This has been one of the biggest annoyances when it comes to med school and graduate level tests, so much of what you have to memorize is easily searchable on the internet. It's important to have a baseline understanding of what's going on but they need to teach a heuristic on how best to diagnose someone and not just memorize a million random diseases.
@@ferretyluv We ahve specialty for a reason. Now, repeat after me: nobody in emergency cares what the rare tropical virus you are dealing with, just tell us the cure.
Doesn't even need to be "on the internet" (which is 99% crap and it's for porn anyway). Just a single diagnosticians dictionary then memorize the knowledge to do it right, not necessarily every little detail. Of course then they'd just spend more time getting indoctrinated into believing the US healthcare system works for more than just a wealthy few. As it was designed to do. So maybe memorizing stuff that they'll forget 20 minutes after the test is over is better? Maybe? For some reason?
This is why I'm a fan of open-book exams for advanced subjects. Don't make me memorize the theory; make me prove I can apply it. (I'm not a doctor and never went to med school, but it works well for advanced math.)
Many computer science exams allowed us to bring note cards/papers (total area of a 8½x11 paper) to written exams. In fact, they expected it of us, since if you had no notes you would basically fail because the questions were hard.
Doesn’t work with medicine as there should be the possible diseases in your head to know what questions to ask the patient. There are things we don’t really care to memorize like disease scoring and different management of the disease at different stages as you can just look them up very easily( to be honest they do put questions on them but it’s usually barely one or two so they are not worth the effort to memorize).
All the discussion about how education is going to deal with ChatGPT is always hilarious because education hasn't even started dealing with the internet, in general, in the first place.
Online school instructors know all about the problem of plagiarism for the past 22 years, trying to identify it and then how to sanction. ChatGPT is just more of the same, plagairizing the same original source materials. Plagiarism identifying software is still able to find and id the original sources, no problem. The issue is in how to respond. Do we care whether a college grad can express their thoughts accurately enough that their audience gets the meanings they intended?
Honestly, this applies to a lot of jobs. I'm a computer programmer, MOST of what I learned in college that I do use, is just an Internet search away. Much of my day is spent interacting with systems that did not EXIST when I was in college and that even my last interview didn't do any _testing_ on.
It's not even that long ago I had my stint in uni and all they ever seemed to teach was Java and Oracle DB. I probably couldn't get a job now if those were all I knew.
And even those skills they did teach you are but a fraction of what you learn in your first week at a proper job. XD Also I seem to have missed all the requirements reading and arguing with the customer classes... And things like billing...
Reminds me of what we were told in middle school, "You're not gonna have a calculator or an extensive encyclopedia of medical conditions and academic papers in your pocket everywhere you go."
At one point, not too long ago (20+ years) that was true, which is why we still have this vestigial "memorize everything" in higher learning. It takes time to change an entire field, especially when vested interests prevent it from doing so.
There are MANY circumstances in which one does not have iAccess to critical information. But understanding the business/administrative aspects of healthcare is essential to help ensure a successful outcome for customer and provider .
@consi1801 not really. Not in the US at least. And if you do, you buy encyclopedias for that environment, or you don't provide services there Besides, shouldn't people specialize for these circumstances rather than assuming everyone will be in the .0001% who want to work without internet?
this makes me really thankful that my med school actually DOES have a dedicated class on all of this, and it lasts the entire preclinical portion (1.5 years, 2 hours a week). i didn't realize until recently that a lot of med schools still don't have a dedicated preclinical course on stuff like healthcare finance, insurance, billing, hospital and clinic administration, etc. it can be boring or downright depressing to learn about, but i'm glad they're taking the time to explain to us how the system we're devoting most of our lives to functions before we do our clinical rotations.
> (1.5 years, 2 hours a week).... that honestly sounds almost a little excessive. I do remember some funny lecturers having to really hit home the difference to our class about the differences between medicare and medicaid during first year.
Why bother teaching a system that is on the verge of collapsing anyways. Why bother learning that system to begin with. By the time I'm in full practice the system will probably have been completely changed.
@@plastictouch6796Even if that was true, it doesn't hurt to know. Having too many hours seems like a better criticism, but what's your point? Doesn't make sense to talk about things that might happen in the future if there isn't a better alternative.
