I had a long talk the other day with a young friend I will call James, who wanted my take on certain things he has observed. As it happens, his observations are mostly accurate, and they do not paint a very pretty picture, even if there may be a bright spot for him.
James is finishing up his Ph.D.—in a life sciences field— at a prestigious graduate school in the East. About halfway into this process, he noted that much of the research going on seemed to bear little direct applicability to actually helping humans. As his interests turned more clinical, he decided to take the next step, and he is applying to medical school.
For the most part, residents of a state are given preference for med school admission to schools in that state, to say nothing of the extreme difference in tuition charged to non-residents. However, in certain states the preferences are not as pronounced, and, as luck would have it, James lives in one of those states. Thus, he has no particular advantage in his own state, and is discriminated against in most others.
I told him that this was all political. Officials of a particular state have to justify the building of expensive medical schools, and thus show favoritism to their own. Of course, they don’t mention that graduates of these same schools are free to practice anywhere, and many do move out of state.
While this favoritism does not apply to most private institutions, although there is so much government funding of all colleges that distinctions between public and private are becoming more quaint by the day, he observed that there are issues involved with private school admissions, as well. Knowing where he was headed, I tried to inject some perspective:
In an attempt to change their stodgy, WASPy image, private institutions, especially the Ivies, started going whole hog toward bigger and bigger doses of political correctness, during the 1980’s. The trend continues unabated. As a result, these schools embarked on the foolish road toward diversity, as if anyone really cares about the race or sex of their doctor to the exclusion of all else. Lemming like, the state universities followed.
We agreed that the end result is that not only are many marginally qualified people being admitted to med school, but the entire admissions paradigm has been changed to favor sycophantic, memorize-their-notes students who could never think out of the box, and may not even know that the box exists in the first place. If you have complaints about the condition of health care these days, the quality of doctors is an important thing to look at, wouldn’t you think?
James wonders how innovation and even quality can survive in such a stifling environment, and he’s not alone.
Then there’s the cost of the education. With tuition averaging over $30,000, tack on living expenses, books and materials, and these students are looking at a staggering debt load. Contrary to the public’s perception, no doubt fed by the class envy boosting Leftist antique media, doctors are not making big bucks these days, unless they happen to be plastic surgeons in wealthy neighborhoods.
So, James asked, where’s the upside? I reminded him that a physician has one of the most portable skills there is, and he would be free to locate, and relocate, essentially anywhere in the world. At least the government miscreants haven’t ruined THAT yet. Furthermore, Medicine is the most noble profession—period. That it does not always live up to this ideal changes nothing. He can still be as great as he wants to be.
Finally, he mused about the forces of peer respect, pride, and lust for prestige convincing highly competent doctors that they must practice in some overcrowded, undercompensated, overpriced, high stress, major urban environment. Why not, he offered, bring your abilities into a less stressful environment, practice your trade, and actually enjoy life?
I told him not to try to understand why so many are controlled by pride, and just follow his own precepts. Getting away from the stress is a fine concept, and the mobility is the best thing he has going for him.
See…there really is a silver lining.