PrintMarch 26, 2010
It's Hard to Make a Doctor
Last spring, I attended my son's medical school graduation. As I proudly watched his class receive their M.D. degrees, I was reminded of all the years of preparation for that day. The academic requirements started early. A child who falls behind in grade school or high school will not become a doctor. Of all the ambitious new college freshmen that choose the "pre-med" track, the majority do not make it. The academic and financial demands through college, and the intense competition for medical school acceptance, insure that only the highest achievers will be successful.
The application process is incredibly challenging. There are only 130 medical schools in the United States. Six states do not even have a medical school. Nineteen states have only one. A successful applicant must graduate with a high GPA from a respected college or university. The required MCAT entrance exam is extremely difficult, and a low score almost always eliminates hope of acceptance. A high score, combined with a high GPA, improves the odds, but is no guarantee.
My son's experience is typical. He attended a large private university with a reputation for a high rate of medical school acceptances. Approximately 25% of the students in his freshman class were pre-med. After four years, only 20% of these finished the pre-med track and applied to medical school. Then, approximately 60% of the applicants were actually accepted. Therefore, from the original class of ambitious pre-med freshmen, typically some of the best and brightest out of high school, approximately one out of ten were accepted into a medical school.
Medical school is a four-year program, and the volumes of knowledge to absorb in a short period of time are difficult for even the best students. There can be no fear of blood, gore, or foul smells. The physical and psychological challenges can be as daunting as the academic ones. First-year students all dissect a human cadaver and become anatomy experts. They move from the classrooms to rotations in emergency rooms, operating rooms, cancer wards, and every variety of clinic. They must develop a professional insensitivity to pain and suffering. My son helped sew the scalp back on a drunk driver's head, scraped dead skin from a young child's severely burned torso, and tried to save a mangled leg injured in a motorcycle accident.
The majority of medical school students live on student loans and finish with well over $100,000 of debt. Following graduation, they enter multi-year residency programs required by their selected field of medicine. My son is now 27 years old and in the first year of a five-year residency. His salary is $44,000 per year. He is on call every fourth night when his shift is over thirty hours. He has one weekend off per month. He will probably add at least one year of fellowship training to the end of his residency, so he will be at least 32 years old when the formal training ends, when he can finally earn a "market" salary and begin paying off loans.
Amid all the debate concerning health care reform, our lawmakers should remain mindful that without doctors, there is no health care. The special few that actually become doctors are bright and motivated, and the process is long, difficult, and expensive. Without significant incentives and compensation, the best and the brightest will simply choose other careers.
For all of us on the receiving end of a stethoscope, scalpel, or MRI, we always expect our doctors to be intelligent, accomplished, and highly trained individuals. In the drive to make health care more "efficient," we should not take for granted that a doctor will always be there when we need one.