Last internal medicine board recertification had up to date right on the computer. While I didn’t always need it I double checked on about 95% of my answers. It made so much more sense.
So I'm from Czech Republic and we actually learn how the system works here from the year 1 of medschool. I watch your channel often and I'm always so confused and terrified of the american healthcare. We don't have it perfect here (nowhere near that) and when it comes to mental health I sometimes feel like we have it worse than for example the countries around us but still... I pity you guys... If I was from US I'd be literally swimming to Europe
People sleeping in hospital hallways are normal in my country and I’m a healthcare student. The image might not look pretty but I prefer the way people are treated here in my homeland tbh. A bit overcrowded but not as dehumanizing for sure
A fresh look at medical education, about 35 years after I went to med school. Back then it seemed defensible to make us memorize everything - there were no smartphones. Nevertheless, some of the more cynical/realistic (your pick) faculty tried to warn us about insurance companies, prior authorization, coding visits so as to get paid adequately, DRGs (look it up, sorry), healthcare disparities, the effects of poverty on health, etc. Alas, we were too busy memorizing to hear everything they were saying.
When I was in med school, most tests in most subjects had a portion dedicated to case studies, where they put you a hypothetical patient and their clinical presentation and you had to answer questions about diagnosis, treatment, differentials, studies to make, etc. To this day, those portions have been infinitely more useful to my carreer than any other part of the tests. If it wasn't obvious by now: I am not American.
I am currently in medical school, and I'd say close to half or more of our exam questions are board-style (patient cases). Maybe it's just because our program is case-based teaching, but I've heard more U.S. medical schools are transitioning to this style (slowly). That's just my experience as a med student in the U.S. It's cool to hear students in other countries learn similarly.
We have case based learning once a week for 2 hours. My favorite part of the course, but its about 1/30th of my training time per week😂 but hey, memorizing the names of every cell stage of erythropoiesis and myelopoiesis is fun…right? Fuckin basophilic erythroblasts.
I went to med school in the 80s and we had such cases assigned to us. We were allowed to work in groups because doctors can get consults in the real world. The cases tended to be clinical pathological conferences from the New England Journal. This was before everyone had a computer so the library simply took the corresponding journal out of circulation for the week of the test. And I’m American. This was at UTMB Galveston, TX.
America still has the most advanced medical care and American medical schools still spend time teaching students how to diagnose. Cope harder Europoor while you live in your tiny irrelevant country
I’m not even a med school student and this is so real. It’s why I always hated school. I mean, I also loved school. I loved learning, the library, and reading my ELA textbook for the short stories in there. But when it came to classes that just teach you the what with no context and the only reason was “for the test”, I hated it. Thankfully now I’m getting a degree in Graphic Design and the major-specific classes are skill and application focused rather than test focused.
This reminds me of comprehensive exams in grad school (non-medical doctorate). Seemed like the faculty cared more about the memorization of material than your ability to apply it in the real world
That’s the sad reality of education. Memorize crap for a test, not fully understand it, move on the the next chapter, and forget 90% of what you covered
In my understanding is a lot of overlap mentality wise between the two which is unfortunate because of while there are certain core concepts you need to know your ability to apply/use them is the real measure of your understanding.
I wasn't even exposed to CPT codes until mid to late residency. A secretary taped piece of paper to the door jamb of the dictation room and said "you have to pick one of these numbers for the office visit". That was about it for my medical business training. Rude awakening when I started my first job post-residency. Once a resident did ask an attending why we weren't taught about the business of medicine and he blustered some ridiculous excuse, like "it's a conflict of interest" or something. Real reason: the attendings had no clue either.
My favourite course was pharmacology. 40% of what we had to learn were 20th century treatments that we no longer use. I was so mad when I had to memorise those. I gladly erased most of the useless information after that.
As an organic chemist who at least has *some* experience with “What’s on the test?” “Literally everything and some examples you have to work out on the spot”… You memorise things so you can work them out quicker, and so you can string multiple problems together much more easily. It’s easier to go from A to B to C to D when you know all the steps beforehand (or even better, know how the middle steps get you to your end point) than having to try to work them all out individually. And then when you’re faced with a problem that’s never been solved before, you can more easily work out what should and shouldn’t work (potentially by analogy) than if you have to keep learning things from the database!
