Alex, You are missing a far bigger point, I fear. This is the voice crying in the wilderness of a long time medical educator...
Most medical schools stopped giving grades about 10 years ago because the current mix of folks enrolled (for various demographic and "distance travelled" reasons rather than for the ability to be competent doctors) were not up to performing at anything near historic levels. So, by AAMC diktat (for practical purposes) they all went to pass/fail where the cutoff point could be hidden (and it is).
This was fine until those same students had to go take national boards where the same problem (many folks NOT qualified to be doctors) reared its ugly head again. The solution? They converted boards to pass/fail, too, with an unknown cutoff.
It is not that there are not good students...there are. But many, many are not qualified and never will be. They have made it impossible for anyone to tell.
My advice? Do not see a doctor under 50...there are many good ones, but you will never be able to know if you have one.
With luck some of the current noise will correct this problem, but there is a cohort out there that will never be corrected. Should scare the daylights out of all patients.
My med school went to pass/fail for quarterly exams in the late 1960s. But we still had to take the national boards and later specialty exams and multiple recerts. IMO grades in medical school did not correlate with the real world of practicing medicine. The "front row" guys in the lecture hall who asked all the questions were the smartest guys in the class by far. When we got to the 3rd/4th year roatations, I experienced first hand the smartest guys (hardly any females in the class at that time) had the least amount of common sense or the ability to translate the book smarts to actual patient care. Many became pathologists
Not wanting to get pedantic in a cool stack like Alex's, but there is solid data on the value of preclinical grades (yep, even starting in the first semester...lol) in predicting performance in clinical rotations, postgraduate care and beyond.
Probably the definitive work is by Gonnella JS, Erdmann JB, Hojat M, "An empirical study of the predictive validity of number grades in medical school using 3 decades of longitudinal data: implications for a grading system," Medical Education 2004;38(4):425-434 (PMID 15025644).
The design: a prospective, longitudinal study of 6,656 medical students at Jefferson Medical College over three decades, built to answer precisely the question the field later decided by other means: whether any important information is lost in a shift from number grades to pass/fail or honors/pass/fail systems. The answer was yes. Small differences in number grades proved statistically meaningful, and important information for identifying students in need of remedial education is lost when students who narrowly meet expectations are folded into the rest of the class in a broad "pass" category. The decile groups formed from first-year numeric grades separated cleanly on later clerkship performance, licensing examinations, and postgraduate competence ratings
Very interesting. Thanks for the info. I decided to go into family medicine in my 2nd year as I wanted to be like our doc who you saw when you were ill and family medicine had recently become a specialty. If I assume that the "A" students went into nephrology, endocrinology, or neurology (I hated that stuff), I guess I would have been a "C" student if we had grades. But I became and still am a pretty good one.
In my day, we had a saying: The top third make the best researchers, the middle third make the best clinicians, the bottom third make the most money. (This was in the day when all thirds were at least competent.) Sounds like you are solidly in the middle third and, as predicted, are a great clinician. Some of those old saws have deep value.
I resent that. If I attended lectures at all, I slept in the back row with the Natives. It was a much better use of my time to study at home, unless I needed a nap. MD Class of '99. AP/CP when it was still five years. Years one and two were both honors/pass/fail, and I wouldn't be able to tell you whether the front row or the back row were better physicians in the long run. I do know the Dean of Students admitted that the best predictor that a prospective student would be able to pass USMLE was MCAT score. My MCAT was 37Q back in the day, and yeah, I passed USMLE. Medical school was pretty easy, relatively speaking, compared to my undergraduate education in engineering, which was ironically earned from the University of Michigan.
😂 As a pathologist I resemble that remark! Actually I wasn’t a front row guy. All my good friends became pretty prominent in their clinical or radiological fields. I believe a lot has to do with the medical school itself as far as acquiring clinical aptitude. One of the reasons I loved pathology is that the pathologists were the smartest guys in the hospital, but the least impressed with themselves. Which is another reason my more direct patient care classmate friends succeeded is that they are more humble than their specialty peers.
YIKES! In New Mexico doctors have left or retired, I had to go with a PA who is 30 something this is very frightening especially since I am now a “senior citizen “.
My understanding is that more than 90% of U.S. physicians are board certified. Do you believe that number would be significantly less if board certification wasn't pass/fail? Given what you've shared it sounds as if the fact that a physician is board certified isn't a guarantee that he/she is competent to practice medicine. If true, that's beyond frightening.
If you want to know about your doctor (first check their degree, could be a PA or Nurse Practitioner too). Next note how long they spent with you and what if anything they physically tested. Finally go to your electronic records after to see how quickly they posted your patient notes and you will know if you had an AI visit, or your practitioner actually knows something about medicine and you!
I think this is good advice. My father was an internist for over 40 years and would often complain about how doctors would enter the exam room with an iPad and not even touch the patient during the exam. He was an excellent clinician and always felt it was so important to observe the patient, touch them and have an extended conversation during the exam - he says he learned a lot about them physically and emotionally in that way and was able to better handle their needs. His patients loved him!
Patient to newly licensed physician as the physician was about to leave the exam room: "Wait, you're not going to give me a physical exam?!"
Physician to patient: "You told me all I needed to know on the 12-page medical history and symptom checklist you filled out before your appointment. Thankfully, AI summarized it for me so I didn't have to read it. And my AI scribe is taking notes for me now so I have time to actually practice medicine. About the physical exam, studies show that routine physicals on healthy people don't add years to a person's life."
Patient to physician: "But I'm not healthy, that's why I'm here."
