I am a Christian. Jesus Christ is my personal savior. I can reconcile my faith with a host of scientific facts including evolution. But as we’ve seen, there are plenty of believers who apparently cannot.
It is distressing because it is difficult to view such individuals as anything but morons. The following is a video posted to GodTube, which is currently being (rightly) mocked on Reddit. You can use the terminology of evolution correctly all you want and create reasonably good looking CG models but it doesn’t make your points any more valid.
Watch For Lightning When Making This Type of Mockery
Some people will tell you 2+2 = 5 and no amount of effort will convince them that their little closed definition is wrong. ‘Creationists’ have no place arguing the science of evolution. They’ve created their own rules, their own definitions which make debate or discussion impossible.
In the end you just gotta let some of them be. Sometimes it ain’t even worth taking a horse to water if you know it won’t drink.
Simplified
In a perfect medical school the basic science education would be cut down. What I mean is that the focus on minute ‘physiologic’ biological processes would be limited. The basic sciences, especially in the first year, have become too complex and unnecessary. Too often what students are introduced to is influenced by the research of the faculty of the school. At the perfect medical school such would be limited with strict curriculum oversight. Further cutting of the basic science years would be limited by the National Board of Medical Examiners and their continued insistence that memorizing a host of biochemical pathways is somehow imperative for a single test day, somehow is imperative to becoming a physician. If that obstacle was removed the perfect medical school would significantly cut down on the traditional ‘first year’ material.
Early Clinical Exposure
The perfect medical school would also compress the basic science years. Already there are schools which do the first “two years” in eighteen months. An applause to such schools. The perfect medical school would do the same. The key is to get the medical student out of the classroom as soon as possible.
As I’ll discuss in the clinical sciences post, clinical exposure would be early in the first year and often. The 18 months at the beginning of the perfect medical school could hardly be called ‘basic science,’ despite the title of this post.
Integrated Curriculum
The perfect medical school would have a truly integrated curriculum. There would be no distinction between ‘first’ and ’second’ year. You would progress through the 18 months of basic science in modules focusing on various topics (i.e. cellular metabolism, cardiovascular system, GI system, etc.) in which you would cover the physiology, anatomy, pathology, related pharmacology, etc. The basics, which are hard to integrate, would be covered in the first two months in the classroom and then it would be off.
Despite the abandonment of the anatomy lab by some schools, gross anatomy and human dissection would remain a strong component of the perfect medical school.
Technology
The perfect medical school would be the most integrated school in the country, technology wise. The obvious things, done in most schools nowadays, would include virtual microscopy (no student should ever have to fix a path or histo slide), online lectures, online grades, online syllabi, computerized test taking.
Summary
Remove frivolous basic science minutia
Condense the basic science education to 18 months of less
Early clinical exposure
Strongly integrated curriculum with no distinction between ‘first’ and ’second’ year
The Bottom Buddy is a device which helps the morbidly obese wipe after using the bathroom. I’ll hold my tongue a bit except to say that it probably says something about the state of and concern for public health in this country. *Sigh*
The above is an ad for americandreamabroad.com, which seems like a front to place Americans in a questionable medical school in China. Still a pretty funny ad.
Pre-Requisites
Pre-requisites for medical school admission should be extremely limited. Indeed, I think in the perfect school, they would not exist at all. Completion of say an undergraduate biochemistry has absolutely no independent predictive value of medical school success. A reliance on standardized tests to assess the pre-medical school basic science knowledge base in appropriate and required pre-requisite classes are simply redundant. Indeed the MCAT is an excellent predictor of medical school success; probably the best single predictor.
As many medical schools there would be no specific requirement for an undergraduate degree. Indeed, I would propose allowing mature high school students sure of their future to study for and take the MCAT without any college preparation and to enter medical school immediately following high school. And I’m not talking about an extended course here (like the 6 year European programs).
Admissions Criteria
As above, great emphasis would be placed on standardized measures (i.e. the MCAT). True, there are anecdotes of those who are merely poor standardized test takers and otherwise excellent students and perform as excellent physicians but in general the MCAT is an excellent predictor, not only of future standardized test performance, but of performance in medical school in general.
Very little weight would be put on prior GPA, which is entirely impossible to standardize versus other applicants. Such would probably help the pre-med attitude a bit.
More than lip service would be given to the intangibles that make a good physician and a demonstration of the right motives for going into medicine, a commitment to research, etc. would be elicited in part through self reporting, letters of recommendation and the unique interview process.
Interview Process
The admissions committee interview team would be entirely limited to physicians and current medical students and basic science faculty would be barred. The idea is that the interview process should solely serve in trying to determine the intangibles which make a good clinician. Hopefully things like a dedication to research can be derived from the applicants’ previous activities.
