Overheard: Truths Universally Acknowledged

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Could it be the winter weather? Or maybe something your CC professor said has started to sink in? Whatever it is, something has turned the Columbia community into a channel for worldly revelation.

On war

Guy: (to guy friend) “You’ve already hooked up with her! That’s more than half the battle!”

On technology

Small Child to 50-something Parent: “It’s called Siri. S-I-R-I.”
Confused Parent: “S-I-I?”

On life

Student: “GPA is more important than, like, your life, if you’re premed.”

Jane Austen would totes be a blogger via Wikimedia Commons

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  1. Anonymous  

    i’ve been meaning to say this for a while and I suppose now’s a better time than never (not to mention i’m currently procrastinating from studying for orgo): there is something very very wrong with the pre-med ethos nationwide and specifically at Columbia. yes, the acceptance statistics are horrifying (<2% is a hard number to even fathom). yes, GPA and MCAT scores are a part of making it into that small percentage. and yes, the “weed-out” nature of the pre-med track does not make sense in this day and age when (unlike in the 50s or so) the brain drain is into finance, not medicine--it’s almost as if admissions officers who require we take all these unnecessary courses forget that there’s a national shortage of doctors…or something. however, the unhealthy obsession with GPA (and the competition it generates) among pre-meds at this school very honestly scares me. personally, i know way too many pre-meds who I would never want to have as my doctor. sometimes i worry that pre-med classes weed out the normal students who are dedicated to helping people but recognize that their own health and sanity are part of what makes them able to do so, leaving the semi-crazed students who are unskilled in interpersonal interactions, driven by the wrong reasons money/parents/what have you), and so absurdly competitive that they will not be able to operate in the future health service culture which will necessarily be based on collaborative care. (NOTE: the previous sentence is a generalization; there are of course many many exceptions). a lot of us make life decisions based on the “pre-med checklist”, which sadly contains things like “clinical experience”, “research”, and “lab classes for every frickin science class you take”, but not “genuine, worldly experience working with those less fortunate”, “intensive work in a healthy, collaborative group”, “foreign language fluency”, “true appreciation for the beauty of the human anatomical form”, “formulation of the kind of sincere friendships that make you remember why it is that the treatment of the human body as a purely physical animal neglects the fact that, as social animals, our physical health is inextricably intertwined in our psychological health”, etc. i don’t mean to rant/complain about the pre-med track and pre-meds and I’m sorry if this comes off the wrong way; i just wish there was a way to convince pre-meds (including myself on particularly shitty days) that part of cultivating yourself to look impressive on a med school app is developing a passion for something—anything!—strong enough to demonstrate that YOU, as a future doctor who will be saving lives, LOVE LIVING.

  2. Anonymous  

    i agree, throughout my four years here, i've seen many great people who actually CARE about others start out as pre-med, and then get driven away from it by the intense coursework (one mowshowitz C goes a long way), shitty advice from preprofessional advising, and the company of overzealous conniving premeds that no one would want to befriend in real life. it sucks that those people are now going into other professions while same overzealous conniving premeds who drove them away in the first place become actual doctors.

    there are many premeds that i know now with awesome GPAs and awesome MCATs but who are awful humans, that i KNOW i would never want to bring my sick kids to them in the future. this is just sad.

  3. Just trying to be realistic  

    I agree that all pre-med students should, ultimately, follow their passions. And the truth is: most medical schools do acknowledge this fact. Many LOVE to see a student invest time in his or her interests, including extracurricular activities, academic hobbies, etc. This shows the human side of the student, something that is important for a future physician, more particularly if he or she is interested in primary care.

    But, let's not forget - the amount of work and studying and information a medical student is required to master is simply mind-boggling. And, there are not enough spots in the U.S. medical school system to accommodate every single person who wants to be a physician - that's just the reality. There must be weed-out process, and honestly, I'd rather be weeded out sophomore year of college than not get into medical school and find myself with nowhere to go at the end of college. At least the student who gets a C in Mowshowitz has time to recuperate, try out new subjects, and turn their life around.

    The MCAT is a critical reasoning exam hidden behind facade of scientific knowledge, and there is plenty of research that correlates high MCAT scores with success in medical school. One's GPA is the 4-year culmination of one's intelligence, determination, hard work, ability to deal with stress, ability to seek help, ability to persevere, and countless other traits. Ultimately, medical schools require that all pre-meds take the same science courses so that there is a standard of measurement to determine who has what it takes to succeed in medical school.

    I never really understood students who complain about the science classes they are"forced" to take - they hope to go into a field where they will, for the rest of their lives, have to read clinical and scientific research to improve their practice. The pre-med student should WANT to do clinical research - how can you aspire to be a physician and not jump at the first opportunity to work in a clinical setting? The pre-med requirements should not be seen as forceful in any way - if too many of them do seem that way, there is a problem.

