Japanese Medical School Deducted Points from Exam Scores of Female Applicants
npr.org
npr.org
It seems like the solution here is "get more doctors through medical school if some want to work part time", but instead they came up with this discriminatory solution.
This is a false dichotomy. They would have more medical services overall if they simply admitted the right amount of female applicants and then expand their training programs overall so that the less-qualified male applicants who are currently getting preferential treatment can simply train elsewhere to become doctors. Sure some female doctors might work less, but some won't, and there would still be more qualified medical professionals in the field overall.
If you'd review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting to HN, we'd appreciate it.
The biggest issue here is that the government has effectively fixed the price to become a doctor at $200,000 (via stupid requirements) which in turn, fixes the price they must charge patients in order to be profitable. This is in addition to all the unnecessary requirements artificially restricting the supply.
Consider Cuba. In 2016, they were spending $813/yr per person while the US was spending $9,403 per person. Despite this, life expectancy was/is about equal. They graduate loads more doctors than the US. Most of these doctor's don't specialize, but instead become primary care physicians. When there are a lot of them, the cost to visit your doctor for day-to-day complaints decreases and disease is caught and treated much earlier (an ounce of prevention).
Degree inflation is a real killer here. A doctor must have a Batchelor's because it was decided that nurses should have one (though everything past the first 2 years makes basically zero difference on the floor). Then there's a huge middle area, so we train nurses to be not-quite doctors in an attempt to deal with the problem, but the schooling requirements for everyone just keep soaring.
Eliminate the Batchelor's requirement and instead require only the classes that are actually pre-requisites for med school. These are more than sufficient to weed out all the really unqualified individuals, but would reduce the cost of schooling by many tens of thousands (allowing lower charges to patients) and reduce the time-to-market by 3-4 years.
That time to market is extremely important. That's an extra 3-4 years of work before retirement. That's also an extra 3-4 years of experience (experience often being the most important thing) and those years are shifted earlier to when learning is easier. For more dexterous (eg, surgical) professions with long residencies, that 3-4 years is a huge amount of the useful lifespan.
Finally, open a few more medical schools to allow more doctors to be trained. With lower costs and faster time to market, costs for all medical visits (but especially primary care).
The only potential concern here is "unqualified people", but none of the tests have changed. Med school hasn't gotten easier either. The big change is more people are able or willing to give it a try and the risk is much lower.
I'm guessing you mean per capita...?
> A doctor must have a Batchelor's because it was decided that nurses should have one
I'm not sure where you got that from. Nursing going to the BS model is extremely new compared to physicians doing so.
> open a few more medical schools to allow more doctors to be trained
The hold-up here is on training positions. New schools are opening every year, but that's just exacerbating the problem on graduation - we're getting to having (we might already be there, I'd have to check the numbers again) more graduates than we have training positions.
Medical colleges in india don't require a bachelor's degree.
also, no residency requires a bachelor's degree.
also, bachelor's degrees don't have to be expensive... people going into 200k debt to become doctor's are mostly over paying. The acceptance rate for 1st time applicants to med school in usa is around 50%. You can get a bachelor's from anywhere and get in, if you know you can do well on the mcat.
That's probably average combining undergrad and medical school. I go to one of the cheapest medical schools in the country, and it's > $240k in loans alone, let alone interest (plus the $130k from undergrad for me)
And that’s without the hope scholarship which anyone getting into MED school in georgia likely qualifies for making (gpa >3.0)
Most state schools are not that expensive at least for their residents.
In any case, that's tuition alone, and at one public medical school in one state (i.e. most people applying to medical school each year won't qualify for that price; caveat is other states with low prices, such as Texas medical schools, which are routinely the cheapest in the country, but also take >95% instate residents).
Also, my medical schools calculates another $30k in fees and living expenses per year.
Here's another datapoint for you: SUNY Upstate in New York. Tuition alone for instate residents: $43k. Taken from: http://www.upstate.edu/currentstudents/document/com_budget_y...
I'm actually curious now what the costs are for each states' public schools. I can't seem to find a single reference for that though.
What Cuba does not have, making this possible:
- huge, huge administrative overhead. Both at the healthcare providers themselves and in the insurance sector. In addition, "rich" patients are not needed to subsidize care for patients who are uninsured/underinsured/cannot pay in full.
- obesity: 35% of US population is morbidly obese compared to 25% of Cuban population. Obesity is a massive driver of medical issues.
- "perverse incentives" where doctors are financially incentivized or, worse, forced by administration to e.g. operate on a patient when conventional therapy would be sufficient (this problem is also endemic in Germany, e.g. https://www.ndr.de/ratgeber/gesundheit/Kaputtes-Knie-Muessen...)
