Why does the director of the Cancer Prevention Foundation believe that medical graduates cannot be trusted with patients because they will kill them? Is it really that bad?

Why does the director of the Cancer Prevention Foundation believe that medical graduates cannot be trusted with patients because they will kill them? Is it really that bad?

The Geopolitics of COVID-19 | Prof Kishore Mahbubani

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answers (3)

Answer 1
September, 2021

Strictly speaking, this applies to graduates in almost all specialties, just with doctors it is more noticeable. Well, yes, the level of training of schoolchildren has decreased - this is again noted by teachers of all universities, not only medical ones. The level of general erudition has dropped noticeably. The programs at universities have changed, the workload has become noticeably less: I remember very well how I studied in the first year of the Military Medical Academy, and I see how first-year doctors study today, one of them lives in the next room - my son. In general, they are required significantly less than from us.

Some teachers also confuse students. I'm not talking about those who can't stand evidence-based medicine and talk about the same immunomodulators or hepatoprotectors as really working drugs, this is not the worst option. There are also those who preach the most real obscurantism: at lectures on genetics they talk about the "wave genome" named after Gariaev, and at patphysiology or pharmacology - about the wonderful properties of water and homeopathy. As a result, instead of a harmonious scientifically grounded system, which can then be used in practice, the students' minds form the most natural porridge.

There are other reasons as well. Thus, the prestige of the profession has been driven under the plinth by the joint efforts of the media, which, with or without reason, go into hysterics about “killer doctors”. This is superimposed on multidirectional and far from always thought out reforms, to put it mildly, very modest salaries of doctors (hello to the beloved state), especially in the regions, which does not add motivation to students.

Yes, we need to change the training system, or rather, there was no need to break the old one. Yes, a university graduate is not yet a full-fledged specialist, he still has to study and study, at all times and in all countries doctors “matured” the slowest, becoming qualified and in-demand professionals noticeably later than 30 (in some areas - even 40) years. But you need to start long before the university. And this requires a clear position of the state, which so far looks very vague and ambiguous.

On the other hand, for those who really feel a vocation in themselves, a lot of opportunities are now available. You can do what you love right from school: there are medical classes, interactive museums, and special educational projects. And in universities, the influence of the digital age is increasingly felt: excellent simulators, accessible and almost bottomless electronic libraries, interactive tools. In general, just learn. There would be a desire. You can't make anyone a doctor by force.

In general, I am rather an optimist in this matter: well, yes, it's bad, but it could be worse.

Answer 2
September, 2021

No, we also have one, they are already over 50 years old and they started in the USSR and they can be counted on one hand.

Do you know how difficult it is to get the title of doctor outside of Russia?

So, in Russia, in order to be called a surgeon, you need to go through 6 years of study at a university and 2 years of residency. There are no special official requirements for the number of operations performed and for the surgical technique in the program. Therefore, someone disappears on operations, and someone occasionally enters the operating room. And the experience gained, the number and complexity of the operations performed depend on the student's desire and how much the training surgeon trusts him.

After 2 years of study, you need to pass a relatively simple certification exam, no one really knocks on it, and you need to try very hard not to get a certificate.

As a result, every year we have hundreds of 24-25 year old surgeons with very different levels of training, but often inexperienced - i.e. still unable to do large operations on their own, alone. Further training and progression is already underway.

In Australia, you need to get a medical education - a Bachelor of Medicine and Surgery (MBBS), usually 5 years. Sometimes 6 if the student takes an additional year for a research project (Honors).

After that, there is a year of internship, where the intern (Intern) must work for a year in surgery, therapy and the emergency department - if one of these is not passed, the internship will not be counted.

After that, the doctor becomes a resident (Resident Medical Officer), and getting a job, says what specialties he prefers. This does not mean that he will work in these departments, but in any case, they will try to take into account his preferences. If you manage to get a job as a resident in surgery, the doctor works in the department, at a simple outpatient appointment, assists in operations (if everything is done in the department), sometimes he will open an abscess.