Physician to patient: "Oh. I'll be sure to review the AI summary of your medical concerns before your next appointment and order the necessary bloodwork and tests."
Anne, I can't begin to tell you how often ED and outpatient after visit notes indicate that I received physical exams when, indeed, I hadn't. But I'm healthy! 😉
I agree...it's always a "mystery" what my "clinical notes" will say in My Chart. I've learned things I didn't know I had, like cancer, new diseases. Sentences that say "patient discussed with doctor..." no patient did not. And they charge for those physical exams that they do not give anymore. For the fun of it after one visit, I asked the doctor what was their opinion on my symptoms and past history...nothing but a stunned face....and a grumbling I'll need to study your notes and message you. Never heard anything. As I've said previously, do not see any doctor under 50.
Ha, sounds familiar, Brian! I am old enough to remember the differences in "physical exams" from 50 years ago vs. today! I also worked for three doctors many years ago and the patients' favorite was the one who took the most time with them (even though they often had to wait an hour to see him!). You can't measure the value of that by "years added" to a person's life. Medicine has gradually morphed into just trying to keep the machine running but forgetting that the human body is much more than just a collection of interacting parts. Fortunately I am healthy as well, but you can bet I will be keeping my antennae up at every doctor visit.
This has been my policy for a long time. I absolutely do not go to see young medical professionals. EVER! Unless, by some chance, I have a friend who was willing to play the Russian Roulette and did not get killed. I am not willing to be the one who finds out they are a DEI hire.
Not telling them the truth about their performance is not going to "solve" any "mental health crisis". To the extent there is one, it has been caused in large part by coddling children from reality.
The point is nobody cares about grades, only the credential. The debt and cost are a joke and out of control. If I were paying that much, I would demand more. What is the point of college? Honestly, diverting all those who want to go into medicine, law and engineering to dedicated 6 and 7 year programs would separate out a lot of the nonsense. C equals degree. Most just want to party and network, do internships and work. The "learning" is a joke at this point.
I have worked in a public university in Minnesota for 18 years (office job, not teaching). The amount of coddling that I have seen over the years is sickening. Professors have to offer free food to get kids to come to any presentations or speakers on campus. For exams they can request an exemption and accommodations to take a test in a private room (and no you cannot ask why). This used to be strictly for disabled students who needed special accommodations--meaning they were in a wheelchair or handicapped in a way that they truly needed an assistance. The accommodations can be anything--quiet music, snacks, drinks, fidget spinners. Safe spaces, transgender BS, etc.--and we wonder why there is a health crisis with this age group. It is very depressing to see what the future holds for our country. I am counting down the days until I retire as it is mentally draining.
I appreciate your story and can understand what you go through. I also liked the story by a teacher in this comments section.
I am in my late 70s. I find it all sort of unreal in that young people don't put effort into learning. I was slow out of the gates (not IQ wise) and in the late 60s wound up in the military.
What would it take for our youth to see reality in a different way ? They have little idea how hard people have it in many countries as well as the USA. I grew up in what was considered blue collar poor. At age 6 I started work in my dad's store.
The mainstream media is a major cause for blame. Is it a cliche to say that whether well to do, poor, or in between the youth have it too easy ? When I was growing up on the streets it was common to hear the older guys and men say that so and so "needs a kick in the ass".
The fools and mediocre minds run too many things. I sympathize with you so hang in there and figure out the best ways to get by. That 60s military probably did the right thing by giving so many complainers and ass draggers a kick in the ass.
Thank you! My husband has always said they all need a stint in the military. I have to say, I am grateful for growing up in a time where "needing a kick in the ass" was all it took.
It made me feel good to see what your husband said.
What would these students do if all of a sudden their world was wrecked and their fantasy land collapsed and they had to find out about surviving?
I never took anything for granted.
I was asked what my best memories are. Other than my mom and dad and siblings especially my little brother It was my grammar school teachers who were nuns and young women.
They were wonderful. I never forget phonics and the blackboard with the alphabet on it and also reciting the times tables over and over everyday.
Look no further than lower education and poor parenting over the past few decades especially by those with means and you'll find your answers. I've been teaching elementary school for 23 years and the lack of caring for our children has hit its low. Sadly, most retirees commenting on these forums as well as the news blame teachers because they've seen purple haired crazy people on videos and assume that's what the classroom teacher is like. Every industry has its crazy and those headlines sell but their solve nothing. The corporate educational monopoly keeps this going as does big tech. Maybe we can get rid of teachers and put children in public education on a screen. Enough angry keyboard warriors and it will happen. Those that can afford to escape, will do so. We hate the disgusting, boring, and ineffective curriculums firced on us by the monopoly educational firms and government entities and we do our best to work around the poor programs. As teachers, we view and view on programs and they are never used. Almost always, the worst programs are picked. I can't help but think corruption and money are at the root of the problem. The districts send out minions that are tax payer funded to make sure every teacher is on the same page teaching the same material. Along with our curriculum are parents have stopped parenting and instead have given their power over to Google. They are shocked when their children misbehave or are out of control because since infancy, the children have not observed any human behaviors as the tasks such as errand running, drining from place to place, grocery shopping, worrying for appointments are all being done while the child is on a phone. The schools serve junk and the parents have no idea what they are getting daily from the school and parents that bring in crap to be shared with the class. They get shuffled into the cafeteria for the federal free breakfast program and the parents will never know it even if they feed them before they come to school. Most children also eat poorly because the parents don't bother to cook or eat with them. This is more normal than your readers realize. The parents fight homework and want grades changed even in elementary school. Our culture has degraded so much that what is acceptable would blow your mind. If people saw the emails coming from both the districts and parents, your readers would understand why teachers are leaving. It's not the money. It's a symptom of a huge problem that we are ALL responsible for.
