<p>With regards to the BMI complaints: most of the research (and some of the clinical attention) is shifting away from BMI towards waist circumference as a measure of obesity and overweight. Waist circumference is a much better marker for health risk than is BMI.</p>
<p>ucb- true. (Not disagreeing with your points at all.) But as laymen, we don’t always know whether aggressive or its alternatives are what’s needed. The whole situation is complicated by insurance oversight. There has to be a delicate and somewhat informed relationship with your docs. A whole lot of trust, with a good dose of questioning. Googling. Interpreting. And being frank about concerns.</p>
<p>There’s also dread disease versus more ordinary issues. Lifestyle impairing or life threatening. Likely to worsen, if not treated vs just wait it out. I’m one who believes you have to partner with your doc, have ones you feel you can partner with. And, by all means, inform yourself. Not easy.</p>
<p>Ever stop to think how much docs, in ordinary circumstances, read you through intuition layered onto their training, lay their hands on you or thump on your back, and can tell when there are signs of trouble or not? A whole chunk of medicine is technique, not technology. I like the docs who are good listeners and talkers, just the right amount of info taken from me and explained back. And, I google. All this is so much more than whether they had the best stats in med school.</p>
<p>I wish a single stat could predict whether a doctor would have the courage to walk into a patients room to tell a family, “we are not inserting a feeding tube. Your loved one is going to die, and we are going to figure out how to make the last few days (or hours or weeks) as good as possible given the terrible circumstances we are in.”</p>
<p>Some medical conditions require the best technician/practitioner. Some require a fabulous diagnostician who then hands off to the technicians. Some require the scholar who reads the medical literature voraciously and attends every conference but may be lacking in interpersonal skills. And some require empathy, bedside manner, and the courage to tell a patient, “We have the skills to prolong your life but we are not going to use them”.</p>
<p>Arguing about which set of skills is better seems pretty fruitless to me. I wouldn’t ask Chief Justice Roberts to handle a divorce or the sale of my house- not that he’s not a good lawyer, but he probably hasn’t thought about those legal issues since he crammed for the bar exam. And I wouldn’t ask my divorce lawyer to weigh in on a constitutional issue, or help Afghanistan draft a constitution.</p>
<p>Why is this a debate- except that scores and class rank aren’t highly predictive of how good a doctor is going to become in a specialty that may require much more than that? My radiologist has Parkinson’s. He’d be a terrible surgeon- he can barely hold a pen.</p>
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<p>These are poor arguments. It’s obvious that if you go into a different area of specialization (e.g., constitutional law), then you won’t be as good at another specialty (e.g., divorce law) as someone with that training. What we are discussing is who is more likely to make a competent lawyer before specialization.</p>
<p>By the way, to answer Beliavsky’s question, there have been studies done showing an inverse correlation between medical board scores and medical malpractice.</p>
<p>By the way, I’ve seen doctor’s mess up diagnoses on family members before. These diagnosis were challenged, but they were dismissed with the usual response, “I’m the doctor–I know best.” When the conditions got worse, then it was easier for them to diagnose. Maybe it would have been beneficial for those doctors to be a little more interested in their job, and a little less satisfied between being right 85% of the time. Are these the same people to memorize and regurgitate enough for the A- in school. Who knows? </p>
<p>However, at any point in the training process, you look at the person’s track record as an indicator for how conscientious they will be in doing well in the next step in training.</p>
<p>One thing that might help you who like data wrt physicians. The medical honor society, Alpha Omega Alpha, is an honor usually given to late fourth yr med students. It takes into account “book smarts” (grades for the first two years, the basic science years), Board scores, and most importantly (imo) grade for the 3rd and 4th year clinical years. These “grades” are more subjective, often not letter grades but a scale (Outstanding, Satisfactory, etc etc) given by the attending doctor but usually also taking into account evaluations by Chief or supervising residents, sometimes even nursing staff. They end up often being given to two groups of students-- smart kids who also do outstanding work in the clinical arena, and okay smart kids who bloom and show themselves to be really good in the clinical years above how they performed in the basic science years. Usually (usually!) the book smart stars who have terrible bedside manner or poor diagnostic skills do not make AOA. Sometimes physicians will have that honor available to those who look. </p>