@@tatienouorest3358 My son is a doctor (cardiologist) and I asked him one time about people self-diagnosing themselves from Web MD and Google. I fully expected him to say that he hated when they do that. But on the contrary, he said that he welcomes their input because it helps him narrow down the scope of what he is looking for. He said he usually starts out with "What leads you to believe that ~fill in the blank~ might be what is causing your problems?" He said patients tend to be much more detailed when they are doing web searches than when they are sitting in the exam room.
The point is not really the memorizing part, even so it was very clear that people would get hang up on that, but rather about learning what's important for your job. A doctor can't sadly be "just" a doctor anymore, he needs to be a businessman, bureaucrat and lawyer as well. After all what point is there to be able to diagnose a patient with an hour from memory instead within 3 hours with help of a database, if the patient has to wait a week for the actual treatment because you didn't know about UH's sensless yet required bureaucratic steps 2 to 4 in the offical process?
I don't disagree... but like, you don't need to know the *exact* biochemistry for everything to remember likelihoods and what's probable... As a computer programmer, I know how programs work, can quickly read and understand code, and can turn a bunch of human centric actions into computer code... but I don't know the names and parameters of every function in the basic library of tools available to me.
This is crazy. Even as a pharmacy student, in Germany (in the last semester after practical training) you have to learn about the health care system and all its laws, even more like how the political system works. That is tested in the last state exam which I am studing for right now. Hope someday it will be better for you guys over there.
I'm a radiology technologist program director in a new program. I spent our 2 weeks orientation time teaching them: patient communication, the healthcare team, CPT & ICD-10 and why it's important, and so much others stuff that people don't realize you can't just leave to "on the job" training- like professionalism. It's made a world of difference.
Medical education uses the same logic as the military during the Vietnam war. Saturation bombing. The idea was that if you dropped enough bombs over a wide enough area, you "probably" would destroy what you were after... In med school, they tried to teach us 200% of what was important in the hope you would retain what you really would need. (or now, what you need to pass some freaking test)
Spot on, Dr G! I don’t know how many of my classes in med school cross covered those rare genetic diseases, but after 40 years of being a doctor, and seeing many, many things, I have seen exactly one case of Hurler syndrome, and that was as I was passing through an airport!
My I.T. education changed in the year 2000. We went from mindlessly memorizing things about computers, to being able to use search engines. Lot of the exams became open book, as the people running them recognized memorizing of facts just held back people with bad memories but great intuitions. Needless to say, I have used these abilities (Search Engine Optimization) to become a laymen in a lot of fields. I talked to my geneticist about amino acids, not because I memorized them in school.... Digital Brains are great, we all need to learn to implement them into our lives!
I've never felt so attacked and vindicated at the same time! I'm a 2nd year about to begin Step studying and this is so very true. They try to teach us about the eletronic health records and how to prescribe medicine, but they don't do that well. I think the plan is to throw us into the hospital in 3rd year and we sink or swim
To be perfectly honest, you can't expect people on these timelines with so much they are mandated to memorize to do all that extra work when if they don't do well on the test their chances at the area of medicine they want to work in can evaporate like smoke. Until residencies stop using it to filter, that isn't going to change. That being said, I agree with you. Much like how I agree with most others going through school that basic life skills like filing taxes and managing expenses should be mandatory education for everyone.
As I tell students, in my generation the struggle was to find the information. In your generation, the struggle will be to sort and curate the information.
I think about this all the time. I remember when I became a nurse to become a nurse practitioner, it was because I loved human physiology and pathophysiology and I wanted to help people. Silly me. I had NO IDEA about the pitfalls of the US healthcare system.
The medical stuff on wikipedia can fit in about 10GB. *The more you know* Also, I am strongly of the opinion that basic probability, financial math, and accounting should be taught in high school. Those concepts are way too useful and ubiquitous for the general population not to learn.
As a teacher, let's be real; most high schoolers don't give two hoots about math, or taxes, or accounting. You can lead a horse to water but you can't make them drink. If I had unlimited time and resources, things could be different - but I find that most people who say "Make [X] a mandatory class in high school" have not actually been in a high school in quite some time.