You're right -- we're all responsible for this. I raised 5 kids and wasn't a perfect parent (though my kids all have jobs except the youngest in community college, support themselves, don't do drugs and have never been arrested.) I left the teaching to the teachers AFTER we picked a parochial school. 9 times out of 10 when there was a problem, my kid(s) were responsible. When I knew there was something else going on (mommy-sense), then I would talk to the teacher. Now? My youngest daughter is a teacher (kindergarten) in a Catholic school and the parents all justify their misbehavior. There are kids who shouldn't be in school at all because they are incapable of doing basic work and their attention span is that of a gnat. (Thanks to screens).
(Example of when I got involved: my son is chatty. He's also smart and was bored in school. When his 6th grade teacher didn't want to "advance" him to algebra in 7th grade based on his "social skills", I went to the administration and said Luke is going into algebra. I didn't take no for an answer. He excelled, had a 790 on the math SAT and graduated in math and computer science from Texas Tech in 4 years and now has a great job as a programmer.)
Thank you for your thoughtful response. Boredom is a common problem and often results in behavior issues. Being passed on to the next level without understanding the material also creates bad behaviors. This is the fault of the industry as a whole. We are also not always right when it comes to your children's needs. Communication is essential and some teachers, like any other profession, are terrible. Honestly, I think the whole system needs to be redone. It's very outdated and children should progess by ability (or not and that's okay) not by age. Learning core subject matter should only take a few morning hours with the children exploring arts, sports, music, camping skills, cooking, finance, etc. after the core subject matter is taught. They would love it! After 13 years of education, most children will come out of school without any skills to get meaningful work, get housing successfully, purchaee and understand insurance, and budget money. College has just become a fee to pay to access a job. It is not necessary for many positions.
The system is a mess. I was happier than not with my kid's education, but I also sent them to private school and had a lot more say in their education. My son (the smart kid) already plans to homeschool. His girlfriend was homeschooled through a co-op of families. He tutored math (Pre-calculus and calculus) while he was in college and says that kids are taught math completely wrong. I just trust him on that :)
Also, I think we need to get screens out of the classrooms. They are causing more problems than they are helping, and screens destroy a kid's attention span. I didn't get my kids phones until they were 13, and I had a lot of restrictions. (My kids could watch tv, play video games, do whatever they wanted ... once their chores were done, homework done, etc. And they all did sports, so didn't have much time between practice, chores, and homework to spend in front of a screen.)
YES! This idiotic idea that kids need to have tablets is one of the primary reasons that we are not getting results. You can thank Bill Gates and his ilk who "donated" so much technology. "Beware Greeks bearing gifts." And for the record, as a former College instructor, no there are not many good teachers in the system. MOST are just as lazy and stupid as the students. Why? Because the teaching colleges were corrupted decades ago. We are in a loop now spiraling quickly downward. I sincerely wish I knew how to fix it. But I have no idea short of burning down every public school. I always tell the young couples in my circle of influence find a way, hell or high water, to home school their kids.
Your personal anecdotes are sobering!!! I'm so grateful for the genuinely dedicated teachers wherever they still exist - and conscientious parents (I grew up with generations of excellence in both). The efforts to home school, parochial school, now, even old fashioned neighborhood schoolhouse - as well as intact excellence in many public school COMMUNITIES - are all exemplary counterpoints and provide essential leaven for society.
The rot is 2 pronged: The elites who CONTROL public education and the parents who defer to them. Both reflect cultural decay. The former BENEFIT of PUBLIC education for ALL, has become an illusion of benefit, as results confirm. It is ULTIMATELY a parents' responsibility. Short of that, society suffers. When 'public' education became the ASSUMED favorable NORM, 2 things began the decay from 'opposite' ends: 'State' entities increased POWER, while too many parents vacated their responsibility. The COMBINATION is the failure being experienced.
I would venture that most teachers quit (or never enter) due to frustrations of parental (and student) BEHAVIORS. Otherwise, the rewards of improving the capacities of potential for the next generations are immense. The FOUNDATIONS and social standards need to be in place.
The parents are at fault. They will NEVER admit it, mind you, but they sure are. Had one mom come to me and ask if her kid could be excused from my midterm (College Algebra) so he could play the away baseball game. I said he could take the test early and she said that was not fair. He missed the exam. I gave him a zero. He withdrew. And his mom came back to yell at me. Filed a complaint she did.
@91K per year for a BS/BA. Explain to me how this is worth it. Please. At any school. I have 4 sons, 3 of which are in college. 1 used the Army to pay for it. 1 used the AF. 1 had music scholarships, earned 3 degrees and is applying to Med schools next year. 1, the smart one, is becoming a plumber. He's the smart one. The others earned or are working on degrees in chemistry, CS and engineering. My plumber has no debt and will have freedom when he is 30. The others, maybe. But they don't have $360K in SL debt. And huge opportunity cost. Only a hand full of doctors will earn enough to make that worth it. Not all of the UM grads will do that. 80% of students will earn degrees that have no hope of earning that kind of money. They should become plumbers, electricians or similar. But alas, they are not smart.
3 of my 5 kids went to a 4 year college and they all went to state or Christian schools, all had scholarships where I paid room and board only, and all are supporting themselves with NO debt. One wanted to go to a super expensive school and I said no because their "scholarship package" included a huge loan. I told her she didn't want to start her life with a hundred thousand dollar debt. She was angry for awhile. (She's my liberal kid, and she rants about "student loan debt" of which she has none, on behalf of her peers who all have debt and she doesn't like my response: they had a choice.)
