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When I entered med. school (no docs in fam), I assumed:
1 Med education would primarily train me to be a doc
2 Cancer screening is an unalloyed good
3 When docs recommend Rx, they knew those Rx work
4 Hours/ schedule worked were based on optimizing education
I was wrong x 4
1 Med education would primarily train me to be a doc
2 Cancer screening is an unalloyed good
3 When docs recommend Rx, they knew those Rx work
4 Hours/ schedule worked were based on optimizing education
I was wrong x 4
With many years, I slowly learned
1 Med ed is not tailored to training the best possible 21st century doc, but primary a series of compromises appeasing entrenched interests
Thus, we are forced to memorize useless factoids (step1) & woefully undertrained in appraising literature
1 Med ed is not tailored to training the best possible 21st century doc, but primary a series of compromises appeasing entrenched interests
Thus, we are forced to memorize useless factoids (step1) & woefully undertrained in appraising literature
2 The evidence supporting cancer screening is generally poor (recent exception is Flex Sig).
Lung ca screening - v v poor
Benefits overstated
Harms ignored or trivialized
This came as a shock and a blow to me https://www.bmj.com/content/352/bmj.h6080
Lung ca screening - v v poor
Benefits overstated
Harms ignored or trivialized
This came as a shock and a blow to me https://www.bmj.com/content/352/bmj.h6080
3. Took me a decade to slowly learn that many many things we do, in fact, do not work.
That false optimism ran rampant in this field, and rigorous studies of practices remain rare
Covid reinforced these lessons https://elifesciences.org/articles/45183
That false optimism ran rampant in this field, and rigorous studies of practices remain rare
Covid reinforced these lessons https://elifesciences.org/articles/45183
4. No profession has more people in power who strongly feel that long long hours (mostly spent writing notes that will never be read again after 3 days) is good
Entire research agendas and subfields are designed to prove these hours do not kill more people- w NI margin 1%
wow!
Entire research agendas and subfields are designed to prove these hours do not kill more people- w NI margin 1%
wow!
I remember the feeling of shock and disappointment as my initial impressions gradually were upended-- through great professors & also reading many articles.
It's hard to describe in retrospect
It's hard to describe in retrospect
the one belief that wasn't contradicted but strengthened was
5 Medicine is a good job
I now feel it is the best job-- a real privilege
And best of all folks (particularly young docs) are open to revising their thinking, being persuaded, to make it better
5 Medicine is a good job
I now feel it is the best job-- a real privilege
And best of all folks (particularly young docs) are open to revising their thinking, being persuaded, to make it better
That idea-- that folks are open to reason enough to change beliefs-- is what motivates me to write papers/ make podcasts/ tweet
In contrast, I believe other topics/ fields there are scant people who are open to reason-- so grateful to be in medicine, where we have a few!
In contrast, I believe other topics/ fields there are scant people who are open to reason-- so grateful to be in medicine, where we have a few!
