An interesting idea to say the least. Also, is that Buffalo NY?
271 karma · joined October 15, 2016
I'm at a private (but good) medical school and this is definitely a problem. My tuition (not including living expenses) is about $50,000 per year. And to be honest, there isn't a huge difference in tuition between most private and public medical schools. I'm from NYS, which does a pretty good job subsidizing its state schools. When I was applying to medical school, the in-state price was around $35,000 per year. However, just over the border in Pennsylvania the price at Pitt (which is public) was around $48,000 per year, for out of state students, and maybe 40 or 42k for in state students.
I went to an in state school for undergrad, and I'm very fortunate to have no debt from that. However, many of my classmates who went to good private undergrad schools (Ivy league etc) will have (a lot) of debt from both undergrad and med school. They literally have no choice - they need to go into a high paying specialty if they ever want to pay their loans off.
One positive argument to having a body like the AMA leverage some control over medical schools is that it helps to ensure that schools only open/expand if the AMA thinks that their students will have reasonably good chances of getting residency positions. It helps to avoid the sort of situation that is currently going on in law school and PhD programs where there are no where near enough positions available for all the students who are graduating from those programs.
And I do generally agree with you that there are some significant regulatory problems regarding training and residency positions, especially since residents have basically zero leverage at all.
If you look at the top performing hospitals, many of them are obscure hospitals or ones that only offer expensive surgical care that most doctors would __never__ go to themselves or recommend to their friends/family: http://www.usnews.com/news/articles/2015/04/17/only-251-hosp...
I know the article is a bit old now, but if I recall correctly the rankings haven't changed much since the metrics are still calculated in the same way.
I agree largely with @GarrisonPrime's thoughts regarding the systematic nature of biological systems. I also share the same sense of trying to understand the logic and intuition of the physiology I learned in the first two years of medical school while many of my peers were just trying to guzzle and regurgitate. I have to admit that I also fell into that mode as well at times, just due to the volume of material that was expected. But that's for another time.
I'm currently taking a year to work on research that is in systems biology/bioinformatics. While there are many things that I like about it, and I'm grateful that it presents an opportunity for me to continue learning about computer science, machine learning (been really getting into learning about Bayesian analysis this year) and biology I have to admit that this article sounds like it was written from the same vantage point that I stood on a couple years ago as I just started getting into this area of research.
The technology we have today to probe cellular systems is amazing and was literally the stuff of science fiction some 20 years ago, but it's not without its faults. This line from the article especially rang true to how I feel these days:
"But there's a problem. The vast data sets that give bioinformatics its power are also its Achilles heel."
The problem is that the systems biologists and bioinformaticists are most interested in are dynamic with complex regulatory systems that we don't have ways of measuring and most methods of measurement either completely destroy the system or alter its dynamics. In addition, it's akin to taking a snapshot of how the system is behaving at one instance in time or condition. Yet many times we are asked to use that information in a way that's akin to trying to describe the dynamics of an entire motion picture from 2 or 3 photos. And those photos are greyscale. Take for example mRNA-sequencing, a type of data that I work with frequently. It's trying to measure the amount of gene product that a cell or cells have at one point in time (basically trying to get a measure of how much geneX the cell is trying to produce). While it is an interesting measure and can give some insight into how the the cell may be adapting to different conditions, those measurements alone tell us almost nothing about the regulation behind those differences, which is the thing we really want to understand. It's a bit like seeing oil on top of water and then trying to infer the complex dynamics of geophysics that are occurring on the ocean floor. Not saying that it's not useful at all, and can help direct your attention to the next interesting thing, but I think that many people overestimate how informative the data is. And then there are still a lot of technical issues but that is a discussion for another day.
The other main point I want to make is that for all the data you think we have now about these biological systems, it's like a snowflake on top of the iceberg. Even many of these large consortium projects like ENCODE have relatively small amounts of information if you want to learn about some transcription factor or cell type that isn't one of the top 10 most well known or studied. And how many of those datasets out there are really lacking in good quality control, and then there is the politics of sharing data in an academic/research environment that is so competitive getting a job (that you will have to continue to work like a madman/woman at) is like winning the lottery.
OK, I don't want this to descend into a full blown rant. Main points - it's still really exciting, and it's a great time to have intersecting interests in medicine, math and computer science. Just that the tech we have to work with right now is still a bit nascent and expensive. I think there will be a point where systems bio and machine learning will revolutionize how we understand biology. We're just not quite there yet.
On a side note - where I do see a lot of potential right now where computer science and machine learning can start to make an impact is more on the clinical side of medicine and using ML to learn from the vast stores of EMR data. But that's also another discussion for another day. If you read this far, here is a smiley face, and have a nice weekend :)