Whenever these tuition, etc figures are listed, it would be equally informative to assess what the mean is (or average??) that one student ACTUALLY pays. I know so many like myself, my own 5 and many friends' college kids (& you) who had scholarships/grants; living expenses way less than listed. Debt at the end may be the more telling figure!!! How can schools be more accountable for justifying THAT ratio of amount/ability to pay (pay back). What is the degree WORTH? An institution is too vested to declare that, but other outside entities could surely ADVISE!!!
UM’s no grading the first frosh semester is a self-confession that their admission process remains awash in DEI. We learn more from our failures, where we learn to strive, than from our successes.
Imagine the stress they would all feel if they had an old smith corona manual typewriter, onion skin paper, eraser and white out and had a ten page paper due in 18 hours and hadn’t read the reading assigned…the horror! The horror! I saw a snail crawling along the edge of a straight razor!
I did a 40 + page double spaced with 60+ bibliography my senior year of college 1968 on a Smith Corona with 2 carbon copies. Yes real carbon copies. Students in the last few decades have no idea what real work is
For my Shakespeare class in 1973 I wrote 8 papers. Minimum length was 10 pages, double spaced. We were limited to one white out correction per page. Don’t recall the brand of typewriter. Do recall I was jealous of my neighbor with his IBM Selectric.
I graduated College in 1975 with a degree in Biology, using the old fashioned A, B C, D and F, sink or swim grading system. I was later told by the department chair that in today's world many of the classes, especially for freshman and sophomore years, have been dumbed down since the students are not capable of of passing them as students before them have done. This sends the problem back to k through 12 with the lack of accountability and coddling. Some of my undergrad classes are now considered Masters level courses. Dr.K comments are frightening and accurate especially to us seniors who rely more on doctors for age related problems. The whole system stinks and needs an overhaul from the ground up.
I was an adjunct professor for ten years. When the goal is to brainwash as many people as possible for power, grades don't matter. And that's the goal. It is no longer teaching people how to think or high educational standards for each field, it's WHAT to think. You don't need grades for that. All conservatives should look very carefully at any university they send their children to and should consider home schooling when they are young--or perhaps religious schools--or we will certainly lose this country. The winners write history and we have been losing a long time in areas that matter.
I waltzed through high school. Never ever did homework and got A’s & B’s. My first semester in college C’s and one D. I was alarmed, embarrassed and ashamed. A’s & B’s from there and forward. I have a fantastic engineering and entrepreneurial career. I cannot be that unique.
This long slow roll of indoctrinating young minds as well as PARENTAL minds must be dealt with! Just when will the TEACHERS UNIONS be held accountable for what they overtly PUSH in K-12 education alone preparing that mind for this very thing the University of Michigan is doing. Anyone ever read "The coddling of the American Mind" by Lukianoff & Haidt!
Gosh. Yet another delay in consequences for the young. With luck the only adversity they'll know in their entire coddled lives is death. They're working on it but at the moment death always wins.
Nobody at college cares about grades unless going to additional professional school afterwards. Otherwise, students want the credential and are just going through the motions. Even at "elite" school like the one I went to, the gentleman C was still a very real thing. Al Gore had a great time at Harvard and had a subpar GPA that America didnt care about either.
It was for all of us. I have three degrees and not a single one is hung on my wall because it has no bearing on anything anymore. Just expensive stepping stones.
When I was in law school in the 80s many of the same problem arose. When Affirmative Action (the forerunner of DEI) mandated that they accept unqualified students on the basis or race, they were practically all washed out by the end of the first year. Naturally the Marxist faculty encouraged the Black Student Union to raise a stink, and some of the professors who had given the low grades were asked to change some of the grades. Most complied, but I witnessed (as a student representative allowed to observe faculty meetings) one professor who stood his ground, arguing that racism was not possible since the final exams were submitted anonymously. When he was shouted down by the then small coterie of radical leftists, he pulled out copies out of the failing finals and began to read them aloud. The reaction was stunned silence. After a minute or so, the Dean (mercifully) interrupted, and the "offending" prof was eventually cleared of the charge of racism.
1. I graduated in 1982. I LOVED college, however, there were many there who had no business being there AND, more importantly, had NO interest in being there.
2. My understanding is in Europe, when students are 14 years old, they are put on a trades and crafts track or a bound-for-college track. We need that here, I believe. College is not for everyone and it is NOT 'elitist' to say so.
3. Walter Williams or Thomas Sowell (both black former Marxists who became conservatives and esteemed economics professors) wrote an article about what happened to the black graduate who was admitted to a medical school over a better qualified white graduate who had sued over it (went to Supreme Court - 1978 Bakke Case.). The black doctor ended up killing a patient because of gross incompetence.
Alex, You are missing a far bigger point, I fear. This is the voice crying in the wilderness of a long time medical educator...
Most medical schools stopped giving grades about 10 years ago because the current mix of folks enrolled (for various demographic and "distance travelled" reasons rather than for the ability to be competent doctors) were not up to performing at anything near historic levels. So, by AAMC diktat (for practical purposes) they all went to pass/fail where the cutoff point could be hidden (and it is).
This was fine until those same students had to go take national boards where the same problem (many folks NOT qualified to be doctors) reared its ugly head again. The solution? They converted boards to pass/fail, too, with an unknown cutoff.
It is not that there are not good students...there are. But many, many are not qualified and never will be. They have made it impossible for anyone to tell.
My advice? Do not see a doctor under 50...there are many good ones, but you will never be able to know if you have one.
