Are the “Right” People Getting Into Medical School? One Doctor Speaks Out.

We need to recruit ethical people to become doctors
Are the “Right” People Getting Into Medical School?

I went to a dinner party the other night and ran into a cousin who is also a physician.  He told me about a UCLA medical student who stole a patient’s iPad (and possibly even glasses) from the bedside after the terminally-ill patient passed away from cancer.  I have devoted much of my life to supporting, educating, and defending pre-meds, medical students, and my physician colleagues.  So, when I heard about this, I felt like a part of me—the part that has always generated hope for my profession–died.

Of course, initially, I was in denial that a healthcare provider could violate a patient like this (whether or not the patient was living or had passed away).  Had the medical student been framed by an evil hospital intruder?   Had she taken the device in order to download a special app that could help the mourning family?  In defense, the student argued that “she thought it was her own iPad and took it by accident.”  That argument did not make sense to me: Then why had she not returned it right away?  Why had she erased all the information on it that had been so critical to this family and the patient?  Why had she renamed it as her own?  What happened to the patient’s glasses that also mysteriously vanished with the iPad?  Had the medical student thought that those were hers as well?

I would like to get down on the floor and sincerely apologize to the family and friends of this patient on behalf of all physicians, training institutions, hospitals, and caregivers.  There is absolutely no excuse for robbing a patient of personal possessions no matter what the circumstance.  It is unbearable enough for a family to lose a beloved life to illness.  But, for a healthcare provider to steal from a patient?  That is an abomination.  I mourn deeply for the family who has not only lost a soul they adored, but who has now also lost faith in the medical profession.  In my opinion, theft from a patient warrants immediate grounds for dismissal from any training institution and—without question–from the practice of medicine itself.

As much as I value my colleagues–and want to do everything in my power to lift them up, support them, watch them build successful practices, and flourish–I believe that we should all have zero tolerance for any healthcare provider or trainee who willingly violates a patient’s trust (of course this violation needs to be proven, without a doubt, first).   Patients are already vulnerable.  The patient-doctor relationship is sacred, and we cannot condone any medical provider who abuses it no matter how successful, skilled, or brilliant they may be.

This incident has forced me to think hard about whom we are admitting to medical schools.  I started to think about my medical school application process.  When I was applying, many of the medical schools truthfully just cared about my MCAT exam. What a ridiculous exam!   I was a slow reader and couldn’t read the passages fast enough to finish the questions.  I knew the answers, but I simply could never get to all of them.  Many of the medical schools punched my MCAT scores into a formula and I was weeded out in round one, even though I ended up graduating with close to a 4.0 GPA from a top college.   In medical school and residency—when there weren’t long passages to read on tests–I aced all of my board exams.  While stellar academic performance, of course, is an expectation for admission to medical school, we have to be careful about placing so much emphasis on the MCAT as a criterion for admission.  I remember going to medical school interviews, and most of the time, the ENTIRE INTERVIEW would revolve around how I won my university’s highest award in English Literature, but got just a “9” on the reading comprehension section of my MCAT.  During interviews, I would think to myelf, “Don’t you guys want to find out what kind of doctor I am going to be?”

Shouldn’t they have tried to find out if I am the type of individual who could “rob” the patients in their highly esteemed medical center?

As a practicing physician for close to 16 years, I can honestly tell you that–not once–have I had to perform “reading comprehension” exams at work.  Not once, has a good or adverse patient outcome depended on the fact that I could read and answer multiple choice questions faster than my colleagues.  What I have discovered and–what I continue to learn as a physician–are the things that are meaningful to my patients:  My patients value their doctors’ willingness to be their advocate until the very end.  They value their doctors’ integrity, their availability, their passion for their profession, their undying support, their sacrifice, their commitment, their investigative skills, their humility, their ability to inspire hope even in the toughest circumstances, their honesty, their scientific curiosity, their work ethic, their empathy, their ability to explain healthcare procedures and diseases on a level that most people can understand, their willingness to consider alternatives–and above all–their respect for the dignity of life.  Are we recruiting these kinds of doctors to join the next generation of physicians?  Or are we recruiting kids who “ace standardized tests” or have “worked in a lab 19 hours a day” who are out of touch with humanity and do not truly understand the meaning of “integrity.”  I propose the following criteria be met when vetting the people who will be the future physicians of the United States.

1. Medical schools need to conduct “background checks” on the candidates whom they are going to admit. Most schools select a small class of approximately a hundred students.  There is no excuse not to do criminal background checks on every candidate, Google searches, and cross-checking of references, dates, school attendance, and extracurriculars listed on applications for every student.  A couple of years ago, I worked with a medical student, whose parents are multi-millionaires, who had been accepted to a medical school program for economically disadvantaged students.  How did that happen?

2. Candidates need to be interviewed by more than one person. One of these people needs to be an experienced physician who has been involved in clinical practice for at least a decade.  One of these interviews should be conducted by a “real patient” who can assess how he/she feels about the applicant’s sincerity and communication skills.  Each interview should last at least 45 minutes.  One twenty minute interview by a current medical student or administrator is definitely not enough to assess the character of an individual who will be responsible for human lives within a couple of years.

3. We need to ask applicants deep, probing questions during all of our medical school interviews to thoroughly evaluate their moral reasoning. It is not enough to rely on medical school application essays alone to assess character.   These can be proofread, altered, and even written by people other than the applicant.  We need to give our applicants challenging scenarios with ethical dilemmas surrounding patient care and see how they navigate them (we can get cases that were brought up in Ethics Boards at hospitals).  We need to dig deeper to understand our candidates’ core values and motivations.  It is not enough to ask, “How can we change the healthcare system,” “where do you see yourself in 10 years,” “what are your hobbies,” or “why do you want to become a doctor?”  Those answers are always rehearsed and it is very hard to assess the sincerity of an applicant based on these “canned” questions.

4. We need to pick apart written applications and investigate the truth behind the words. During the interviews, we need to ask about the extracurriculars and medical experience listed and find out if they were exaggerated or real.  Did that candidate really join the Peace Corps?  Did they join it for the “right” reasons?

5. We need to get to know about a candidate’s family. Are any of the candidate’s family members physicians?  Are their parents role models?  What values did the parents uphold when the applicants were growing up?   How have they demonstrated “integrity?”  I worked with a pre-medical student who told me half-drunk at a party that his father had stolen old pre-med exams for him so he could get “A’s” in his science classes in college.  Very sad.

Let’s take this unfortunate iPad incident and use it to make some real, positive changes.  We must do everything in our power as physicians to prevent anything like this from ever happening again.  This is a loud “wake up call” for us decision makers at medical training institutions to be more vigilant and wise about whom we choose to become our future doctors.  While academic achievement is absolutely essential, we must look beyond the GPA’s and standardized scores of our applicants.  Lab experience should not be a pre-requisite.  Many students who are great basic science researchers are simply not fit for patient care.   We need to probe deeper to find out about our medical school applicants’ life struggles, their families, their depth of character, their moral reasoning………………These applicants may be your healthcare provider one day.

Will you trust your own lives to them?  Who will you want as your physician at the end of your life?  The doctor who had a perfect MCAT score, but has absolutely no conscience?   Or the doctor who is smart, hard-working, selfless, and embodies “integrity”?  It is up to us to recruit a new generation of physicians who will make us feel proud to be doctors and who truly deserve the privilege of caring for patients.

“The Doctor Who Spoke Out”

Anonymous Submission to Founded by physicians from Harvard University and the Johns Hopkins School of Medicine.  We provide the top medical jobs + practice resources for over 500,000 healthcare professionals worldwide

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