@@gooel I think that's a fair assessment. I can also tell you that I had highly qualified teachers, in a school district that did a good job. That being said, I was required to take "social studies" and english every year. I would have gained life utility from trading Moby Dick for understanding compound interest and how loan repayment works.
@@gooelyou cannot expect children tò have the maturity to understand the importance of what they are doing, dealing with this is a big part of what being a teacher is.
Just passed Step 1 last summer. There were some questions about medical ethics and patient communication, but I don't recall any questions about the US healthcare system or insurance. I did study the basics of different healthcare insurance models (e.g. PPO vs HMO vs EPO, Medicare vs Medicaid, etc.) when preparing, but it wasn't on my exam. I think adding these as required components of medical school curriculums into LCME accreditation requirements would be the way to go, because many aspects of the US healthcare system and health insurance are subject to rapid and frequent changes from legislative and market conditions and would only exacerbate medical students' stress if added on to the USMLEs.
And so, the same hiatus concerning the "system" exists in Canada. Nada in four years med school or one year internship. Bless the one MD who took me aside in residency and started with " maybe it's time you know how things really work". ps. Everything I know about US medical system comes from Dr. G, my American cousins usually froth at the mouth when I ask them.
Don't worry, med school administration has heard your complaints, and will be addressing them in the new curriculum. New accelerated organ-system case-based interdisciplinary learning modules make use of both vertical AND horizontal integration to technically sort of cover most of what some people somewhere think students need to know. Also, students now have 2 weeks to study for step 1, a lot of material that attendings and the general public expect doctors to know has been either removed or significantly de-emphasized, and there is an additional 10-20 hours per week of pre-recorded lectures that may or may not relate to anything else. These video lectures will have silly and confusing names that may not reflect what they are actually about. If any of this sounds absurd, ineffective, or unhealthy, that's ok -- this is also part of the curriculum. Studies show it improves retention among surviving members of the cohort. However, students are able to submit feedback through one of the administration's approved channels, and they will be happy to appear to address their concerns. For next year's students. By rearranging the order of lectures, giving them different silly names, or just adding more of them.
I just heard an NPR show about the problems with private equity run medical practices, and how the laws in place to protect patients aren’t being enforced. Sounded just like all the points from your September video series. Maybe you helped raise awareness:)
Our access to raw information has evolved so much faster than our "education" system. Whereas in times past the data were siloed and needed specialized training to even obtain, now we have TOO MUCH data. Even though I can argue that the practice of learning and memorizing these facts can train a certain level of mental discipline I use every day in practice, I've found Med students and residents I teach increasingly able to "shotgun" information with exponentially less understanding of how it integrates and how to apply. The system is pretty good at teaching "what" and some of "why", but the "HOW" depends on the mentorship and modeling of wise, experienced and talented medical educators. And medical learners willing to become classical disciples of medicine, not mere test-taking machines 😢
Prior auths, formularies, proper diagnosis codes and posting/submitting claims, timely filing periods, and so much more - these are things I never learned about until I got a job in a private practice clinic. I feel like they should host workshops or something in undergrad, heck even a 1-credit hour course or something, to familiarize people with this stuff. Also business related electives for people who want to open their own practice one day, or at least understand how owning/unning a practice works. It's crazy that you're expected to learn all this as you go, on your own, making it harder for you to just care for patients and increasing the number of expensive mistakes you'll make when you're fresh out of training and need to pay the bills. It's stressful as heck
The first required course in med school should be titled “So You Want to be a Doctor: Intro to the US Healthcare System.” Teach all of that first and half your students will drop out and save themselves the expense and stress of preparing for an occupation that will make them indebted and miserable.
Nearly all of my tests in college were open book with internet available. Sometimes there is a reason to memorize but most of the time learning how to apply that knowledge or knowing what to google is more important to the real world.
The picture of the neurologist in the background is staring in to my soul. Some of these apply to nursing too. Nursing school - Memorize EVERYTHING, you can't have your phone on you! Nurse practitioner school - Here are some good apps for your phone and always make sure your computer has a link to Up To Date.