At this time, the doctor is working hard to enter the training program for a surgeon at the College of Surgeons, i.e. become a Registrar. The competition is very large, and personal achievements, experience and recommendations from previous jobs are very important. In order to form a decent resume, you need to take many courses, the total cost of which can reach up to $ 20,000. In addition, to apply for admission to the program, you need to pass a rather difficult exam in normal and pathological anatomy and physiology, which costs about $ 3,000. Didn't pass the first time - pay for the next try. Many also write PhDs to improve their chances. A successful exam and completed courses do not guarantee getting into the program, but are only a condition for considering a candidate, and usually it can take several years to enter the College, since there are many applicants, and there are few places (70-100 for two countries).

Therefore, after 2-4 years of work as a resident and awaiting a response from the College, the doctor becomes a non-accredited registrar - i.e. he didHas all the same responsibilities as a trained surgeon (accredited registrar), but is not in the program and will never become a surgeon until he enters it. And there are many of these duties - to conduct an appointment at the clinic, guide patients in the department, monitor the work of residents, independently watch the hospital at night (yes, surgeons sleep at home at night), operate depending on experience.

After several years of working as an unaccredited registrar, the College is finally accepting our doctor into the program. The program is divided into 5 years of study (SET1 - SET5). The total is the number of transactions per year - participation in at least 200 transactions per year. The difference by year is the percentage of independent operations (from 20% to 60%). Oh yeah, appendicitis or hernia doesn't even count as surgery. 200 large operations. As a result, by the end of the program, the registrar had hundreds of large operations performed independently and thousands of "small things" such as appendicitis, paraproctitis, and so on.

During the last year, you need to pass an exam for college membership, without this you cannot become a specialist. The exam is extremely difficult. So you can imagine: the year before the exam, doctors have no personal life at all. Only books, books, books. And about half of this exam fails. Another six months in the books, and then they usually pass. But again, not all. Those who have passed the exam get the right not to call themselves "doctor" (Dr), but to use the prefix "Mr." (Mr) or "miz" (Ms).

After all this, additional training takes 1-2 years (Fellowship) in the chosen narrow specialty (colorectal, endocrine, mammology, hepatobiliary, etc.), where now the surgeon masters the subtleties of the most complex operations in a large hospital with a large number of operations in the selected subspecialty.

And after that, our doctor, who has already passed 35, and often over 40, comes to get a job and says: "Hello, I'm Mr. Smith, surgeon."

Answer 3
September, 2021

Well, how can I tell you.

50-70% definitely better not to trust. I judge by my institute. On my course, in an amicable way, 50% of people should be driven away, but they stay - they either negotiate for them, or they pay. And here it becomes scary, because there are people who cannot distinguish the aorta from the rectum (sic!). What can we say about something else.

Of course, many are eliminated by the 3rd course - there are many exams, not all of them pass. Others are eliminated by practice - after the same notorious 3 course, medical students go to work as nurses / brothers. And then trash, frenzy and sodomy rush. For we begin to understand that everything we have been taught is fierce delirium. Theory and practice differ significantly, and you realize that you know nothing and cannot do anything. If you come across a sensible curator, they'll make a good doctor out of, sorry, shit, no - well, what can you do, either turn around yourself, or throw it away, since it's not yours. And after this practice, many quit, because they understand that they will have to almost plow, but they pay pennies (I am here from LeNeRe, we are generally deplorable, because the salary of students, if they are lucky, is 3-4k, and the prices are Russian).

But.

You understand that 9 normal sheep come to one black sheep. So, it's not all bad. For those who paid all the time (mostly, these are the children of those in power or simply very good earning people) - they already have a place in the sun ready in advance. Well, everyone else is trying to carve out a place for themselves not in some villages beyond the Arctic Circle due to good studies.

So I believe that it is still not 90% that cannot be trusted, but at least 30-40 %.

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