In regards to 4 years of undergraduate + 4 years of medical school, most students are expected to take gap years too in order to become competitive enough for medical school.
Interesting fact, I personally think it's too easy to become a nurse while doctors are way to hard. Becoming a Nurse versus a Doctor is the equivelant to being a computer engineer (Doctor) & a computer repair man. (Nurse) Anyone can be a computer "repair man" it doesn't take much training to be able to troubleshoot and repair almost every problem with a PC. Engineers on the other handle need formal training to successfully engineer Computers and there internal components. I personally think schools & trade schools overestimate how large the job market is for non-engineer and non-programming based jobs. It's almost non-existent beyond a startup in a small town.
@@icarusunited do you have experience working in the healthcare industry? It appears you aren’t aware of the extensive clinical judgement that goes into what they do.
@@icarusunited u really don't know LMAO nurses do so much more. You act like a know it all yet come across as a child. Get some real world experience why don't ya
The undergraduate years are also chock full of fillers. Why should the students who 100% know that they want to be a part of their college's pre med program be required to take extra classes, when pre med classes are already challenging enough? The common answer is: to fulfil the bachelor degree prerequisites. But the real answer: this is just America's politics of weeding out pre med students by overwhelming them with extra courses. America limits its number of physicians long before medical school admission.
I cannot be convinced that 11 years of training are necessary to be a primary care provider. That is absurd. Add $200k of debt on top and you have Dr.Miserable. There are so many resources readily available to reference in the event that a patient presents with a rare pathology. In my home country (DR). Premed and medical school can be done in 5 and a half to 7 years and you can start practicing as a general provider. The state sponsored school takes 7 years to complete, but it is very affordable.
I think a big waste of time is having undergrad students in medicine take GE classes unrelated to medicine/STEM (with the exception of some basic English, mental health, learning strategies, and finance classes). If I am to be honest, at the end of the day they were not the classes that helped me learn how to learn or discipline myself. Just my experience.
@@CoronaryArteryDisease. totally agree. In most countries i know of, medical school is 6 years (give or take 1 year). You can have someone become a general practicioner right after or choose to attend residency. It is worth noting that there are a few 6 year ba/md programs in the state. However, these are extremely expensive. For me at least, these would have not been an option.
@Jason Smith well man, 200k is a conservative estimate and still nothing to scoff at. You can buy a decent home in quite a few places with that amount. 350k in debt would cause me a stroke lol.
Great coverage of this really interesting topic. I've been thinking about this a lot lately (US MD student) and when reading the Atlantic piece I wish they had covered how massive hospital corporations (i.e. HCA, Ascension, etc.) really started to gain traction within a similar timeline of the physician surplus narrative. Within the same time frame, NP and PA training programs have had tremendous growth. Given that these hospital corporations are primarily driven by income, it makes sense to cultivate a majority $pecialist physician workforce and midlevel or APP primary care workforce who on average make more specialist referrals than their physician counterparts. The doctors who do work for these companies (~70% of all physicians), report not having enough time with patients to do comprehensive work-ups/having to make specialist referrals due to lack of time. So, the work conditions also favor a specialist-heavy physician workforce where primary care is merely a referral machine. I think the solution to this is removing primary care from insurance and corporate influence via direct primary care or other private practice models.
I'm soo thankful that you did this. I've been trying to tell several people these concepts without the data that you have. I'm sharing this with several people. Please come out with more content. Also please make it go viral so that more people understand this
We have so few because there is a bill introduced in 1997 signed by bill Clinton that only allows for a certain number of physicians to become licensed with residencies every year. Our population has gotten much larger since then. The shortage has everything to do with the lack of Medicaid paid residency spots. Without them, drs cannot become licensed. Short answer, we need to not have a limit on residencies spots….
Yes, and we should allow for those who graduate medical school to get a license and practice. Currently you can’t get a medical license unless you have completed at least a 1 year internship, and we are at a shortage of intern and residency spots even though med schools are increasing
medicine in the US is a business, yet they fail to provide more funding to open more spaces to decrease the shortage of doctors; it seems like it's on purpose because they sure do have the means to change that.
It’s interesting to me (US MS) how with the US at 8 years of schooling (4+4) is on the highest end of the spectrum compared to other countries but that most students in the US do not go “straight through” the full 8 years meaning the duration of schooling on average is even longer in the US comparatively.
In 1912, the AMA instituted the Flexner Plan to limit the number of MD's. The minimum GPA in undergrad is 3.8 (out of 4.0) so that if you are 3.7 down to 2.0 you are "ineligible" and not even considered for med school. 95% of all med school applicants are rejected. If you go to med school in Mexico and come back you will have to take and pass THREE re-entry exams and 1-2 licensing exams. These exams are MURDEROUSLY difficult and take years to pass if you ever pass them at all. The motivation is MONEY, each doctor makes $250 grand.