The interview process would be given a huge amount of weight, as a measuring tool of applicants’ intangibles as mentioned above. I imagine a full day ‘interview’ or perhaps two half day ‘interviews’ to standardize the rankings the admission committee members give to the applicants they interview.
What I mean, is that the admissions committee members would give an entire half day to interact with the applicant. Your a clinician in clinic then the applicant comes along or he scrubs into that surgery. The applicant and interviewer sit down for lunch together and then perhaps dinner with a second interviewer.
Summary
No pre-requisite courses
Potential for admission directly from high school in unique circumstances
If I was creating a medical school from scratch there are some specific things I would incorporate. Many of these ideas exist at various medical schools here or across the world. Some of these ideas are wholly new. This is essentially just a random collection of thoughts and not exactly an outline of how to start a school (no duh). For obvious reasons these ideas ignore current accreditation standards.
This series was inspired by a lengthy conversation I participated in (admittedly over drinks) concerning the perfect medical school. It was a group discussion amongst second and third year medical students from schools all across the country. It obviously focuses largely on ‘undergraduate’ medical education, which should be the primary focus of any medical school (many medical schools lose sight of this).
In the spirit of Orac over at Respectful Insolence I’m posting some woo I recently ran across as I left my school’s library.
My Favorite Part: Leaving Out “Back Pain”
I have no idea the faculty involved in this research or what their funding is. I did a little Google search on Nithya Spiritual Healing and turned up a bit.
Nithya Spiritual Healing Broken Down In A Video
And here’s some about Nithyananda, the swami (?) creator of Nithya Spiritual Healing. There is more about him on Wikipedia. My favorite thing though is the disclaimers put up for anyone interested in becoming a Nithya Spiritual Healer,
Understand and acknowledge that the practice of Nithya Spiritual Healing is a religious and spiritual prayer and meditation service only. It does not involve the diagnosis or treatment of any medical or psychological conditions and does not involve the use of any physical intervention or manipulation of the human body. Any benefit that an individual experiences comes from within him or herself, based on his or her body’s ability to heal on its own.
[…]
Do not use the word “Patient” to describe someone who elects to receive your Nithya Spiritual Healing services.
[…]
If you are a licensed physician or other licensed health care practitioner, advise anyone to whom you are providing Nithya Spiritual Healing services that such services do not constitute diagnosis, care or treatment or the practice of medicine or any other health care profession. Further, do not engage or claim to engage in medical diagnosis, care or treatment or in the practice of medicine or any other health care profession in conjunction with any of your activities as an Nithya Spiritual Healing Practitioner.
Hopefully there is some private funding behind this little research endeavor and it doesn’t represent your tax dollars at work.
This is a drawing from a lecture today. Actually a very good lecture and not just because we got a kick out of the drawing. Any guesses as to what condition is being…crudely…illustrated?
“We Have Transformed Our Energy State Into Something Different. That Is The Definition of Disease”
Much thanks to the blog Bad Science for publicizing the homeopathic weirdness of optometrist Charlene Werner (I can’t even bring myself to put the title Dr. in front of her name). It is funny to watch though.
2 years and ten months total program length
3 starting classes per year: January, May, September
No MCAT - NOT required for MD licensure
No Bachelor’s Degree - NOT required for MD licensure
No Minimum Undergrad Credit Hrs -NOT required for MD licensure
No AMCAS Application, Apply Directly via School Website
No Age Limit
The school apparently has no clinical partners (no hospitals or clinics for students to do rotations at) but instead says that you can go find your own rotations at various Veterans Affairs hospitals and clinics around the country. And I say: What?
The school isn’t accredited by the LCME, but claims a loophole in that it will be listed in a World Health Organization Directory. It is true that for foreign medical school graduates most states use the WHO directory as a starting point for accreditation. But this almost certainly only applies to foreign graduates. For U.S. graduates you have to be a graduate of an LCME or AOA accredited school.
The school has been roundly mocked on the web and rightly so. Over My Med Body! (side note: congratulations to Graham for his great match in Emergency Medicine), on Student Doctor Network, and on other blogs throughout the web. Over My Med Body! in particular did some actual detective work and uncovered something far sketchier than even Stewart Unviersity’s crappy website might imply.
In response, defenders of the school have made some biazzare claims. Over My Med Body! reports a conversation with someone at the school,
I just spoke to a man who answered the phone, who was very confrontational when I asked “Where is the school located?” He started rambling about how ValueMD and StudentDoctor have been harassing and stalking people from the school. He admitted the address on the website is a PO Box, and said the school does not release the address or location of the school until an applicant has been accepted. (”Fine by me,” I said, “But it seems a little weird that a medical school wouldn’t be visitable or even map-able.”) He then noted that “members of Al Queda have been in contact” with the school, and the school had to file a “400 page document with the FBI” because of this. Yowsers.