I'm doing healthcare informatics for my undergrad (aiming for med school though) and we have to take a healthcare systems class. I know med school is all about the clinical side, but they could fit at least ONE course about the system lol. (Although if I had to pick only one meta-topic, I'd rather they fit in an extra course about patient communication/trauma-informed care, because I think that would ultimately be more impactful for patient outcomes, but that's my special interest so I'm biased, and of course the practitioners need to be armed to advocate for themselves on the business side too)
Trauma informed care is such a new field that even organizations you would assume have adopted the practices, like mental health treatment orgs, haven't fully integrated it in, at least in my experience. Healthcare is extremely slow to change and adapt in any way other than finding new ways to screw people (patients and providers, mostly) out of money.
@@dirtbagdeacon 1000% agreed. I'm unhoused and have been working for years with my unhoused peers (first aid and medical resource navigation mostly) and have been in healthcare in some form or another for essentially my whole life, and my broader social community is largely neurodivergent and pretty trauma-literate -- so basically, I'm spoiled on lots of high-quality discourse about this topic lol. Even after all my study and experience, I still tend to assume everyone working """Real Jobs""" must surely be more hip to all this than I am, because I'm just some weirdo self-taught enthusiast and, like, how on earth can anyone be in public health or clinical medicine these days WITHOUT talking about this? It's the CRUX of effective communication with the most underserved/maltreated populations!!! And communication with patients is the crux of outcomes! It always shocks me when I'm talking to other healthcare or public health pros and I refer to "chronic trauma populations" (my personal niches being the unhoused or otherwise chronically impoverished, people with substance use disorders and other behavioral disabilities, and ex-offenders, but I find the umbrella term "chronic trauma populations" to be very useful) and people act like I'm speaking Martian just by using the phrase "chronic trauma". Like ... how is this not common parlance in healthcare? Blows my mind a bit.
@@ItsAsparageese Yes to everything you said. In my experience, unless people in 'real jobs' are forced to do training by their own organization, they don't tend to innovate or learn new skills/new theories at all. Keep on fighting the good fight...I burned out after 10 years of trying to get healthcare organizations to do a better job of using evidence based care to care for vulnerable populations. It got to the point where I wondered why they kept me around if they were just going to ignore everything I told them. Now I just do straight health data stuff. I needed a change.
I see both sides. Doctors need to know a lot of stuff that they might never see because who knows, they may need that information someday. On the other side, doctors absolutely should be learning stuff they have to deal with every day, like the finances and how to order prescriptions. I'd recommend hardcopy backups to the phone though, just in case the cell reception sucks that day. Always keep your textbooks!
As someone with a rare disease, I absolutely rate my doctors on their skills when it comes to researching it because I know most doctors haven't heard of it
This is why I wish "diagnostician" was a real specialty (I checked after watching House; it isn't). Apparently nephrologists (which is House's actual specialty) and anesthesiologists come the closest to knowing All The Things, but there isn't anyone who focuses on being able to identify what is wrong without needing to constantly keep up with the current treatments. If we weren't relying on cram memorization at exam times for diagnosis of rare diseases, maybe doctors would understand the health care system better and it wouldn't take a decade to get a rare disease diagnosed.
My major professor designed his test where a memorized could not make an A. He always had 20-25%of total points allotted for essay questions that required you to integrate the material.
This is interesting Where I study, they even teach us the laws that are related to medical practice. Our uni makes sure we know how to protect ourselves in court. The questions about the healthcare system are also included in the final test at the end if the 6th year
Memorization was something that we needed before the internet. You still need as an expert to know a lot about your subject, but practice & searching on actual matters that you face everyday, is gonna gonna make you a lot more knowledgeable than randomly memorizing the whole dictionary. Tests should give the opportunity to people to think about an answer, having all the info (the internet) at their disposal. We could have people a lot more educated and with a lot more common sense, if the education system went pass the "memorize everything" tests.
Dr. G, how did healthcare and insurance become such a labyrinthine mess? I personally would love to see a cast of characters from any period of time where healthcare made sense speak to a current doctor trying to give everybody (patient, insurance company, administrative metrics peon) what they need. You have a way of getting to the heart of the matter with humor and grace. Thanks from one of the non-medical people who follow you. Thanks!
Your hypothetical cast of characters can’t come from the USA. Healthcare never made sense here. Yes. There was a time when the vast majority of claims were paid without argument by the insurance company. But, in the USA, that was a time when we had a horrifying number of Americans with no health insurance at all.
