and only sleep of 6 hours out of those 40 every thing else being equal. They don't, because of the power that the hospitals have over residents in granting their licence and the cultural ubiquity in practice. Similarly, there are very limited spaces to enter medical school and it's extremely difficult to enter. How many new orthod…

Medical degrees are first degrees in the UK:

http://en.wikipedia.org/wiki/Medical_school_in_the_United_Ki...

I believe traditionally junior doctors in the UK were also made to work extremely long hours - there have been efforts to change this recently.

Re: Why you should not go to medical school

#174

Post by kenjackson »

shabble wrote: post #156
kenjackson wrote: post #155

Earlier quoted context omitted.

How do these ability manifest? I suspect what you might be seeing is latest demand. There are a lot of people that would see the doctor more often, but often don't due to prices. Once access and prices become more reasonable they seek out medical services they normally wouldn't have.

Or doctors see their profit-margins / wages declining, and lower the threshold level for various kinds of specialised testing. So, you complain about a mole or a lump, and instead of a quick diagnostic poke and an "It's probably fine", it's off for an invasive biopsy, "Hmm, the results were inconclusive, better safe than sorry" surgical removal, and maybe a few extra scans for follow-up. I'm sure that there a many ar…

I'd argue this happens today at almost the maximal level they can extract. In fact this was my point earlier. The problem with doctor's is less proficiency, but more ethics. I honestly have more faith in my car mechanic than virtually any doctor I've worked with. I'm not sure how increasing supply can make an already worst problem worse -- except to expose more people to it.

Re: Why you should not go to medical school

#175

Post by krschultz »

roentgen wrote: post #168
arn wrote: post #163

Earlier quoted context omitted.

My income's not tied to it, so I'll say it. Computers reliably interpreting films as the final word is not going to happen in the near future (within this guy's career). Reading films is as much an art as it is a science. I'm sure a lot of advances can be made on it, and we might see nice proofs of concept. But to the point that it actually replaces radiologists? Even if you assume the technology can be perfected, th…

This guy gets it. Many replies in this thread are asking about computers interpreting scans, assuming I know nothing about the underlying technology, or am blinded by some form of bias. I have been programming computers since I was 5 years old. I have a MS in neuroscience, and I am a board certified radiologist, so I think I'm qualified to understand the problem. Believe it or not, nothing would make me happier than…

The day computers can do your job, they can do every job.

But never underestimate the ability of programmers to oversimplify every other job while proclaiming a computer can do it.

Computers are tools to aid doctors, they are not doctors. It's like a blacksmiths claiming the horseshoes can get you somewhere without a horse. It's just not going to happen.

Re: Why you should not go to medical school

#176

Post by krschultz »

roentgen wrote: post #138
larrys wrote: post #119

Earlier quoted context omitted.

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 hap…

Sorry, but I wanted to be completely honest. There were a few guys like me in my medical school. There needs to be a counterpoint to the doom and gloom reports of "no life" and "living hell".

(Not a med student, but I double majored in two different engineerings so I had a pretty tough road)

Honestly I think people over rate how difficult school is.

I was definitely in the camp of 'it's so fucking hard, I have no life, it's horrible' etc etc etc. And I'm a smart guy. Guess what, when I actually went through and figured out how much time I was spending working, it wasn't that much. If you clear out the procrastination and bullshit and just sit down and work hard while you are working, it's not bad.

Then you actually have free time.

I struggled with this for years, but working at 50% effort for twice as many hours is a horrible way to go about things because you end up living a miserable life.

At my graduation they announced the valevictorian. It was one of my friends. We had no idea. He never talked about grades. He never bitched about work. He went out drinking nearly every day of the week. He spent a lot more time chasing women than chasing grades. But when he went to the library to work, he worked.

Remember, 6 hours a day of hard work is worth a lot more than 12 hours of half assed work, and thats what he did. That leaves 18 hours a day to enjoy yourself.

