The New Path To Med School …

I am not a doctor.  I don’t even play one on TV.

Disclosures now complete, I can say that over the course of the last several decades I have first hand experience being operated upon once by an incompetent doctor and, fortunately, several times by competent doctors.

There’s no contest .  I’d much rather have a highly qualified guy than a second-rate schmuck.

But now, it seems, being politically correct is much more important than being qualified in biology and science.

While indulging in a brief moment of masochism listening to NPR, the local affiliate came on with their own “morning edition” story featuring their “medical commentator,” Dr. Joseph Sirven.  When not pontificating on NPR affiliate KJZZ, Dr. Sirven is the chairman of neurology at the Mayo Clinic.

In his introductory remarks, Dr. Sirven told an anecdote about a young patient who wanted to know what he majored in while in college.

He explained that he had received a standard pre-med biology degree, and when further queried whether or not he’d major in biology if given the chance, he said he wasn’t sure.

One would think it might be hard to simultaneously denigrate and be proud of attaining rigorous education.  But somehow the Dr. Sirven manages.

My generation of doctors — me included  — took a very traditional science path to medicine. We didn’t have a choice. You majored in chemistry or biology, took a whole host of other science courses and survived. What a shame!

With no little excitement in his voice, the good doctor explains the new, more enlightened path to becoming a doctor.

There’s been a dramatic shift in the college path to medicine. Recently, the Medical College Admission Test, the MCAT, announced its first major revision in 25 years.  This test  — the SAT for medical school  — is longer, broader and more interdisciplinary. 

It used to be that when you took the MCAT, it was reflective of general science. This new test contains a large section with questions on psychology, sociology and the biological foundations of behavior. 

The official content outline for the test now includes concepts such as, and I quote here, “social inequality, class consciousness, race and ethnic identity, institutionalized racism, discrimination, power, privilege and prestige.”

Gone is the essay. Gone is the old scoring system.

Unfortunately, this is not a spoof, and NPR doesn’t generally engage in satire.  The Wall Street Journal confirmed that,

… one quarter of the test—covers psychology, sociology and the biological foundations of behavior. Official review material includes concepts such as social inequality, class consciousness, racial and ethnic identity, “institutionalized racism and discrimination” and “power, privilege and prestige.”

And it’s not just the content of the test that is changing.  The new, more comprehensive exam is going to take an additional three hours and will be scored by an entirely new system.

Scores for each of the four sections will be reported separately so medical schools can emphasize or de-emphasize some parts if they choose.  Emphasis WWTFT

Catherine Lucey, vice dean of the University of California, San Francisco, School of Medicine and a member of the MCAT review committee, explained that rather than make the test pass fail, the new scoring methods were adopted.

“There was some sentiment that a person’s future shouldn’t rest on a mathematical score,” said Dr. Lucey. But it was ultimately decided that reporting scores gave admissions committees more flexibility.

I wonder what the heck that means?  Do the scores count?  Maybe they should just award participation grades.  This article in medpagetoday.com confirms Lucey’s assertion,

Schools are increasingly moving away from test scores and grade-point averages in the traditional sciences and want a broader understanding of an applicant. Admissions officers want a sense of what a prospective student’s bedside manner will be like.

Were I a skeptic, I might think that offering  more “flexibility” allows medical schools more “tools” to achieve the cultural diversity they value so highly, (unless you happen to be Asian).   Med school admission boards will now be able to assess,

… whether or not someone has the knowledge base and the ability to critically think about appropriate social interactions,” said Geoffrey Young, PhD, senior director of student affairs and programs at the Association of American Medical Colleges, which administers the MCAT.

…

“Admissions is interested in selecting the best and the brightest,” Young, of the AAMC, told MedPage Today in an email. “I think at one point the best and the brightest was defined by looking at numbers, and we know that numbers don’t necessarily make one an outstanding physician.”

Medical schools are revamping their prerequisites for admissions, moving from rigid, defined courses in sciences to encouraging and even requiring undergraduate classes in humanities and ethics. Schools are encouraging students to take psychology and sociology classes as an undergraduate to prepare for the test’s changes.  Emphasis WWTFT

Personally, I’d rather have a doctor who knows what he’s doing.  Apparently objective measures are now passe – too rigid and defined.

“Many people outside of the admissions process assume that admissions decisions are determined solely by academic metrics. Nothing could be further from the truth,” said Carolyn J. Kelly, MD, associate dean for admissions and student affairs at the University of California at San Diego School of Medicine. “We look for critical thinking skills and quantitative reasoning skills. In addition to academic metrics, we consider social and communication skills, cultural competence, and service orientation as important competencies.”

Not everyone is jumping up and down for joy though, old fuddy duddy doctors like Ronald Hansing, a pathologist in Columbia, MD, didn’t mince words,

“This is not science. [It’s] agenda-driven garbage,” said Ronald Hansing, a pathologist in Columbia, Mo., who earned his M.D. in 1975, of the sociology material posted online by the Khan Academy, which worked with the AAMC to create 900 free videos to help students prepare.

Lucey’s condescension is not terribly well disguised,

“Change is hard,” said Dr. Lucey. “We are trying to send a message that in order to be a highly effective physician, you need to have a foundation in a broad section of domains.”

For those who think that the new test is going to be difficult, they are probably correct.  However, this has been in the works for quite a while now.  In anticipation of the new test, brainwashing er, preparation has been underway for the past two years.

Undergraduate pre-med advisers have been adjusting their curricula to prepare for the new test since 2012.

Gosh, that’s sure a good thing.

I am sure that one does not become chairman of neurology at the Mayo Clinic by mastering “social inequality, class consciousness, race and ethnic identity, institutionalized racism, discrimination, power, privilege and prestige,”   but as for me, I’d rather have a rigorously trained professional physician, than one schooled in race and ethnic identity.