<p>However, as has been mentioned before, it’s usually performance during residency that reallly shows who the stars are and who may struggle in the future as a practitioner (rather than a “study-er”) of medicine.</p>
<p>@jarlynn: That seems reasonable. I think they should do some rigorous studies on what sorts of non-academic activities as an undergrad correlate to being a good practitioner, though. There’s a lot of assumptions.</p>
<p>I suspect someone with a mohawk, facial tattoos or a tongue/lip piercing would not get accepted by a medical school in US. I have no evidence to prove it.</p>
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<p>Oh please. The best and the brightest - as measured by the Almighty SAT and the Almighty Elite School education – went into banking. And look what that did for the country. It should be self-evident to anyone with a brain that while smarts are important – and I myself value them highly – there are other, softer characteristics that are important in life.</p>
<p>I value the “soft” characteristics. I thought HYP had been selecting for them, in plenty of time to have used those selection criteria for the students who subsequently went into banking and in some cases showed a lack of ethical responsibility.</p>
<p>I don’t favor selecting on SAT scores only. But would they have done worse by doing so? As I understand it, Harvard is looking for the people who will be most “successful” down the road. In some cases (e.g., banking before the bust), this does not correlate well with an overly fine sense of ethics.</p>
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<p>Yeah, exactly. </p>
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<p>Bingo. Jeff Skilling of Enron infamy was interviewed for admission to Harvard Business School, because, as we know, intelligence should not be enough. They asked him if he was smart. He said, “I’m #@#$ smart.” A lot of humility there. I’m not impressed with that.</p>
<p>Actually Q, successful has many connotations. It’s not quantitative or even necessarily hierarchical.</p>
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<p>This was in the documentary about Enron, “The Smartest Guys in the Room.” It is also listed on Jeffrey Skilling’s wikipedia page.</p>
<p>My statement that Harvard was looking for the people who will be the most successful came directly from someone who used to work in the Admissions Office there. You could take up the issue of the meaning of “successful” with the Director (Dean, whatever) of Admissions at the time.</p>
<p>I don’t think Harvard was looking for the person who would be the world’s greatest stay at home mother–even though I think that option should be available to women (and to men, mutatis mutandis) and I think it would certainly count as success.</p>
<p>I don’t claim that this is broadly true of Harvard students/graduates, but it is true of a high fraction of the Harvard graduates of my acquaintance: quite a number of them take the status quo as it is, and are eminently successful (financially, by position, by status) within the constraints of the status quo.</p>
<p>I am sure that there are Harvard grads who are challenging the status quo, and working to improve conditions for those who are at the greatest disadvantage in American society today. I don’t know any of them personally.</p>
<p>[Guidance</a> Office: Answers From Harvard’s Dean, Part 3 - NYTimes.com](<a href=“http://thechoice.blogs.nytimes.com/2009/09/14/harvarddean-part3/]Guidance”>Guidance Office: Answers From Harvard's Dean, Part 3 - The New York Times)</p>
<p>“The truth is that there is substantial overlap among the three categories — potential scholars, extracurricular stars, and the substantial majority who are most easily seen analytically as “all-arounders.” The attributes that led them to pursue their interests in secondary school will lead them to seek others in the same kind of context in college. Extracurricular activities and research opportunities in the lab or the library provide settings that allow students from many different backgrounds to educate one another in ways that make the college experience transformative.”</p>
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<p>Bill Gates dropped out of Harvard. In dollar terms he is one biggest philanthropists of all time.</p>
<p>Somewhere in the Yale site, after telling that they seek future leaders, they define that broadly. I remember it as not only captains of industry, et al, but teachers, community workers, ministers, etc. This idea elites are limited in their thinking is a perception. Not necessarily reality.</p>
<p>lookingforward, I would be very interested to know the number of ministers who have graduated from Harvard in the past 10 years.</p>
<p>Beliavsky’s point does illustrate that “success” in the standard definition does not conflict with providing very important services to the world’s people most in need of assistance.</p>