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Comment by wallace_f | Hacker News Reader

They're not magical. If I want to be a doctor, there are two primary sets of exams I need to take: 1-the MCAT, and 2-the USMLE.

Both sets are managed by non profits.

There should be no reason why a poor minority, boy or girl, struggling to make ends meet in a rough neighborhood cannot get online, self study, and one day go and take a seat for these exams. In fact, this should be subsidized by government more than university classes--it is far more efficient and more fair, just better overall.

So these are the primary tests, both in a literal and figurative sense, which establish ability and competency to practice medicine.

After this point, getting the residency requirements and practical lab skills is just a formality.

If what it comes down to is basically some exams, we should be able to give more people access to that. Especially in STEM fields.

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> They're not magical.

> Both sets are managed by non profits.

without an explanation as to how these non-profits are founded, given authority to regulate a given credential, and populated with people, fail to see how 2 negates 1.

Wait... You think someone should be allowed to self-study, take a test, and be a medical doctor?

You can do this with some professions, but I'd like to think my medical doctor has had actual experience with living people and cadavers.

Read my post again. Someone should be able to circumvent the academic complex's monopoly on credentials, as long as they can demonstrate the same aptitude and proficiency.

At that point, as I said, the hospital training is just a formality with some exceptions. Surgeons obviously need to demonstrate dexterity and composure. Candidates need to show up to work on time, etc.

That's marginally better. I'm still not sure I want a self trained physician. A lawyer who didn't go to school and still passed the bar is more acceptable.

We standardized for a reason. Could those standards be changed? Absolutely. I still don't think some poor person should be allowed online study and then to pass an exam and be a medical doctor.

What's wrong with 'some poor person'studying and passing an exam to be a doctor?

Fwiw, I'm still saying we should have residencies.

The same things wrong with a wealthy person doing so. There is much more than is on exams. Exams are easy to pass, experience is hard to fake. Much, much more is covered than exams cover. That stuff is also important.

If that is the case, then it equally applies to university students.

In both cases you study the material and are tested on it. There is nothing magical about paying to study inside a university.

They have more tests that are administered and you glossed over them covering more than is on the tests you mentioned.

It sounds like you're on board with the testing idea, but just think the tests should be more/longer.

And more intermittent. They cover things in medical school that are important (and tested for in class) that don't make their way to the final examination. Those are things a medical doctor should know.

There are also labs that cover things that aren't going to be on the tests. There are practical examinations along the way. It's a whole big process and fairly standardized for a reason. It's not like many other disciplines. I got to witness my daughter go through it.

As much as love her and think she's the most brilliant person ever, she needed the full educational experience and would benefit from more. In fact, many medical doctors keep adding to their education.

I think a lot of us here are engineers who came from unrelated disciplines, or some even with no formal education at all beyond HS.

Other fields could be the same way, if they could get over the cultural and authoritarian bureaucracies. Architecture has less scientific foundations, but it's nearly impossible to do without the prestige of an academic institution.

Medicine is one of the most difficult fields, but I still think if you can demonstrate the same ability, you should be able to go to a residency program.

Academia has an unfair grip on modern credentials, and I think that is one of the great things about tech. For example, some of the very most brilliant modern innovators abandoned academia, Musk, Gates and Newell come to mind.

They can CLEP some classes and skip them. That sort of helps.

In med school or just in undergrad?

Residency is not just a formality. A pre-residency doctor is about as useful as a fresh CS grad who has never seen, or worked on a real codebase in their life.

Except that instead of checking in awful, unmaintainable spaghetti, they'll be making life or death decisions.

I wouldn't let an unsupervised zero-work-experience fresh grad be solely responsible for a product. Doctors make important decisions - without any supervision or 'code review' on a daily basis.

Fair enough, either way we both agree there should still be residency.

An objective test removes the power of picking winners and losers from the academics, they will never allow that to happen.

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