Are today's medical students wusses? Consider what's different now.

Lately I've heard more and more rants about how today's medical students need to "grow up" or that we are "wusses" for not wanting high-stress jobs or for asking what we need to know for the exam, or how today's senior physicians are "washed up and out of touch."

Don't get me wrong, I strongly agree with the fact that medical students should not be recording remains of body donors (as mentioned in here). This does NOT happen at my medical school; along with virtually all of my classmates, I am strongly in support of my faculty's oft-stated policy that bringing cameras into the lab is grounds for dismissal from the program. While you can be upset at the students for doing this, there's also a lot to be said for not giving the students the opportunity.

What I am referring to is the impression of some more senior doctors that today's medical students are wimps, and that medical students today recoil to comments like this by saying that old doctors have no idea what it's like now.

One retired MD in my faculty, extremely well-respected among nearly everyone who knows about him, made the entire first-year class an exception to this during a lecture by making comments to them that he thinks they never would have survived medical school back in his day.

This only generates division between the generations. "How can he say that?" they reply. "HE would never make it through OUR medical school class. There is SO much more known about medicine today... heck, DNA wasn't even INVENTED when he was a medical student!" Despite their exaggerated protests, they have a point. One example: a rheumatologist told us "The things you are learning in this week in your second year of medical school weren't taught to me until my fellowship."

And whereas most people respect him very highly for his accomplishments in the faculty, all the first-years I spoke to on this won't see him for that. In their words, they think he is a "tool."

In fact, that retired doctor is right in one regard - today's medical students wouldn't make it through medical school back in his day... but only because they wouldn't make it in to medical school back then. This goes both ways, though - he and many from his generation (as I've heard many M.D. interviewers from that generation say during interview weekend) would likely not make it past the admissions process to get into medical school if he submitted his application from 1950 to one of today's medical schools.

And that leads me to the point of this post. Admissions procedures, like so many things, are very, very different today from how they used to be. Comparing a medical school class of today to a medical school class of 20, 30 or 40 years ago is virtually impossible.

Some of the differences I can come up with:

1. How medical students are admitted.

---> Class of 1960: Chosen on the basis of GPA.
---> Class of 2000: Chosen for extracurriculars, personality, answer to the ... . These days, many people in medicine know someone with stellar MCAT marks and GPA who are not in medical school. Back in the day, they were the only ones in medical school.

As a result of the admissions, this leads to a difference in:

2. The type of medical students that are admitted.

---> Class of 1960: Students who put medicine first. Everything else second.
---> Class of 2010: Variety of extracurriculars and social supports (family, friends, etc.) Can't get in to medical school without demonstrating this.

The type of students that get in is related to:

3. How the students that get in approach a high volume of information.

---> Class of 1960: Medicine comes first, so I will learn it all.
---> Class of 2010: How much do I need to know to pass the tests, so I can still have time to enjoy time with my family, friends, and extracurriculars?

This impacts:

4. Types of specialties students choose

---> Class of 1960: Specialties that allow them to be doctors 24 hours per day, live at the hospital, and surround their lives around their career
--> Class of 2010: A documented increased interest in "Lifestyle specialties" (a term now recognized and used by the AAMC) such as the "R.O.A.D. to a good lifestyle" - Radiology, Ophthalmology, Anesthesiology, Dermatology. Or, working 4-day work weeks. As medschoolhell puts it, "Honestly, why work 60 hour weeks for $120,000 per year if you can work the same amount of time and pull in $300,000?" This way, they can spend time with their families and doing the things they love, with their career on the side. Apparently that is what makes us wusses.

Put both types of medical students in a high-stress situation, and that leads us to the fifth difference.

5. What happens when these medical students are subjected to extreme stress

---> Class of 1960: Learn the physiology, pathology, and stay awake until you know it all. This is not a problem because its what they did during undergrad, and medicine comes first so sleep is the only thing that needs to be sacrificed.
---> Class of 2010: Learn the physiology, pathology, and stay awake until you know it all. This is a major problem because during undergrad, these students relied on their many extracurriculars to help relieve stress... but now, the volume of information is much too great to have time for anything other than study. So, far too many students have outlets in other ways... drugs to help them get to sleep (both prescription ie. sleeping pills, and non-prescription ie. alcohol), full-on medically diagnosed anxiety attacks, many minor freak-out sessions.

Anatomy on the Beach has written on this as well, and mentions a number of other factors: dashed expectations, professors who could probably do a better job of explaining the relevance of some of the seemingly irrelevant, nitpicky details we're expected to memorize and regurgitate, and the reality and stress of medical school which can dampen the enthusiasm of learning.

Well, this is just my take on the situation - in my opinion, the Class of 1960 and Class of 2010 are too different to be compared to each other and call one group "wusses" in relation to the other. I would be very interested in hearing from people who have been around longer and therefore know about this situation a lot better than I do...or anyone who has thoughts or can think of other differences.

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