Syndney Smith, author of Medpundit, is so out of touch with medical students (and probably the future generation of doctors) it’s not even funny:

Maybe medical schools should treat medical students the way an employer does an employee – make attendance count, and have quarterly evaluations of behavior in addition to grades. But do it for everyone, not just for the problem students.

The scary thing is, I can’t tell she’s the exception or the norm. Doctors? Doctors? Bueller? Bueller?

Make attendance count? Have behavior evaluations? I’m pretty sure I signed up for medical school, not choir class. I’m an adult. If there’s a problem with my behavior or attitude or professionalism, I expect my preceptors to discuss it with me–or at least bring it up on my formative comments of my clerkship evaluation. I don’t need another hoop to jump through, showing that I go to class and that I’m a caring, respectful, professional guy (I do, and I am, according to my evaluations so far).

That being said, I agree that medical students should be on-time, professional, and working hard. If a student isn’t, it’s a problem, and it needs to be dealt with. That also being said, I’ve seen examples (uncommonly) of attendings and residents act with prejudice, act using stereotypes, or make gross assumptions about patients–so the assumption that a preceptor is necessarily a model of good behavior and professional conduct isn’t all that valid for certain people.

“Attendance” is a problem when one’s classes are broadcast online for classmates who study better at home or want to pause the lecturer to write things down. “Grades” are a problem when they don’t exist at a medical school to begin with.

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Today is one of those days that makes me want to move to Canada, France, Spain, or Great Britain, because I’m just utterly disgusted by the Almight Dollar. I’m probably mesmerized by dreams of a greener grass, but today I’m willing to risk it–the weeds we’ve got here are downright rotten .

So we start off with Health Care Renewal’s postings about for-profit institutional review boards (the committees that are supposed to protect you and me from unethical trials like the Tuskegee experiements) and a Bloomberg article describing illegal immigrants desperate for cash being recruited for experimental drug trials . I’m *sure* they’ve all been adequately consented, and their translated consent forms have been approved. By a for-profit institutional review board. Now even Hopkins is using for-profit review boards. ( In case you were wondering by bioethicists haven’t been up in arms about this. ) The whole *point* of an IRB is that it’s supposed to be objective. It’s supposed to be free from outside influences that may skew the committee in one way or another. But *paying* them, oh no, that’s fine. He who pays the piper calls the tune.

And then I go read Kate’s find that we’re wasting hemorrhaging (that means we’re really wasting) money on the new Medicare Drug benefit . Had we just expanded the VA system, senior medications could have been automatically available and at hundreds of dollars per year of savings. (This matters a lot when you’re on a fixed income.) Note: ask your doctor if there are alternatives to the medications you’re on. For example, the “Protonix” example given could be changed to omeprazole (Prilosec), a much cheaper alternative drug in the same class as Protonix and nexium.

And then to top it all off, I go see Syriana. A perfect end to a anti-American day.

I’m a firm believer in the mantra that you can judge a society by it treats its most vulnerable members, and frankly America, we’ve earned an F.

(That’s with the grade inflation.)

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Kate is back from her surgery and back to blogging. She has a great write-up about what it’s like to be a surgical patient , and I’m sure I’m guilty of waking up countless patients at 5am (6:30 is sleeping in, Kate!). Sorry.

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