March 13, 2019 Wednesday
Bedtime Story
The Changing State of Residency
The matching of a medical graduate to a
residency program in a country as large as the United States is a herculean
task.
The situation is made even worse with
Foreign Medical Graduates (FMGs as they are codified in the great American
tradition that we will keep encountering in our bedtime stories; Mon Ami keeps
on generating such coding in everyday conversations that bedevils me to no
end).
In 2008 for instance around 10,600
applicants in the category of FMGs were vying for a mere 1,392 residency
positions making it an extremely competitive process.
It was not so in the early days when the
residency programs for specialization in medicine was initiated in 1920s.
Those days were characterized by far
greater number of hospitals than interns being churned out from medical schools
forcing the hospitals the “grab” the interns and fill up their vacancies as
soon as they could.
In those times it was to the advantage of
medical graduates to delay their final joining or acceptance to any particular
program as committing to one residency would seal their fate.
In fact in those days the situation in
medicine – as far as gaining entry into residency programs was concerned – was
something like it is today for engineering and business management graduates
from top colleges in India.
So in 1920s till 1940s the medical students
would often find themselves occupying a position in hospitals even as early as
two years before they would graduate.
But then things began to change with the
increase in population.
Soon after the World War II the number of
candidates applying for residency programs began to outgrow the numbers of
positions available in them.
Now the hospitals and their management had
the upper hand; it was the classic supply and demand theory of economics
determining the price of a commodity or the value of a service being offered in
action.
The idea of demand and supply must have
been known to economists of all civilizations but it was formally codified by
the British economist Alfred Marshall in his 1890 book titled “Principles of
Economics”.
I want to quote his view on distribution of
wealth in society since it pertains to our ongoing story of how physicians are
trained, treated and valued in societies.
It is very important that a practical and
realistic physician sees himself as a labor and service provider in a free
market similar to any other labor in the market and not view himself with an
exalted and distorted exaggerated image of an incarnated deity of health.
It is an essential perspective mandatory
for a physician to succeed as it will keep him grounded to the solid earth.
This is one of the fringe and unexpected
blessings of attending various courts (ranging from Bombay High Court, Metropolitan
Magistrate Court to Consumer Forums) regularly and personally.
Stay tuned to the voice of an
average story storytelling chimpanzee or login at http://panarrans.blogspot.com
Good night Mon Ami and my fellow cousin ape.
Advertisements
Another great educator and a teacher that I am aware of is
Professor Subhashish Chattopadhyay in Bangalore, India.
While I narrate stories, Professor Subhashish an electronic
engineer and a former professor at BARC, does and teaches real mathematics and
physics.
He started the participation of Indian students at the
International Physics Olympiad.
Do visit him here:
All his books can be downloaded for free through this link:
For edutainment and English education of your children, I
recommend this large collection of Halloween Songs for Kids:
No comments:
Post a Comment