According to AAMC, their report on “Active Physicians who are International Medical Graduates (IMGs)” for 2019 concluded that 24.7% of ALL physicians in the United States were IMGs. That means that 1 out of every 4 physicians in the US were not educated by a US medical school. Seems our system already depends on doctors with a shorter education from other countries. Also, it seems that IMGs are able to perform at a level very close to USA educated doctors according to the recent studies I read. I still want to read more about that however.
What IMG and US grads learn is very similar. Plus we are in a digital age so most people (no matter their location) have access to the same online resources. The main difference is really the mandatory undergraduate degree.
I don't really see how 28 hour shifts for residency for 5 yrs is necessary but they really should not set the standards of entry lower. As soon as they do, too many mediocre people will flood in cause they only want the title and money and drive a porsche, while not really giving a shit about patients.
There are already people like that who are med students and doctors now. Nepotism is pretty big in medicine and there are a ton of sociopaths who dont actually want to help people who go into medicine
I’m curious about how they measure the quality of physicians in various countries. Perhaps I missed it but you mentioned that the increase in education does not correlate with an increase in quality of a physician…how is that data calculated and where can it be found? Something that I’ve heard is that American medical schools are the gold standard and that people from around the world work hard to get into American Medical Schools because they are recognized as high quality schools internationally - this could simply be the bias that I’ve been exposed to here in the States and it could also be related to the high percentage of specialists per capita, but if we are cranking out “the best” physicians, why stop? I know you said that it doesn’t seem that we don’t have better outcomes than other countries, but is that simply via the financial aspect of healthcare? This seems like a multivariate analysis, so it would be interesting to compare the quality of medical schools and the resulting physicians with the cost of their education, not simply the cost of education with the price of medical care. Great video with solid information regardless.
I am still reading up on their performance, but 1 in 4 physicians in the USA in 2019 were IMGs (International Medical Graduates, meaning they were not educated at a US medical school). This means that America is pretty much already full of doctors with a shorter education span.
Im not a doctor, but work in the claims billing sector. I got my CPC credential and have to take tests to keep my credentials. Anyways, I took a test and one question was how many physicians would rethink their career choice if they could. The answer was I believe high 40 something percent forgot the exact number but just know it must be a stressful or annoying profession for a lot of docs to be rethinking it.
I’m a chiropractor who has people coming to me for crap I shouldn’t be seeing due to cost and the long wait to see the gp. (I work at a hospital in the US maybe that’s why) Many of these patients come to me with things like a GI issue just because I can refer them to the GI specialist and I don’t have a 2-4 week wait to be seen…. If the US allowed a bridge program for paramedical professionals to undertake the training without all of the debt, I know several chiropractors, pharmacists, dentists, nurses, etc that would be willing to help fill this gap.
I agree, there should be an accelerated program for ppl with healthcare experience that have over a certain amount of clinical hours. Maybe admission would include taking one of the USMLE exams instead of MCAT and having the option to test out of certain competencies and skills learned in year 1 or 2 and enter medical school as a year 3 student instead.
Question: Why does America make it so hard to become a doctor? Answer: They didn't... until the 1997 balanced budget act to artificially create a shortage of doctors because other doctors wanted less doctors.
Waiting for the video about solutions ! Because I really think that it's so much for a medical students here I'm an IMG and trust me we have a great surgeons and great specialists with the half of all this time and all this money ! Well what you said about not visiting a general practitioner until having a serious disease I think one of the causes is the cost of health care here in us, so people don't go to the doctor until they get sick really bad and need a specialist then and not just a general practitioner.
There's also the problem of increasing the number of doctors causing a reduction in doctors' salaries. If this were to happen, the path would literally only be for the rich (even more so than it already is!!) because the only people who would be able to accrue so much debt without being paid sufficiently later would be people who have parents who can pay their bills. If doctors have a large salary later, this allows for a more reasonable possibility that someone less "well off" can go through the system and pay off their debt later.
@@dinakarassane4123 That might work in a smaller country, but it would crash the economy in America. Education here is extremely expensive and there's a lot of people going into it. Either that or it wouldn't crash the economy, but would greatly decrease the quality of education here because schools would have to make many cuts with less money.
@@dinakarassane4123 yes that's exactly what I'm saying. It works for a country like Canada with a population of 38 million, but it wouldn't work in America with a population of 340 million (economy would crash..) but anyways we can disagree lol
@@tal8871 im just curious why you would think the economy would crash? Undergraduate education was free/reduced in the US back in the 50s and 60s pre-Reagan
I have met more than one doctor who is currently driving an Uber full time to make a living. They are doctors who were qualified and practicing in another country but for whatever reason are unable as of right now to take the steps necessary to practice in the United States.
I'm a current dental student and 200K for us would be a blessing, how messed up is that?! It is normal for a dental student to be in over 300K in debt while being paid lower than the avg physician. I often have to ask myself how this makes sense for current and future dental students to take this type of debt on.
