Tuesday, August 03, 2010

Science and premeds, continued.

In response to comments on last post:


you'll just have to wait and see! Or, you know, lurk more often.

lost academic,

actually I think it's an interesting question, because I really had to think back on what my reasoning was at the time. It's funny to think about now only I could have known back then what would end up happening.

I have students ask me from time to time, "should i major in this or that?" or worse, tell me they want to go to grad school in my field. I always tell them to do the engineering version of what I do, because at least then they MIGHT be able to find work. Full stop. Without grad school or postdoc.

Usually the ones interested in med school are just really gung-ho, so they're not asking. OR, their parents are insisting that they have to go to med school, so they have no choice in the matter. Those two groups are more likely to pick majors where they're sure they can get straight A's and still have time to volunteer as candy-stripers or EMTs.

My parents would have loved for me to go to med school, but they didn't know that the science track was a careerless wasteland, or they never would have let me do it. Part of my reasoning with them was that I could get paid to go to grad school, but I'd have to go into debt to go to med school.

Still, I wouldn't have done it if I had known there would be no jobs after all this "training".

I thought med school + internship + residency was too long to wait to have a Real Job!

Okay I can kind of laugh about it now...


I hate to say this, but I think you're right that med students don't get enough training in how to reason through evidence in support of newer or alternative treatments. Although, I think younger doctors coming out of school now are much more prepared than older doctors.

However, I don't think most undergraduate programs provide this kind of training, either. I'm not sure that requiring lab experience at the undergraduate level provides enough exposure, either. Most of those kinds of internships are in advanced dishwashing and basic pipetting. A good way to get your hands wet, maybe, if you want to see what the research life is like. But it doesn't really show you more than a glimpse.

Instead, I think that perhaps some of the classroom time that med students currently spend memorizing and being tested on out of date material would be better invested in laboratory time learning how research is done and how to evaluate new information with critical thinking skills.

But hey, that's a crazy idea and nobody would ever do it, right?

No, I'm kidding of course. (Some? Or most?) med schools already do lab rotations even with their regular MD students. Sometimes it's just an elective over the summer, or whatever, but it's there for the students who want it.

My beef with this is two-fold, but this is an important point so I'm going to break it down:

1) it's too short
2) it has no consequences.

It's too short

It's usually not long enough for the students to become really invested in their research projects and go through the publication process that basic scientists go through.

In fact, I was astounded to learn how relatively easy it is for MDs to publish their research. Essentially, they just write it up, send it out, and voila! It's accepted.

it has no consequences

Totally bizarre, right? Where's the long wait? Where's the nasty reviews? Where's the arguing with the editor? Where's the political dance you do with your collaborators to avoid citing their boys' club friends just to help cover their asses?

Why no teeth-gnashing, hair-pulling, heavy drinking, suicidal thoughts? Why no threatening fights where your PI says he won't renew your fellowship if you don't make this experiment work the way he wants it to?

No I mean, seriously. They don't even have to have someone sponsor them as a PI. They can just, uh, write it up and publish it. Totally bizarre.

Which I think is probably part of why MDs often don't seem to realize how flawed the basic science literature is, how corrupt, how painstaking the process can be just to get a few years' worth of work out the door.

It's really surprising, in some ways, how some MDs assume, like my parents and probably most laypeople, that basic science is somehow really honest or just slow and that's why it takes so long.

It's not slow at all. Academic basic research is just really really fucked up. That is why publishing takes so long.

In other, better news, there's this new thing that I've been clamoring about for years.

So maybe there's hope for us after all.

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At 11:06 AM, Anonymous lost academic said...

Yeah, we could have an entire lengthy thread or even a blog in and of itself regarding undergraduate decisions to or not to APPLY (let's move ATTENDING aside) to medical school, since there are so many loaded reasons and factors starting long before college, with additional complications along the undergraduate path. I think that really gets us into what is perceived value with regard to a major, and then afterwards, with a career.