- CYA policies, e.g. when out of fear for malpractice lawsuits, unnecessary tests/labwork are done on the patient
- malpractice lawsuits/damage awards driving insurance premiums through the roof
- a tendency, especially in elderly people, to prolong their life at immense cost, even if it only brings them half a year in utter misery and pain (which is fine from an ethics point of view, intensive care at that level is just expensive as hell)
- hard drug addictions across wide swaths of the population. Smoking and drinking are bad enough but only the US has a huge problem with hardcore drug addicts. They cause cost in the system due to e.g. overdose treatments or contamination-caused complications
- large amounts of homeless/untreated mentally ill people, who often enough
- only come to a clinic when their health is so fucked that it's enormously expensive to nurse them back to health (aka on the brink of death)
- have their illness cause injury in other persons (e.g. due to fights)
- are directly affected by a lack of protection from the elements (e.g. freezing in winter, lack of shade in summer, lack of hygiene during the whole year)
- "abuse" medical resources to have a warm bed (which I'm not mad about, everyone deserves a warm bed, it's just a mis-allocation of resources contributing to the high costs for everyone else)can anyone refute this? it sounded a bit too slick to me, but I don’t know enough to say if it’s true/false.
Source: ex-USSR experience.
For example, maybe it's discriminatory social expectations of men to be breadwinners, so they're forced to work at really hard jobs like being doctors while their wives can make a free choice to stay home with the kids.
I don't intend this reply to support either view. I'm just saying, discrimination is not necessarily the reason, and even if discrimination is the reason, there are two sides to that coin.
See for example, your own gendered language on who does the "hard job" and who makes a "free choice".
We aren’t talking about dropping off the executive/promo track, it’s returning to work in the same profession at all.
All that being said, it looks like it’s the backlog, not dropout. Less than 10% of US med school grads were women in the 70s (https://www.theatlantic.com/sexes/archive/2012/12/more-women...).
Assume a 40 year career and 34% female is right about where you’d expect the numbers to be.
Or, the US has lots of male doctors from non-US medical schools.
(I actually think all three are factors.)
If the issue is dropout because women are forced to make a decision between career and caring for/watching their child grow surely we can come up with a better solution?
With 9-5 this doesn’t work. Remote work helps alleviate some of these issues, but not all. There need to be organizational innovations to make this happen.
Ask to work 4 ten hour days, for instance instead of 5x8. The state will force the employer to pay overtime for the hours past 8 in a day.
Perhaps one solution is to offer a safety net i.e. grant, incubator, accelerator etc. for women in this position that allows them to create the job that works best for them? I suppose not everyone is cut out for it but this will at least encourage some.
While there are some upper limits, parents usually get their full salary paid by their employer, who in turn get refunds from the government. There is a variation on this giving slightly more time off for less pay as well, plus some exceptions for single mothers, adoptions etc.
It's not a perfect system, and it's not created with the mother's career in mind, but it does accomplish some things:
-The father spends time with the newborn; if he chooses not to use his third of the parental leave it disappears. This leads to more involved fathers, and also help to even the score on who tends to the house.
-Parents can't be fired or refused employment for being pregnant. You also don't have to disclose this during interviews.
-Companies knows that having kids is natural, while smaller ones may struggle to find replacements during parental leave, the system is flexible enough to allow people to work a few days a week if they choose to. This is up to the parents to decide, employers can't dictate what they should do.
-Employers know that employees taking parental leave will come back, so any experience and work-related knowledge isn't lost just because they are having kids.
For a number of reasons, female physicians don’t work as much over their careers as men statistically. I’m guessing that this is why med schools might practice this unsavory discrimination against women. It’s really unfair to individuals that might or might not go on to make more important contributors to the field than the average male doctor.
I was married to a brilliant woman that went to medical school at a time when there was much more overt sexism in the field. Her abilities were unusual; she was always near the top of her class, and in a field like medicine this provided some protection from prejudice. However, women shouldn’t have to be better than their colleagues to simply survive medical training.
Personally, about half my doctors are now female and I’m very happy with them.
What data supports this statement, or is it good old fashion common sense and gut instinct?
If this article is an acceptable form of desperate measures, I think an equivalent would be Exxon deciding there are too many rich black people, and thus paying black engineers less. (private organization using unfounded information to take an action that doesn't make any sense outside the generally accepted social contract)
The US is deeply imperfect -- but no one will tell you that having had a child you can never, ever go back to your profession.
It's not just the systemic gender discrimination but the fact that women in Japan aren't given a chance to balance careers with marriage/children is what's made this such a sensational story.
1. https://www.works-i.com/column/panelsurveys/%E8%90%A9%E5%8E%...
And I've got a bridge in Brooklyn for you.
This is the sort of prestigious medical school where sons and grandsons and nephews of wealthy families are expected to be able to graduate. When too many of them were suddenly not being admitted because smarter, harder-working women were outclassing them on their exams, the admissions department needed to "calibrate" the superior scores of the female applicants in order to maintain a healthy stream of legacy revenue.
Regarding US training bottlenecks. Speaking of specialties more than general Doctor positions, it takes a certain number of cases per year to train a doctor and to sustain the skills of doctors that require specialized hand skills (surgeons of any kind, ortho etc). Those skills are perishable and many hospitals get lower number of cases of certain types than needed to sustain multiple good surgeons. For example, you wouldn’t want to go to a doc that does less than 4 Whipples per year if you need a Whipple. The bottleneck in training docs is the number of cases in the US in each specialty.