At high school graduation’s in my experience (3 kids) everyone and their brother wants to be a doctor/PT/nurse practitioner. SO many.
Flash forward 4-5 years…SO many of those students did not pursue a medical/health care degree. Hard to know at age 18 that you want to commit yourself to the rigor of medical/health professions schooling for years. I think the undergraduate degree helps health professions students see if they can sink or swim and mature to realize if they can handle the responsibility and emotional investment day after day of a medical career.
Yes. I keep hearing a lot of the initially pre-med interested kids dropping off like flies through the years of undergrad. Really smart, hard working kids.
It’s not just the rigor of the classes and the competition…it can also be that in college is where students get more up close and personal experiences of what medicine really entails. One intensive summer internship was enough for me to know that I was on the wrong path. I still worked in a health care related field but doing something where I had much more patient interaction/connection.
It’s not that the courses are hard. It’s just a long and arduous path. And the financial attractiveness of medicine has gone down relative to fin and tech for a given number of academic years. That is the rationale I have heard. And I am talking also about Val/sal type kids that went to HYP type schools
CMS funding for residencies is determined by a formula outlined in the Direct Medical Education Act of 1982. The number of federally funded residencies was set in December 1996 and gets revised upward every year as Medicare funding increases.
In addition to the normal annual increases, CMS made a one-time addition of 1000 new residency positions last year.
Also besides federally funded residencies, about 1/4 of all residencies are funded by non-federal sources, mostly through state programs and individual hospital systems.
Residency is not the bottle neck in the process. Every year about 7000-8000 residency positions are filled by IMGs and FMGs because there aren’t enough US grads to fill them.
The bottleneck is that there aren’t enough teaching hospitals in the US where medical students can rotate to complete the clinical education portion of their undergrad medical training. Most privately owned hospitals do not allow med students to rotate on their wards. (Private hospitals allow medical residents to work for them because residents are cheap/free labor and make money for the hospitals. Rotating med students, otoh, cost hospitals money due to the time lost it takes to teach & supervise them.)
I’m not sure it’s necessarily the financial aspect of a career in medicine that keeps these students away. They’re probably smart enough to become one of the more lucrative specialists in medicine. The other high paying careers generally can’t match the longevity and stability of a career in medicine and the associated long-term financial benefits. The long path leading to a medical career may deter some kids, but it isn’t really longer for a kid who intends to pursue a PhD. The cost of medical school may deter some of the kids. Some of them may also feel that medicine isn’t sufficiently challenging.
Based on senior nights I went to for my kids, about 60% of their classmates should be in medical school or engineers. By far the most popular majors listed/stated during senior nights. Factually it isn’t how it works out though. But no one is checking those kids; free to list whatever you want. No harm in that though.
Of the close friends I have who are doctors and who have kids, each one of them has at least one kid tracking towards medical school, in medical school or graduated medical school. One has one graduated, one in and the other 2 tracking towards it. They still believe the economics are there and will be going forward.
The really bright kids that also have a reasonable amount of risk appetite do not end up in medicine among the kids I have seen. If they are sufficiently interested in biology, I have seen them go into an MD/PhD, and at some point move completely over into research at the cutting edge.
I interestingly I didn’t see the same attrition for kids wanting engineering. I only know one of D’s HS classmates who didn’t follow through on her engineering plans. Maybe because it was a STEM focused hs with pre engineering courses and lots of exposure.
This matches my experience. From what I’ve seen over the years, engineering is not a field with high dissatisfaction level. I’ve come to realize it wasn’t the best choice for me, but I believe I’m an exception. I’ve only ever met a tiny number who left the profession or have said they wouldn’t do it again.
This may vary from field to field, and most people probably encounter a job/company they dislike at some point. But overall, the engineers I know are happy withtheir work.
ETA, I realize @momofboiler1 was referring to high school-to-college attrition and I was talking about in-career attrition. But maybe those who become engineers are just better at figuring that out early.
Anecdote of one - my chem e has significant overlap with the classes required for med school. Pretty sure the only class she’s missing is A&P. She felt her chemistry and bio courses were a walk in the park compared to her engineering , upper level math, and physics courses.
Actually in the relative scheme of things, pre med classes aren’t that hard. Except for biochem, all of them are intro level classes that taught at nearly every community college in the country. The physics sequence required for med school is algebra based, not calculus based like engineering majors, chem majors and many other STEM career require.
It’s that med school admission requires top grades in those classes, not Cs.
I remember getting first freshman year chemistry test back in college. Person sitting next to me said “And here dies my dream of ever becoming a doctor.” Difficulty of classes is very relative and in the eyes of the beholder.
My son graduated ChemE. There were a lot of kids who started with him who didn’t graduate with engineering degrees. I had a roommate back in college who graduated in aeronautical engineering. At graduation they cheered the nursing college (who they wanted to date) and booed the business college (because that is where many of the engineering drop outs ended up).
Even the worst weed-out situations in engineering typically are not as aggressive as the weed-out of pre-meds. For example, Texas A&M ME or CS probably needs a 3.75 college GPA to pass secondary admission. Pre-meds aim for that GPA, and cram for the MCAT for a high score, and do lots of pre-meds extracurriculars before applying, and then only 40% get admitted anywhere.
I am not saying they are easy. At the same time I don’t think they are hard. There is some analytical aspect to it, but the skillset that is most required is retaining vast amounts of information.