Anecdote: A good friend of mine, brilliant, attended college on the highest merit scholarship awarded to incoming students, intended to be premed, partly because That's What You Do when you are brilliant and successful and Good At Science (and for sure, when your parents Expect It). You probably want to major in something like chemistry, biology, or biomedical engineering on top of that, because anything else Wouldn't Be Worthwhile. A couple years in, he had serious, serious doubts. He really loved history, really wanted to major in that and maybe pursue it as a career, but practically his entire life he had been shuffled down this one particular path. Now he's going into economics and business at some top tier school, probably Harvard. But his agony over not just changing his pathway, but justifying it to others, was intense.

I honestly see the majority, though not quite the vast majority, of college educated students who are friends or acquaintances working or having careers in something they didn't study specifically in college. There's not a few who really know what they want out of life and career and they're sticking with it, and more importantly, they are both happy AND successful at it. But I don't think we ought to pretend that when you're 18 or 20, you really, really know, necessarily. Some of us do, but I'd say most people don't. It takes some digging to find out what the real goals are for themselves and figure out the options that might fulfill those goals.

Anyway, all of that aside: I think if we stopped putting so much damned pressure on people who really aren't (since they don't act or are fully treated as) adults to make permanent decisions about what they'll be doing with their life by using their undergrad major as a trigger for it, we're probably have happier, more successful people who didn't slog away at what they were SUPPOSED to be doing.

At 11:55 AM, Anonymous Namnezia said...

I agree, that is a better idea - reform the Med School curriculum to add an extra year of basic science, with inquiry-based coursework, mostly lab based, culminating with a required research internship. I'd sign up.

As far as what you say about MDs publishing their work, maybe that's true for crappy medical journals, but for the most part to publish in something more scholarly, they have to jump through the same set of hoops.

At 1:26 PM, Anonymous Anonymous said...

I also thought med school (4 years) + residency (3-4 years) was too long before I could become a doctor, so I chose grad school. My young delusional mind thought that I could finish grad school in 4 years and get a job as a scientist. But really, grad school (6 years) + postdoc (4-5 years) is way longer that the MD track. Gah. How come no one told me? The thought of staying longer to finish my PhD (I already wasted 4 years not getting any positive results) and then doing a postdoc was really not appealing, so I hightailed it out of there. I now do bench research at a non-profit, making regular wages. It's not that exciting, but at least I get paid to do it. I just wish I could go back, choose a different major, and not go to grad school.

At 3:41 PM, Blogger Ms.PhD said...

lost academic wrote:

But his agony over not just changing his pathway, but justifying it to others, was intense.

Isn't that always the way? It's not hard enough to make a change, but getting people who supposedly love you to understand why you're doing it, after already much agonizing...


I guess I have the impression that you can get a lot farther, and publish much more frequently, with these "lower" medical journals than you could in basic science. We don't really have an equivalent, from what I can tell?


I know, right? I have friends who went back to med school later in life and love it, but I am just too damn tired to even consider something like that at this point. I'm not sure I need exciting, but hideously boring would be bad. I hope your job is pleasant enough for now & until the economy magically improves. =p

At 9:23 PM, Anonymous Anonymous said...

It's not hard enough to make a change, but getting people who supposedly love you to understand why you're doing it, after already much agonizing...

+1 to that.

I know what I like and dislike. I'm the one doing the daily grind, dealing with stuff, and yet other people seem to assume that they know what I actually want to do. I guess people try to form a stereotype of you and think "Well, they studied X for 5 years, so they must really want to do X forever and ever."

At 11:15 PM, Anonymous Thinkerbell said...

Medschool considerations aside (though I never even realized that indeed PhD + postdocs = more years than it takes to become a neurosurgeoun... boy, that's depressing), I had the same reaction as anonymous lurker after your previous post: Did you leave???

At 8:21 AM, Anonymous Anonymous said...




At 7:59 AM, Blogger GMP said...

Ms PhD, this is unrelated. I think something may be wrong with RSS feed. At my place and many others the latest post of yours has been listed as Witnessing Idiocy for a long while now. Just wanted to let you know. Cheers


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