With luck some of the current noise will correct this problem, but there is a cohort out there that will never be corrected. Should scare the daylights out of all patients.
My med school went to pass/fail for quarterly exams in the late 1960s. But we still had to take the national boards and later specialty exams and multiple recerts. IMO grades in medical school did not correlate with the real world of practicing medicine. The "front row" guys in the lecture hall who asked all the questions were the smartest guys in the class by far. When we got to the 3rd/4th year roatations, I experienced first hand the smartest guys (hardly any females in the class at that time) had the least amount of common sense or the ability to translate the book smarts to actual patient care. Many became pathologists
Not wanting to get pedantic in a cool stack like Alex's, but there is solid data on the value of preclinical grades (yep, even starting in the first semester...lol) in predicting performance in clinical rotations, postgraduate care and beyond.
Probably the definitive work is by Gonnella JS, Erdmann JB, Hojat M, "An empirical study of the predictive validity of number grades in medical school using 3 decades of longitudinal data: implications for a grading system," Medical Education 2004;38(4):425-434 (PMID 15025644).
The design: a prospective, longitudinal study of 6,656 medical students at Jefferson Medical College over three decades, built to answer precisely the question the field later decided by other means: whether any important information is lost in a shift from number grades to pass/fail or honors/pass/fail systems. The answer was yes. Small differences in number grades proved statistically meaningful, and important information for identifying students in need of remedial education is lost when students who narrowly meet expectations are folded into the rest of the class in a broad "pass" category. The decile groups formed from first-year numeric grades separated cleanly on later clerkship performance, licensing examinations, and postgraduate competence ratings
Very interesting. Thanks for the info. I decided to go into family medicine in my 2nd year as I wanted to be like our doc who you saw when you were ill and family medicine had recently become a specialty. If I assume that the "A" students went into nephrology, endocrinology, or neurology (I hated that stuff), I guess I would have been a "C" student if we had grades. But I became and still am a pretty good one.
In my day, we had a saying: The top third make the best researchers, the middle third make the best clinicians, the bottom third make the most money. (This was in the day when all thirds were at least competent.) Sounds like you are solidly in the middle third and, as predicted, are a great clinician. Some of those old saws have deep value.
I resent that. If I attended lectures at all, I slept in the back row with the Natives. It was a much better use of my time to study at home, unless I needed a nap. MD Class of '99. AP/CP when it was still five years. Years one and two were both honors/pass/fail, and I wouldn't be able to tell you whether the front row or the back row were better physicians in the long run. I do know the Dean of Students admitted that the best predictor that a prospective student would be able to pass USMLE was MCAT score. My MCAT was 37Q back in the day, and yeah, I passed USMLE. Medical school was pretty easy, relatively speaking, compared to my undergraduate education in engineering, which was ironically earned from the University of Michigan.
No animosity like dueling intellectuals animosity.
If they like you they let you live.
There is no animosity. Medical staff has always had a friendly rivalry with the pathologists. It's a lack of understanding, mostly, and a little envy.
😂 As a pathologist I resemble that remark! Actually I wasn’t a front row guy. All my good friends became pretty prominent in their clinical or radiological fields. I believe a lot has to do with the medical school itself as far as acquiring clinical aptitude. One of the reasons I loved pathology is that the pathologists were the smartest guys in the hospital, but the least impressed with themselves. Which is another reason my more direct patient care classmate friends succeeded is that they are more humble than their specialty peers.
YIKES! In New Mexico doctors have left or retired, I had to go with a PA who is 30 something this is very frightening especially since I am now a “senior citizen “.
No, an inconsequential irrelevant disposable citizen.
Yikes!!
Yikes?!
Whatta ya all say when iatrogenic mortality rates go up logarithmically?!
Yeah, when SOMEONE YOU LOVE dies from outright medical incompetence, and from something easily avoided 15 years ago?
When people die from appendectomies. When people die from strep infections. When people die from getting a colonoscopy.
Yeah, laugh it up, fuzzboys…
(Star Wars reference for comic relief… what your ‘doctor’ will try in the ER…)
My understanding is that more than 90% of U.S. physicians are board certified. Do you believe that number would be significantly less if board certification wasn't pass/fail? Given what you've shared it sounds as if the fact that a physician is board certified isn't a guarantee that he/she is competent to practice medicine. If true, that's beyond frightening.
If you want to know about your doctor (first check their degree, could be a PA or Nurse Practitioner too). Next note how long they spent with you and what if anything they physically tested. Finally go to your electronic records after to see how quickly they posted your patient notes and you will know if you had an AI visit, or your practitioner actually knows something about medicine and you!
I think this is good advice. My father was an internist for over 40 years and would often complain about how doctors would enter the exam room with an iPad and not even touch the patient during the exam. He was an excellent clinician and always felt it was so important to observe the patient, touch them and have an extended conversation during the exam - he says he learned a lot about them physically and emotionally in that way and was able to better handle their needs. His patients loved him!
Patient to newly licensed physician as the physician was about to leave the exam room: "Wait, you're not going to give me a physical exam?!"
Physician to patient: "You told me all I needed to know on the 12-page medical history and symptom checklist you filled out before your appointment. Thankfully, AI summarized it for me so I didn't have to read it. And my AI scribe is taking notes for me now so I have time to actually practice medicine. About the physical exam, studies show that routine physicals on healthy people don't add years to a person's life."
Patient to physician: "But I'm not healthy, that's why I'm here."
Physician to patient: "Oh. I'll be sure to review the AI summary of your medical concerns before your next appointment and order the necessary bloodwork and tests."