Such claims of being targeted by terrorists are echoed elsewhere. Check out this comment on Wikipedia,
We have experienced a flood of stalking behavior from students concentrated at a small number of schools (particularly Wayne State University) who have created a fictitious group on Facebook, and stolen copyrighted material from our website repeatedly at www.stewartmed.org and posted it illegally on other websites including www.studentdoctor.net. I suspect that these same individuals, some likely related to Al Qaida, have misled you regarding our school because it seeks to give US military veterans admissions preference to the school.
I seriously laughed out loud while reading that. The entire idea of Stewart University New Scotland International School of Medicine is just too stupid to take seriously, otherwise I might be concerned about the school’s encroachment onto the turf of legitimate medical education.
I haven’t posted on avian flu in a while. That’s probably because as far as the main stream media is concerned that story is dead.
This Movie About An Avian Flu Pandemic Was Aired As A Network MOW
While it pains me to link to a website which calls itself, “The world’s most popular natural health newsletter,” I think it is pretty clear that the threat from bird flu was overstated.
I used to get these weird comments from avian flu alarmists sites, telling me how real the threat was. But the further we pull away from coverage of avian flu, the more convinced I am that it wasn’t really difficult to predict that this made for media crisis would pander out.
But avian flu has not gone away. Nor has it become less lethal or less widespread in birds. Experts argue that preparations against it have to continue, even if the virus’s failure to mutate into a pandemic strain has given the world more breathing room.
There were 86 confirmed human cases last year compared with 115 in 2006, according to the World Health Organization, and 59 deaths compared with 79. Experts assume that the real numbers are several times larger, because many cases are missed, but that is still a far cry from a pandemic.
Dr. David Nabarro, the senior United Nations coordinator for human and avian flu, recently conceded that he worried somewhat less than he did three years ago. “Not because I think the threat has changed,” he quickly added, but because the response to it has gotten so much better.”
No doubt it remains a disease to be addressed and not ignored. But as the next 1918 flu? How can you make a prediction like that with a straight face?
I’m surprised about all the hardcore numbers that fly around concerning hours worked. For some people there’s a lot of pride in being hardcore and claiming a lot of hours on the clock in sheet. This is, of course, especially true on surgical rotations.
But how accurate are some of these figures you see?
Now granted, I’m on the ’slow’ general surgery service but there are friends on the other county hospital team who are claiming 100+ hours/week for consecutive weeks. I’m sure it’s possible but…damn, I just don’t know what they’re doing.
I wanted to see if I could “stretch” my numbers. I haven’t taken any days off in the rotation so far and I’m using a liberal interpretation (e.g. on Wednesday I had some ‘free’ time between didactic sessions, which since I was using it to study up at the hospital I’ll count):
Sunday: 6am - 12am (Total Hours for Week: 18) Monday: 12am - 10am (Total Hours for Week: 28) Tuesday: 6am - 7pm (Total Hours for Week: 41) Wednesday: 5am - 6pm (Total Hours for Week: 54) Thursday: 5am - 4pm (Total Hours for Week: 65) Friday: 5am - 12am (Total Hours for Week: 84) Saturday: 12am - 8am (Total Hours for Week: 92)
Okay, that is as far as I can actually stretch it. I guess I am legitimately, conservatively above 80 hours but I also had some time off Friday afternoon but then had trauma call o/n.
Is this just a chump rotation I’m on? This week I didn’t stay past 7pm when I wasn’t on call, I had that ‘free’ time in the afternoon on Wednesday and Friday, and I got out by ~10am both my post call days.
All that said, I still can’t reconcile how my friends at other schools, and my own school, are putting in so many more hours consistently. Is that legitimate?
I did my undergrad work in USC's School of Cinema-Television Cinematic Arts. I have a Bachelors of Fine Arts in Writing for Screen & Television. I loved it, but a future of waiting tables and taking meetings with B-List producers was not for me.
This blog is ostensibly to discuss healthcare policy and maybe educate a few of my fellow medical students. But it will stray into current events, politics, and other science topics when they draw my interest
Other odd notes about me:
I've skied half the resorts on this list (Squaw Valley/Lake Tahoe, Snowbird/Park City, Whistler, Taos, Vail)
I "played" lacrosse in high school and through a club level team in college
Nothing on this website is to be taken as medical advice. I am not a physician. Please consult a physician concerning any health related questions.
This blog is entirely self funded. It accepts no advertising or other supporting revenue. The author has no relevant financial relationships to disclose.
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Endorsements
"Please be more precise in your practice of medicine than you are in your blogging!"
- Mark Lanier