Healthcare should be something that every person gets, paid for by society through the mechanism of taxes. Instead, the USA has a healthcare “industry” that is designed to suck wealth out of society and put it in the bank accounts of private equity and their controlling oligarchs.
So true to all doctors around the world. We keep studying and memorizing so many things and still come under equipped for dealing with everyday work. Nobody cares to teach the basic day to day managerial work all doctors have to do.
You NAILED this one. I am a provider educator and for YEARS I have been trying to get into the system to teach providers what they need to know when they hit the 'real' world if they want to get paid and not have the men in black show up at their door. I mean the only code they end up knowing is I10 and I think that is because the dx code set is ICD-10-CM. The time that could be saved and money paid (not that I mind getting paid) in lack of education is crazy. Instead they bring me in when it is already a problem. Thank you for this video!
The same is true in seminary. Greek, Hebrew, and theology can be easily accessed on the web. Things like running business meetings, minor repairs around the church, and visiting with sick or dying patients has to be learned on the job.
Never agreed more with a video here. So many education systems based on rote memorization of facts that need urgent care, and to adapt to the current world!
Yesterday I watched a medical student try to walk through a solid glass-wall instead of the very obvious automatic-doors.... the future is in safe hands.😬
In my country, I remember one time that my friend asked me about the government policy on public health coverage (I don’t know I use the correct term or not but hey it’s a good one, you can only pay like 1 USD and get necessary healthcare.) He need to submit a report on it about its detail and consequence. It may not appear on the test but I think it’s still good for them to have this subject!
Third year chemistry. All tests were open book. Absolutely the hardest tests in the world.😅. First year A&P. The doctor teaching the class wrote the lesson with his right hand on the chalk board, while erasing it with his left hand as he moved along the board. Really helped us to intensly focus.😮
That's the MOST deviously intelligent thing I've ever heard in terms of developing a student's ability to think on their feet and present their answers as you required! Just exactly as the real world would do! This person has a TRUE grip on how the world works! My highest kudos to them from someone who has a Master's degree in Leadership and Higher Education! School of Education.
One of the best psychiatrists I ever had was one that wasn't afraid to say "I don't know". I asked her a complex question once, and answered "I don't know, but I will for your next consultation" 2 weeks pass and voilá, I learned the coagulation cascade.
I'm a medical student from Norway with my final exam this month. Our university has shifted its focus from memorization-based questions to those that require applying knowledge. We also have numerous lectures focused on the healthcare system. It seems quite the opposite of the US approach.
In programming we value and memorize one very important skill, what do we google when something(inevitably) goes wrong, as long as you are able to understand random answers in forums you are a professional. Though, US med school does look like a good place for you learn medicine, to then practice it in another country.
testing for problem solving and the understanding of your field along with basic memorization is how things should be. a good test is hard even when you get to use your phone (and the test isn't just there online for you)
I felt this deep in my soul. Especially 0:59 - 1:08 Memorized the Krebs Cycle. Used to calculate anion gaps in my head. For what????? If an EMP suddenly wiped communications off the face of the earth, the last thing I'll be thinking about is how acidotic you are. I might not even be to work. And I wish they had taught billing and coding in med school. I didn't formally learn the day-to-day practice management skills until my FM Residency. And here's to one day becoming our own "Money People"! 🍻
My father's an architect. Undergrads started with art, eventually got around to engineering. I don't know how much about practice (other than building codes, &c.) they had to learn, but a lot of that varies by what kind of firm you're going to work for, what kind of work they do, and what kind of work you'll be doing for them. So I'm not sure It's possible to have a simple, comprehensive education for how the practical end of architectural practices work. I would not be surprised if the same were true to some extent for some physicians, although there certainly should be *some* basics taught.
So very grateful to my residency who once a month sat us down & made us check each others coding of visits. If we were to off too often we had to go to a coding class. It was priceless! I wound up teaching friends proper coding for years since then. We had several classes like that in residency. .
That's why Direct Primary care is so great. No insurance billing. Just like it used to be. Patient sees doctor, patient pays doctor. Reasonable, rational, realistic.
