Sunday, May 27, 2012

A Whole New Breed

The students being admitted to medical school has changed drastically in the recent couple of decades. Medical schools are no longer just picking the students with the best MCAT scores and the best grades. While these are still two of the most important factors, medical schools are trying harder to find students that are well-rounded. As a result, the coming years will witness the birth of a whole new breed of doctors. The question I will try to answer is what does this change means for the practice of medicine.

One major change seen in students admitted to medical schools is their course of study or undergraduate major. Science majors have always dominated, and they continue to make up the majority. The percentage of applicants who are science majors has remained steady, but what’s changing is who gets in. Medical schools are now accepting an increasing percentage of non-science majors. For example, the University of Pennsylvania now matriculates a class with about 40 percent non-science majors. In 1999, a national survey of first-year medical students found that 58 percent took a social-science class for personal interest. In the 2006 entering class, the number was more than 70 percent. Additionally, humanities students also score better on the MCAT. Data from 2006 shows that humanities majors outscored biology majors in all categories.

The MCAT will be changing in 2015, and these changes are indicative of this new non-science trend. There will be a new section called Psychological, Social and Biological Foundations of Behavior. According to the AAMC, the addition of this section stresses the importance of socio-cultural and behavioral determinants of health and health outcomes.

Another major change in the medical school admissions is that schools are accepting more older and non-traditional students. In fact, about 30 percent do not take a traditional pre-medical path. The average age of medical students is increasing; not too long ago the average matriculation age was 22, and now it is 24. More students seem to be getting a Masters or PhD, or taking time off to work or travel before starting medical school.

The curriculum at most medical schools is also changing. Despite having to learn more material over the years, medical students are spending less time in lecture. This provides more time for independent study, research, and personal pursuits.

Clearly we are breeding a whole new class of doctors. So what does all this mean? Are our doctors going to be better or worse in the coming years? There is reason to believe that this new generation of doctors will better be able to relate to their patients. This is extremely important and will perhaps be more difficult to do because the patient population is also changing; patients are becoming older (due to aging Baby Boomers) and more racially and ethnically diverse. Therefore, we need our doctors to be more diverse (I mostly mean diversity of experience) and well-rounded. Students who take classes outside of the sciences are more well-rounded. As a result, they have lives outside of medicine, which will make them happier and less likely to be overwhelmed, which in turn will help them be better doctors. Furthermore, taking more non-science classes and pursuing other interests will allow doctors to better connect with their patients. I have experienced this while volunteering in the Emergency Department at the V.A. Hospital in Madison. One of the veterans I was helping told me about how he served under Patton during World War II. My education in history enabled me to have a great discussion with him. Another time one of the veterans made a reference to Joseph Heller’s Catch 22. I read the book in one of my previous literature classes, so I was able to converse intelligently with him. Connections between doctors and patients will bring them closer together, enhance the patient-doctor relationship, and make the patients feel more at ease during their time of suffering.

My only concern with this new class of doctors is that some have less education in biology and biological research. They may be better able to connect with their patients, but does this matter if they are not as capable of diagnosing and treating patients compared to past doctors, who almost all had strong science backgrounds and spent more time in lecture during medical school? This is a tough question to answer, but the strong science education that medical students receive should be enough to give them the tools they need to think like doctors and scientists and treat patients. Therefore, there is definitely reason to be optimistic about the future of medicine.

Monday, May 21, 2012

The Adventure Begins

Before I begin my blogging expedition, I will introduce myself. My name is Ryan Denu, and I just graduated from the University of Wisconsin-Madison with a BS in Molecular Biology. I will soon begin the MD/PhD program at the University of Wisconsin School of Medicine and Public Health (As an aside, I think it is so cool and very progressive for a medical school to incorporate as much public health education as Wisconsin does. I am definitely looking forward to this.). My hope is to become an oncologist and cancer researcher.

I decided it would be a good idea to start a blog after reading Atul Gawande’s Better. At the end, he offers bits of advice for people entering medicine, and one of them is to “write something.” Also, my girlfriend is an avid blogger (and a darn good writer I should add) and has inspired me. My goals for this blog are fourfold. First, I want to continue this blog or something similar throughout my entire career in medicine. Second, I hope that it will foster discussions among my fellow students and eventually my fellow doctors, professors, and scientists. Third, I hope to increase awareness about certain issues in medicine and perhaps inspire people to pursue solutions to some of these issues. Lastly, I hope that this blog will allow me to reflect and think through problems. Obviously these are somewhat lofty goals, but my philosophy has always been to aim high. I try to live by this quote from the English poet Robert Browning: “A man’s reach should exceed his grasp.” I may never achieve my goals, but the journey and the pursuit of these goals is enough.

The name for this blog came from my observation that the field of medicine is very ambiguous and characterized by much uncertainty. This uncertainty in medicine was also a major theme talked about by Gawande in Complications (I will probably reference Gawande a lot. He is an incredible writer, and I recommend all of his books).

As for content, I will be writing about trends that I see in the medical field and my responses to my experiences in medical school, research, and medicine. I am also interested in ethical issues in medicine and health care, so I will probably include posts pertaining to bioethics. Additionally, I am somewhat of a health freak, so I will probably write about nutrition and tips about healthier living that I come across. I am open to suggestions, discussions, and criticism, so please do not hesitate. I hope you enjoy reading.