Re: Why you should not go to medical school

#177

Post by [deleted] »

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…

[deleted]

Re: Why you should not go to medical school

#178

Post by jfoutz »

roentgen wrote: post #168
arn wrote: post #163

Earlier quoted context omitted.

My income's not tied to it, so I'll say it. Computers reliably interpreting films as the final word is not going to happen in the near future (within this guy's career). Reading films is as much an art as it is a science. I'm sure a lot of advances can be made on it, and we might see nice proofs of concept. But to the point that it actually replaces radiologists? Even if you assume the technology can be perfected, th…

This guy gets it. Many replies in this thread are asking about computers interpreting scans, assuming I know nothing about the underlying technology, or am blinded by some form of bias. I have been programming computers since I was 5 years old. I have a MS in neuroscience, and I am a board certified radiologist, so I think I'm qualified to understand the problem. Believe it or not, nothing would make me happier than…

First, a radiologist made a judgement call and saved my mom's life. I've got a lot of respect for what you do.

Second, there must some set of scans that are easy. It's not hard to imagine a device that says, "yes" or "see a real radiologist". Perhaps later revisions can even say "No". an example might be a mammogram analyzer. I think even 10% getting an immediate answer would save a lot of money.

I think it's the normal progression of technology. Generally, you don't need a Phd in math or physics to program computers like was required in the 60's. The net effect will be the average case you look at is much more challenging.

Re: Why you should not go to medical school

#179

Post by larrys »

krschultz wrote: post #176
roentgen wrote: post #138

Earlier quoted context omitted.

Sorry, but I wanted to be completely honest. There were a few guys like me in my medical school. There needs to be a counterpoint to the doom and gloom reports of "no life" and "living hell".

(Not a med student, but I double majored in two different engineerings so I had a pretty tough road) Honestly I think people over rate how difficult school is. I was definitely in the camp of 'it's so fucking hard, I have no life, it's horrible' etc etc etc. And I'm a smart guy. Guess what, when I actually went through and figured out how much time I was spending working, it wasn't that much. If you clear out the pro…

"but working at 50% effort for twice as many hours is a horrible way to go about things because you end up living a miserable life."

For how long? The years of college and graduate school?

Misery is not working hard enough and then ending up being one of those people unemployed in later years. (Which I agree can happen to anyone obviously.)

"6 hours a day of hard work is worth a lot more than 12 hours of half assed work"

True. But you will never be able to work as long and as hard as you can when you are young. The fun comes later. And once you have a family and kids all bets are off as far as how much you can work.

Look different things are important to different people.

But in life (as in entrepreneurship) you never know the thing that you do that will eventually benefit you. You have to learn and do as much as you can. I can trace things now that are of great benefit today that I did 15 years ago by foregoing a summer and actually summers of fun.

It's easy to look back (even roentgen at 800k) and say "look it all worked out for me and I was able to party". But we don't really have much data to support that strategy (an outlier as pointed out by verisimilitude) and in fact it doesn't really make sense that you can put in half the work and do AS WELL as putting in more of an effort without completely wearing yourself down.

Re: Why you should not go to medical school

#180

Post by carbocation »

roentgen wrote: post #172
carbocation wrote: post #143

Earlier quoted context omitted.

Intuitively, I think I get a different sense of the HN demographic. It's one thing to say that the brightest aren't going to medical school. It's another thing to say that the best and brightest aren't even going to college . I might argue that going to college is no longer necessary for the purpose of learning, because the material is so widely available. Even though I think that's true (for some fields), I still wo…

Have you seen a typical medical school class recently? The people getting in these days is almost shocking. I have a hard time believing that qualified people are being shut out of admission.

Yes? I mean, I am a medical student, and I'm routinely impressed by my peers. But I'm not trying to claim that my peers are better than their predecessors. I'm just doubting your assertion that medical students now are worse than before. The null hypothesis certainly is that things are the same as they always were.
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