Anne, I can't begin to tell you how often ED and outpatient after visit notes indicate that I received physical exams when, indeed, I hadn't. But I'm healthy! 😉
I agree...it's always a "mystery" what my "clinical notes" will say in My Chart. I've learned things I didn't know I had, like cancer, new diseases. Sentences that say "patient discussed with doctor..." no patient did not. And they charge for those physical exams that they do not give anymore. For the fun of it after one visit, I asked the doctor what was their opinion on my symptoms and past history...nothing but a stunned face....and a grumbling I'll need to study your notes and message you. Never heard anything. As I've said previously, do not see any doctor under 50.
Ha, sounds familiar, Brian! I am old enough to remember the differences in "physical exams" from 50 years ago vs. today! I also worked for three doctors many years ago and the patients' favorite was the one who took the most time with them (even though they often had to wait an hour to see him!). You can't measure the value of that by "years added" to a person's life. Medicine has gradually morphed into just trying to keep the machine running but forgetting that the human body is much more than just a collection of interacting parts. Fortunately I am healthy as well, but you can bet I will be keeping my antennae up at every doctor visit.
This has been my policy for a long time. I absolutely do not go to see young medical professionals. EVER! Unless, by some chance, I have a friend who was willing to play the Russian Roulette and did not get killed. I am not willing to be the one who finds out they are a DEI hire.
This is positively terrifying!
So, when you don’t have much choices for a doctor, or one believes his ailment is not too serious; follow up with ai?
Not telling them the truth about their performance is not going to "solve" any "mental health crisis". To the extent there is one, it has been caused in large part by coddling children from reality.
The point is nobody cares about grades, only the credential. The debt and cost are a joke and out of control. If I were paying that much, I would demand more. What is the point of college? Honestly, diverting all those who want to go into medicine, law and engineering to dedicated 6 and 7 year programs would separate out a lot of the nonsense. C equals degree. Most just want to party and network, do internships and work. The "learning" is a joke at this point.
Including the federal government that funds everything (most nonprofit institutions have most of their funding from government grants and loans).
Think about this:
You walk in as a White Heterosexual Independent Judeo-Christian American Male, the medical folks practicing since 2016 will want to kill you.
I have worked in a public university in Minnesota for 18 years (office job, not teaching). The amount of coddling that I have seen over the years is sickening. Professors have to offer free food to get kids to come to any presentations or speakers on campus. For exams they can request an exemption and accommodations to take a test in a private room (and no you cannot ask why). This used to be strictly for disabled students who needed special accommodations--meaning they were in a wheelchair or handicapped in a way that they truly needed an assistance. The accommodations can be anything--quiet music, snacks, drinks, fidget spinners. Safe spaces, transgender BS, etc.--and we wonder why there is a health crisis with this age group. It is very depressing to see what the future holds for our country. I am counting down the days until I retire as it is mentally draining.
I appreciate your story and can understand what you go through. I also liked the story by a teacher in this comments section.
I am in my late 70s. I find it all sort of unreal in that young people don't put effort into learning. I was slow out of the gates (not IQ wise) and in the late 60s wound up in the military.
What would it take for our youth to see reality in a different way ? They have little idea how hard people have it in many countries as well as the USA. I grew up in what was considered blue collar poor. At age 6 I started work in my dad's store.
The mainstream media is a major cause for blame. Is it a cliche to say that whether well to do, poor, or in between the youth have it too easy ? When I was growing up on the streets it was common to hear the older guys and men say that so and so "needs a kick in the ass".
The fools and mediocre minds run too many things. I sympathize with you so hang in there and figure out the best ways to get by. That 60s military probably did the right thing by giving so many complainers and ass draggers a kick in the ass.
Thank you! My husband has always said they all need a stint in the military. I have to say, I am grateful for growing up in a time where "needing a kick in the ass" was all it took.
You and your husband are dealing with reality.
It made me feel good to see what your husband said.
What would these students do if all of a sudden their world was wrecked and their fantasy land collapsed and they had to find out about surviving?
I never took anything for granted.
I was asked what my best memories are. Other than my mom and dad and siblings especially my little brother It was my grammar school teachers who were nuns and young women.
They were wonderful. I never forget phonics and the blackboard with the alphabet on it and also reciting the times tables over and over everyday.
Look no further than lower education and poor parenting over the past few decades especially by those with means and you'll find your answers. I've been teaching elementary school for 23 years and the lack of caring for our children has hit its low. Sadly, most retirees commenting on these forums as well as the news blame teachers because they've seen purple haired crazy people on videos and assume that's what the classroom teacher is like. Every industry has its crazy and those headlines sell but their solve nothing. The corporate educational monopoly keeps this going as does big tech. Maybe we can get rid of teachers and put children in public education on a screen. Enough angry keyboard warriors and it will happen. Those that can afford to escape, will do so. We hate the disgusting, boring, and ineffective curriculums firced on us by the monopoly educational firms and government entities and we do our best to work around the poor programs. As teachers, we view and view on programs and they are never used. Almost always, the worst programs are picked. I can't help but think corruption and money are at the root of the problem. The districts send out minions that are tax payer funded to make sure every teacher is on the same page teaching the same material. Along with our curriculum are parents have stopped parenting and instead have given their power over to Google. They are shocked when their children misbehave or are out of control because since infancy, the children have not observed any human behaviors as the tasks such as errand running, drining from place to place, grocery shopping, worrying for appointments are all being done while the child is on a phone. The schools serve junk and the parents have no idea what they are getting daily from the school and parents that bring in crap to be shared with the class. They get shuffled into the cafeteria for the federal free breakfast program and the parents will never know it even if they feed them before they come to school. Most children also eat poorly because the parents don't bother to cook or eat with them. This is more normal than your readers realize. The parents fight homework and want grades changed even in elementary school. Our culture has degraded so much that what is acceptable would blow your mind. If people saw the emails coming from both the districts and parents, your readers would understand why teachers are leaving. It's not the money. It's a symptom of a huge problem that we are ALL responsible for.