@@tyrant-den884Ummm you get one from a lab or radiology centre. MRIs and X-rays are also extremely expensive because of insurance. If people had to pay for it themselves, the labs would be forced to give them at reasonable prices and recoup their cost over a normal period instead of charging insurance
This is reminding me of the old Math teachers saying, "You won't always have a calculator on you, so that's why you need to memorize and learn these formulas". And now we have phones.
Wooowwww, this one hit home! As a class of 2006 med school graduate, this feels all to accurate. Thank you as always for educating and entertaining us!
As a matter of fact, it is pretty much the same in Germany and Austria, where I went to med school. Very little to almost no information on how things work, how health insurance works, how you get paid, the difference between public and private hospitals, or even aspects of law. You have to figure that stuff out on your own after university.
Man I’m not even in healthcare, my mom is though, and your videos are maybe single handedly making her understand why RU-vid is great. She utterly loves your stuff ❤❤
The cell phone idea makes sense until your patients start doing the dumbest things ever because they read on Google and WebMD and as a medical professional you have to be able to know what is right to begin with and no what is wrong not just face everything on the Internet, and pray that the wind doesn’t shift
I'm a nurse trained in the UK. I did a module on healthcare policy and the history of the NHS. This was 20 years ago. There have been two government reorganisations in the last 10 years changing organisation of healthcare. Back when i learnt we had primary care trusts (PCTs), they were scrapped then it was clinical commissioning groups (CCGs) that came with public-private partnerships and dividing up services so private companies could bid from contracts to deliver the less complex care. Now we have integrated care systems (ICSs) that work across a "patch" to decide where funding should go. Still worth learning as i learnt how to read government policy and understand the politics of the NHS and why my hospital now have so little money we can hardly afford paper, while the good l government wrote off £35 billion to pay for a dodgy covid app.
While not a doctor, in HVAC we aren't expected to always know the answer, but we are expected to know how and where to start looking to find the answer. I've worked alot in hospitals and I see these kids going through residency studying in their work room at 3am looking super stressed. I understand tgat human lives are on the line, but you can't be expected to know everything when youre brand new
We always seem to have such issues when the teachers trained in a different era than the students. I’m a retired physician. My teachers trained in the day that residents were called residents because they lived at the hospital (for free) and they were cared for. They had cook and maid service. Such teachers couldn’t understand why we were so tired. Of course, we had to commute, clean our own apartment , grocery shop, cook and spend considerable time budgeting because of our meager income. Back in the day, I made friends with the workers in “Medical Records” and I went there regularly to sign my charts. That was how it was done. No EHRs. But I couldn’t believe how many of my own teaching attendings left huge stacks of records unsigned. They would often order the workers to pull all their charts and bring them to the doctor in clinic on a cart and then they still wouldn’t sign them. And dictations would often wait weeks or months to be done. So it wasn’t JUST ignorance about our “business of medicine” responsibilities. It was often an arrogant entitlement attitude. An attitude that such things were below them and unimportant. I saw my teachers verbally abuse such personnel. Medical records folks were just trying to get the facility paid and making sure there were records for the next provider. And those poor “Utilization Review” folks. They would review charts on the hospital floors then approach doctors to let us know that the insurance was maxed out for the current diagnosis. They would ask if there were other medical issues that could be documented or if the patient was a candidate for discharge or transfer. Many of these folks were subjected to harassment. I wish those folks had been allowed to teach us. The business of medicine has been rapidly changing. We should be teaching more about it in school but I would love to see more continuing education.
I have a degree in engineering. One of my teachers made all his tests open book because we will always have resources. The test was to see if we understood and could use the information.
"All the information in the world is inside it." Sure, until the power goes out or the service lowers cuz the weather's ick or whatever. Memorize what you can, whatever your profession. Don't rely on the magic box for everything!
There are offline versions of apps. I mean, nothing beats memorizing for recall speed, but nobody can memorize and retain things the way a digital book/library can.
In defense of memorization, which is a needed step in medical studies: if you don't know *anything* off of the top of your head, you won't even know what to google for to find the answer. You won't even know what question to ask in the first place. Of course you're going to forget many of the details from the pre-clinical sciences, but the knowledge melts into something new overtime. I see it as a working 3D network of physiology, anatomy, histology, nutrition, etc. of what the body is and how it works. Of course you have to also logically link all the info. Memorizing it like a telephone book does 0 for your knowledge.