If you're close to the finish, might as well finish the program. There are nurses travelling making 200k+ since covid started. With only a 2 year degree or bachelor's.
@@dennis8964 I’m about to finish up my 1st year. It’s very difficult to drop out if anyone wanted bc the cost of just one year is around 100K-140K so even if you are just starting it’s an amount that is way to hard to pay off if you don’t have the right college degree. I wish they would’ve of told us about travel nurses back when I was in high school or about computer science jobs but ofc high schools don’t tell you anything.
Two factors physicians have mentioned to me why the specialize is that it allows them to have more control over their patients load, demographic, and insurance they deal with. Another thing is that if you just want to be a PCP/GP it makes more sense to become a PA or FNP when you consider time and financial investment vs return.
The biggest thing that stops many of us from trying to be a doctor is the costs. It is insanely long but I wouldn't mind doing it if it weren't for the damn costs. 400k debt?! Jesus. The length I could take but it is just the costs. Americans literally have to work to live as a doctor under intense debt and pressure while having a family. Makes it so hard for people to become doctors which is where the shortage is coming from. I can get a MBA, a Masters, and Bachelors all for 1/3 of that 400k cost in CyberSecurity/IT stuff and get paid 6 digits like a doctor. I mean I'll try it in the future I'll find a way to become a doctor I won't give up my dreams but I'm not going to try it without have a solid ground to stand before I get hit with debt.
I haven’t watched the video yet, but isn’t it likely hardest in Canada? There’s far fewer medical schools, and it’s largely academics based which makes it much more competitive between applicants to stand out. Your CARS value on the MCAT makes all the difference, and you need a 3.9+ and 128 to make the cutoffs for even the schools with the least standards that go through the applicants by 0.01 at a time before even looking at your primary. Your extracurriculars are valued, but not nearly as much as how they’re valued in America, which lets you make up for a lower GPA since there’s far more options and spots. It’s why I actually prefer the American process, and I say this from experience in my struggles getting in before I was successful. Feel free to correct me.
@@nbveneno9452 40% of US pre med make it into the US, 21% of international students applying to US med school make it, around 19% of canadian applicants make it to canadian med schools
When an institution is hell bent on income, this is what happens. They forget that patients and HCWs are humans too and not just money generators. This insurance burn out and pressure to always specialise drives many physicians out of the industry.
just make it si years. trust me it is fine to go to medical school after graduating high school. I have done it my father has done in fact every doctor in Europe has done it and it is fine
tough situation. i agree that it takes too long, but at the same time, i don't think anyone under 25 should be practicing medicine since their brain hasn't fully developed and they haven't lived life. not a good idea to go into a field at such an early age that's going to consume all of your time. if we did have a model where students could go to med school at 18, i'd say school should be 4-5 years and then residency until at least 28. so, either way, it would take a while. lastly, i wonder how many americans fly to other countries for care ? i see a lot of documentaries of foreigners coming here for treatment but not the other way around. if our doctors aren't any better, why do they travel here ?
Kill the MCAT, have a true "premed" degree tract 5 years duration. 4 years of medical school 3 of which are clinical. The last year should be a residency transition year. Make the USMLe 2 steps. 9 years flat including undergrad and 3 years full specialty residency.
I agree with your assessment. Do you think if the way in which physicians were compensated (perhaps greater pay for preventative measures) would help reverse the trend towards specialization and lead to better overall health outcomes in the US? Obviously it’s hard to look at things so isolated, as the American diet and exercise regimen (or lack thereof) are also significant contributors to the health outcomes we see
It depends. If primary care physicians are paid more, it could help with disease prevention, BUT only if insurance companies agree to cover more costs for patients(which they probably wont). So its a double-edged sword since you cant convince someone to go to the doctor if they cant afford it, even with insurance
Not a stupid question. A really important question. Maybe in the next year things will get better, but there are some major economic issues in America and we can’t afford to be inflexible in our critical thinking here. I hope you aren’t a teacher.
There is no legitimate reason for it to be that hard. Besides academic rigor (which rightfully has a place) medical school should not put people $200k plus in debt. Thats just absurd. If you go to med school and don’t meet the standard, you are dismissed, try something else. Here is another reality: doctors are human. They will make mistakes. Medical errors are still very prevalent, and often fatal. What I am getting at is that we should be looking at ways to make medical school more affordable and make the accesibility to primary care (not surgeons, not anesthesiologist, etc) more accesible. If you want to specialize, cool. If you just want to provide primary care and low acuity care to your communinty, is 12 years of training really necessary? Specially when half of undergrad is filled is riddled with stuff that won’t make you a better provider?
Listen the courses a med student sees are repeats of the same courses they saw back in undergrad and while studying for the mcats, its a waste of time, only the upper level courses add any value
It’s crazy cause doctors that are trained for 8 years don’t know a simple question as to what I’ve asked and then I would have to research in google to see what the problem is lol 🤦🏻♂️