You're right -- we're all responsible for this. I raised 5 kids and wasn't a perfect parent (though my kids all have jobs except the youngest in community college, support themselves, don't do drugs and have never been arrested.) I left the teaching to the teachers AFTER we picked a parochial school. 9 times out of 10 when there was a problem, my kid(s) were responsible. When I knew there was something else going on (mommy-sense), then I would talk to the teacher. Now? My youngest daughter is a teacher (kindergarten) in a Catholic school and the parents all justify their misbehavior. There are kids who shouldn't be in school at all because they are incapable of doing basic work and their attention span is that of a gnat. (Thanks to screens).
(Example of when I got involved: my son is chatty. He's also smart and was bored in school. When his 6th grade teacher didn't want to "advance" him to algebra in 7th grade based on his "social skills", I went to the administration and said Luke is going into algebra. I didn't take no for an answer. He excelled, had a 790 on the math SAT and graduated in math and computer science from Texas Tech in 4 years and now has a great job as a programmer.)
Thank you for your thoughtful response. Boredom is a common problem and often results in behavior issues. Being passed on to the next level without understanding the material also creates bad behaviors. This is the fault of the industry as a whole. We are also not always right when it comes to your children's needs. Communication is essential and some teachers, like any other profession, are terrible. Honestly, I think the whole system needs to be redone. It's very outdated and children should progess by ability (or not and that's okay) not by age. Learning core subject matter should only take a few morning hours with the children exploring arts, sports, music, camping skills, cooking, finance, etc. after the core subject matter is taught. They would love it! After 13 years of education, most children will come out of school without any skills to get meaningful work, get housing successfully, purchaee and understand insurance, and budget money. College has just become a fee to pay to access a job. It is not necessary for many positions.
The system is a mess. I was happier than not with my kid's education, but I also sent them to private school and had a lot more say in their education. My son (the smart kid) already plans to homeschool. His girlfriend was homeschooled through a co-op of families. He tutored math (Pre-calculus and calculus) while he was in college and says that kids are taught math completely wrong. I just trust him on that :)
Also, I think we need to get screens out of the classrooms. They are causing more problems than they are helping, and screens destroy a kid's attention span. I didn't get my kids phones until they were 13, and I had a lot of restrictions. (My kids could watch tv, play video games, do whatever they wanted ... once their chores were done, homework done, etc. And they all did sports, so didn't have much time between practice, chores, and homework to spend in front of a screen.)
YES! This idiotic idea that kids need to have tablets is one of the primary reasons that we are not getting results. You can thank Bill Gates and his ilk who "donated" so much technology. "Beware Greeks bearing gifts." And for the record, as a former College instructor, no there are not many good teachers in the system. MOST are just as lazy and stupid as the students. Why? Because the teaching colleges were corrupted decades ago. We are in a loop now spiraling quickly downward. I sincerely wish I knew how to fix it. But I have no idea short of burning down every public school. I always tell the young couples in my circle of influence find a way, hell or high water, to home school their kids.
Thank you for this.
Your personal anecdotes are sobering!!! I'm so grateful for the genuinely dedicated teachers wherever they still exist - and conscientious parents (I grew up with generations of excellence in both). The efforts to home school, parochial school, now, even old fashioned neighborhood schoolhouse - as well as intact excellence in many public school COMMUNITIES - are all exemplary counterpoints and provide essential leaven for society.
The rot is 2 pronged: The elites who CONTROL public education and the parents who defer to them. Both reflect cultural decay. The former BENEFIT of PUBLIC education for ALL, has become an illusion of benefit, as results confirm. It is ULTIMATELY a parents' responsibility. Short of that, society suffers. When 'public' education became the ASSUMED favorable NORM, 2 things began the decay from 'opposite' ends: 'State' entities increased POWER, while too many parents vacated their responsibility. The COMBINATION is the failure being experienced.
I would venture that most teachers quit (or never enter) due to frustrations of parental (and student) BEHAVIORS. Otherwise, the rewards of improving the capacities of potential for the next generations are immense. The FOUNDATIONS and social standards need to be in place.
My daughter the kindergarten teacher dislikes the parents far more than the kids. She likes the kids for the most part.
The parents are at fault. They will NEVER admit it, mind you, but they sure are. Had one mom come to me and ask if her kid could be excused from my midterm (College Algebra) so he could play the away baseball game. I said he could take the test early and she said that was not fair. He missed the exam. I gave him a zero. He withdrew. And his mom came back to yell at me. Filed a complaint she did.
💯 Very well stated.
@91K per year for a BS/BA. Explain to me how this is worth it. Please. At any school. I have 4 sons, 3 of which are in college. 1 used the Army to pay for it. 1 used the AF. 1 had music scholarships, earned 3 degrees and is applying to Med schools next year. 1, the smart one, is becoming a plumber. He's the smart one. The others earned or are working on degrees in chemistry, CS and engineering. My plumber has no debt and will have freedom when he is 30. The others, maybe. But they don't have $360K in SL debt. And huge opportunity cost. Only a hand full of doctors will earn enough to make that worth it. Not all of the UM grads will do that. 80% of students will earn degrees that have no hope of earning that kind of money. They should become plumbers, electricians or similar. But alas, they are not smart.