    I think many people take for granted the intelligence and hard work of physicians and forget how few actually made it that far, how few actually mustered up the will to keep studying and working (and working and working and working...). Again, it's 4 more years of school, then 3-5 more years for residency, and potentially 1-3 years for a specialty Fellowship. That's anywhere from 7-12 years of education - not every can handle that. Not everyone is cut out for medical school, just like not everyone is cut out for finance or engineering or the fine arts. Just because a students wants to help others, doesn't mean he or she is cut out for medicine - there are plenty of other occupations directly concerned with improving the lives of others.

    Humanism is extremely important, but only after the student develops a solid intellectual and academic foundation. A nasty, though intelligent and knowledgeable physician will save more lives and have a more positive impact than an empathetic, less intelligent and less knowledgeable one.

    • chick_who_wrote_initial_comment  

      hmm…i think this is a little unfair. i have a 3.93 and am an extremely hard worker. i can’t WAIT for those “7-12 years of education” because i will be learning things THAT WILL HELP ME BECOME A GOOD DOCTOR. the point is that some kids who are “weeded out” of being pre-med are intelligent AND hard working, but don’t see why it’s necessary to have no time for friends in order to pursue a career in medicine. so what makes someone “cut out for medicine”, in your view?..cause all your post says is that the only unique requirement (vis-à-vis “finance or engineering or the fine arts”) is that you be willing to have no friends.

      …i also think you a simply factually incorrect. there are a lot of med school spots; there are not enough RESIDENCY spots. see the link for one of the many many people who are saying so.

    • girlwhowrotetheinitialcomment  

      hmm…i think this is a little unfair. i have a 3.93 and am an extremely hard worker. i can’t WAIT for those “7-12 years of education” because I will be learning things THAT WILL HELP ME BECOME A GOOD DOCTOR. the point is that some kids who are “weeded out” of being pre-med are intelligent AND hard working, but don’t see why it’s necessary to have no time for friends in order to pursue a career in medicine. so what makes someone “cut out for medicine”, in your view?...cause all your post says is that the only unique requirement (vis-à-vis “finance or engineering or the fine arts”) is that you be willing to have no friends.

      …i don’t want to be a dick, but you need to check your facts. there are a lot of med school spots; there are not enough RESIDENCY spots. see the link for one of the many many people who are saying so.

  4. Postbacc Anon

    I agree with the entirety of the original post. I, too, fear that the premed program is selecting for people who are not equipped to care for the health of others and for skills that may undermine patient care. While it could be argued that premedical program at any university could be subjected to the same critqiue, I strongly believe that the presence of nearly 400 postbac premeds on campus adds to the toxic atmosphere of the premed program. With a few notable exceptions, these students see their premed education as a means to an end and are not interested in cultivating anything other than the credentials required for admission. While this is admittedly a generalization: postbaccs are petty, not intellectually curious, and are willing to cheat and undermine other students in order to succeed, (I have seen this and it is ugly!) However, it is the university that should be held to account for their behavior and for the toxic atmosphere that they bring to premedical education. The acceptance rate into the Columbia Postbacc program is supposed to be over 50%. The University credo appears to be: if you are willing to pay us, we are willing to let you into the program. Unlike for other postbacc programs, there are no interviews to assess the character, motivations, and quality of the student. It is obvious that the economics of an essentially zero marginal cost program are just too enticing to limit the postbacc class size and select for students committed to their premed education and committed to eventually caring for patients.

    I also want to respond to "trying to be realistic" apologist for the current state of the premedical education. Central to your argument is the idea that a premed program should select for those who will survive the rigours of training. This seems myopic. A professional training program should be selecting for those that will be successfulin the profession not simply selecting for those who can survive the training. Moreover, we should keep in mind that the attrition rates from medical schools are in the single digits because medical schools allow students to repeatedly fail and take classes. So, while the training is demanding, medical schools and residency programs are actually quite forgiving. Given the talent in this country, I think there is little risk that students won't finish training if we selected for students who are well equipped to be a wonderful clinicians and researchers instead of a wonderful med students/residents. Finally, the apologist invokes several troubling ideas and facts
    (1) Apologist cites an ostensible correlation between MCAT scores and "success." This oft cited statistic is a correlation between MCAT scores and STEP scores. A student's STEP scores reveals nothing about their capacity to be a competent and caring clinician. We need a different outcome measure
    (2) Apologist seems to believe that the current basic science premed curriculum in necessary and sufficient. While quantum physics is absolutely fascinating and possibly the greatest intellectual achievment of the last century, 99% of clinicians have no use for it. You will be hard pressed to find a clinician who remembers anything about organic chemistry, physics, or even basic cell bio. If the MCAT is a vieled critical reasoning test, why then require these basic sciences? Why not approach medical school training the way law school training is approached? The basic sciences can and should be taught in medical school in the context of training students for medicine. If any classes should be required it should be classes in logic, statistics, bioethics, public policy --- classes that medical schools are ill-equipped to teach but that will serve doctors well in clinical practice.
    (3) Apologist seems to believe that you need to be brilliant to be a wonderful physician. Frankly, most front-line physicians do not need to be. The work of a physician is not easy, but it does not (unlike some other professions) require brilliance. Compassion, manual dexterity, and other skills that are not selected for and are not cultivated by the current system are much more important than IQ (which is a culturally biased and incomplete measure.)

  5. Anonymous  

    While there are definitely some I do not think that there are that many incredibly talented and hard working people driven out of medicine. Also, to be perfectly frank if they can't cut the competition in undergrad I wonder how they will feel about the intense competition in medical school. To perfectly frank I believe that people who are pre-med/pre-professional develop the most severe case of tunnel vision I've ever seen, but that does not mean that we should be making the process less competitive to allow more humane, but less academically capable people into medicine.Instead, I think that advising services as well as student groups should make a greater effort to promote a feeling of community and collaboration rather than that of competition. However, to reiterate, I do not think that the standards are too high by any means. It's not getting any easier in med school and the people will not be any less anal.

  6. still trying to be realistic  

    I don’t really know which post I should be responding to, since my comment drew such large criticism. I actually agreed that pre-medical students should absolutely follow their passions. But just having a passion for a field of study and future professional does not entitle the student to earning the right to practice it as a career. Contrary to popular belief, there is logic behind the pre-medical curriculum. The science and art of healing is based strongly upon science (and experience – I am not disregarding that fact; only, experience cannot be taught at an undergraduate institution). Thus, medical schools have based the pre-medical curriculum upon the basic sciences, because of their inherent connection to medicine, anatomy, physiology, pathology, etc. But the important point is that the Columbia pre-medical curriculum forces the pre-medical student to apply knowledge in new, novel ways – one cannot hope to succeed in biology, organic chemistry, or any of the sciences without an ability to apply their knowledge, and this requires intelligence and persistence practice. The modern physician is similarly bombarded with new patients and symptoms each day – he or she must be able to apply their education and knowledge, come up with a diagnosis, and select a course of treatment. The parallel is obvious.

    Moving forward: the pre-med path is not a pre-law path. As a lawyer, you might save your truly guilty client from decades in prison. Nobody will ever know whether or not your client was truly guilty – after you make your argument, it all depends on the jury/judge, i.e. law is a relatively subjective field of study. In medicine, after you make your “argument” (i.e. course of treatment), nature is your judge and the patient’s condition either improves or worsens – there is an inherent objectivity in medicine. Not surprisingly, the basic sciences, the cornerstones of the pre-medical curriculum, are unforgivingly objective – only in the “softest” of them, biology, will you find swaths of partial credit. Bioethics is inherently subjective, as is public policy (besides, both are offered in medical schools as electives and dual-degree programs). Statistics is already recommended by many medical schools, and mathematics is just a numerical application of logic – the same method of reasoning will be developed through mathematics and the application of knowledge in the hard sciences.

    I never said that to be a pre-medical student requires that one sacrifice all of their social life. It is true: the pre-medical path requires certain sacrifice. But all paths require sacrifices, some more than others (not surprisingly, those with the most sacrifice yield the greatest rewards at the end). The pre-medical path is a CHOICE. The student can elect to do worse in their classes and, in return, improve their social life – it is their prerogative. To get to the core of the argument: nobody would say that a human being has a right to practice a particular profession. That would be ridiculous.

    I also never said that MCAT scores correlate with being a caring clinician (being caring does not allow you to score high on the MCAT – I agree with that). I said it predicts success in medical school, which is heavily weighed by success on the USMLE. The USMLE does not measure “compassionateness,” and nor should it. Its goal is to measure the intellectual capacities and knowledge foundations of medical students. And remember: an entire stage of the admissions process, the interview, is solely devoted to selecting candidates based on measures such as compassion and humanism.

    And finally, there is a shortage of residency spots yes. However, my entire argument is simply that there are not enough spots in general for all of the students who wish to become physicians (whether the road block occurs at the medical school stage or the residency stage is irrelevant).


  7. Anon

    Mowshowitz, get off this thread!!!!

  8. Anonymous  

    I would want to bring my sick kids to a doctor with the medical knowledge and critical thinking skills necessary for coming up with an accurate diagnosis and effective treatment plan. But if you want to chose a physician based on good intentions, be my guest.

    Also, since when are caring about other people and success in pre-med classes mutually exclusive? A strong desire to help others should only serve to motivate your studies, and make your realize in the long run that it is worth it to spend a little more time studying than socializing.

  9. Anonymous  

    house has the medical knowledge and critical thinking skills necessary for coming up with an accurate diagnosis and effective treatment plan. i would never want to bring my kid to him.

    caring about other people and success in pre-med classes become mutually exclusive when you realize that to do well on a test you need to do better than everyone else. it's not a matter of motivation. i believe everyone is motivated, but to become so tunnel-visioned into studying that students move away from socializing and humanizing to a memorizing zombie serves no one in the long run. life can't be lived out on a textbook

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