Mike Rowe has been dead on about the trades for over a decade now. mikeroweworks.com
3 of my 5 kids went to a 4 year college and they all went to state or Christian schools, all had scholarships where I paid room and board only, and all are supporting themselves with NO debt. One wanted to go to a super expensive school and I said no because their "scholarship package" included a huge loan. I told her she didn't want to start her life with a hundred thousand dollar debt. She was angry for awhile. (She's my liberal kid, and she rants about "student loan debt" of which she has none, on behalf of her peers who all have debt and she doesn't like my response: they had a choice.)
Whenever these tuition, etc figures are listed, it would be equally informative to assess what the mean is (or average??) that one student ACTUALLY pays. I know so many like myself, my own 5 and many friends' college kids (& you) who had scholarships/grants; living expenses way less than listed. Debt at the end may be the more telling figure!!! How can schools be more accountable for justifying THAT ratio of amount/ability to pay (pay back). What is the degree WORTH? An institution is too vested to declare that, but other outside entities could surely ADVISE!!!
UM’s no grading the first frosh semester is a self-confession that their admission process remains awash in DEI. We learn more from our failures, where we learn to strive, than from our successes.
Imagine the stress they would all feel if they had an old smith corona manual typewriter, onion skin paper, eraser and white out and had a ten page paper due in 18 hours and hadn’t read the reading assigned…the horror! The horror! I saw a snail crawling along the edge of a straight razor!
I did a 40 + page double spaced with 60+ bibliography my senior year of college 1968 on a Smith Corona with 2 carbon copies. Yes real carbon copies. Students in the last few decades have no idea what real work is
For my Shakespeare class in 1973 I wrote 8 papers. Minimum length was 10 pages, double spaced. We were limited to one white out correction per page. Don’t recall the brand of typewriter. Do recall I was jealous of my neighbor with his IBM Selectric.
Your comment is 💯.
I graduated College in 1975 with a degree in Biology, using the old fashioned A, B C, D and F, sink or swim grading system. I was later told by the department chair that in today's world many of the classes, especially for freshman and sophomore years, have been dumbed down since the students are not capable of of passing them as students before them have done. This sends the problem back to k through 12 with the lack of accountability and coddling. Some of my undergrad classes are now considered Masters level courses. Dr.K comments are frightening and accurate especially to us seniors who rely more on doctors for age related problems. The whole system stinks and needs an overhaul from the ground up.
I was an adjunct professor for ten years. When the goal is to brainwash as many people as possible for power, grades don't matter. And that's the goal. It is no longer teaching people how to think or high educational standards for each field, it's WHAT to think. You don't need grades for that. All conservatives should look very carefully at any university they send their children to and should consider home schooling when they are young--or perhaps religious schools--or we will certainly lose this country. The winners write history and we have been losing a long time in areas that matter.
I waltzed through high school. Never ever did homework and got A’s & B’s. My first semester in college C’s and one D. I was alarmed, embarrassed and ashamed. A’s & B’s from there and forward. I have a fantastic engineering and entrepreneurial career. I cannot be that unique.
This long slow roll of indoctrinating young minds as well as PARENTAL minds must be dealt with! Just when will the TEACHERS UNIONS be held accountable for what they overtly PUSH in K-12 education alone preparing that mind for this very thing the University of Michigan is doing. Anyone ever read "The coddling of the American Mind" by Lukianoff & Haidt!
Send them to me....I will sort them out! I'm the kindergarten teacher they wished they had! :-)
Gosh. Yet another delay in consequences for the young. With luck the only adversity they'll know in their entire coddled lives is death. They're working on it but at the moment death always wins.
Nobody at college cares about grades unless going to additional professional school afterwards. Otherwise, students want the credential and are just going through the motions. Even at "elite" school like the one I went to, the gentleman C was still a very real thing. Al Gore had a great time at Harvard and had a subpar GPA that America didnt care about either.
Huh? That’s not me nor many of my past fellow students (4 degrees). Are you being presumptuous or speaking from experience?
It was for all of us. I have three degrees and not a single one is hung on my wall because it has no bearing on anything anymore. Just expensive stepping stones.
💯
When I was in law school in the 80s many of the same problem arose. When Affirmative Action (the forerunner of DEI) mandated that they accept unqualified students on the basis or race, they were practically all washed out by the end of the first year. Naturally the Marxist faculty encouraged the Black Student Union to raise a stink, and some of the professors who had given the low grades were asked to change some of the grades. Most complied, but I witnessed (as a student representative allowed to observe faculty meetings) one professor who stood his ground, arguing that racism was not possible since the final exams were submitted anonymously. When he was shouted down by the then small coterie of radical leftists, he pulled out copies out of the failing finals and began to read them aloud. The reaction was stunned silence. After a minute or so, the Dean (mercifully) interrupted, and the "offending" prof was eventually cleared of the charge of racism.
1. I graduated in 1982. I LOVED college, however, there were many there who had no business being there AND, more importantly, had NO interest in being there.
2. My understanding is in Europe, when students are 14 years old, they are put on a trades and crafts track or a bound-for-college track. We need that here, I believe. College is not for everyone and it is NOT 'elitist' to say so.
3. Walter Williams or Thomas Sowell (both black former Marxists who became conservatives and esteemed economics professors) wrote an article about what happened to the black graduate who was admitted to a medical school over a better qualified white graduate who had sued over it (went to Supreme Court - 1978 Bakke Case.). The black doctor ended up killing a patient because of gross incompetence.