I really liked the Rosen vs Lamar jackson example because it shows that even those who don’t have the most impressive academic/sports pedigree can still have the potential to be a generational talent
As a medical student jumping through the hoops to get research this summer i relate so closely. Also can you discuss how this is happening on the med school level and people are getting masters degrees and taking research years just to apply to medical school.
Te bar has raised a lot, but more is not better it means that you are more dedicated, that you’ve invested more and as you did say these positions are gonna be given more and more to students with more resources. In the big picture competition will always be good and will enable to produce better physicians, the main challenge is going to be discover talents without as many possibilities
At the end of the video, you suggest residency selection via lottery as a possible option for program directors. While I’m sure you meant this in a somewhat facetious manner, I’m curious what your thoughts are on how this would play out if implemented in real life. Say we set a minimum bar for applicants to enter the lottery that are based on the average Step scores, research pubs, volunteering etc of a matched ortho applicant from 10 years ago (a more reasonable standard, as you mention in your video). After a student met this, they could put their name in the hat for an ortho spot. Obviously there are lots of logistical issues that would need to be overcome, but for the sake of the thought experiment, I’m curious of your thoughts. Would the quality of students who match ortho be any better or worse than they are now?
Great question - and I think the only real answer is “who knows.” We have a criterion problem in medicine. What I mean is, there’s no consensus on what, exactly, a good doctor is. But if we can’t agree upon what a good doctor looks like, it’s impossible to say that ANYTHING we do in residency selection is better or worse. In theory, a lottery is the fairest way to allocate a scarce resource. In reality, it still perpetuates old systems of advantage, for the very reason you mentioned: you have to surpass some standard to become eligible for the lottery. Interestingly, lottery-type systems have been used in medical school admissions in the past. In the Netherlands from the 1970s until 2016, some medical school positions were assigned by weighted lottery (with probability improved by grades). But it’s notable that all these systems get dismantled. The idea of leaving something like this to chance just doesn’t sit right with people. My sense is that it’s easier to stomach losing in a system that has some rhyme and reason than it is to lose because of chance alone.
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I wish every PD was as open minded about making changes like those you talked about. Such a good talk. Hope to see this catch on
I wish more PD has such vision
Very interesting to listen to as an IMG. Thank you for sharing
I really liked the Rosen vs Lamar jackson example because it shows that even those who don’t have the most impressive academic/sports pedigree can still have the potential to be a generational talent
Thank you for watching - and for your kind words.
As a medical student jumping through the hoops to get research this summer i relate so closely. Also can you discuss how this is happening on the med school level and people are getting masters degrees and taking research years just to apply to medical school.
Te bar has raised a lot, but more is not better it means that you are more dedicated, that you’ve invested more and as you did say these positions are gonna be given more and more to students with more resources.
In the big picture competition will always be good and will enable to produce better physicians, the main challenge is going to be discover talents without as many possibilities
Great use of the sports stories
Had to try to find some way to build rapport with a group of orthopedic surgeons. :)
Thank you for taking the time to watch.
thank you for this! crazy how we are not peering behind the veil or just taking a moment of introspection as a profession.
Much appreciated
Thank you for watching.
At the end of the video, you suggest residency selection via lottery as a possible option for program directors. While I’m sure you meant this in a somewhat facetious manner, I’m curious what your thoughts are on how this would play out if implemented in real life. Say we set a minimum bar for applicants to enter the lottery that are based on the average Step scores, research pubs, volunteering etc of a matched ortho applicant from 10 years ago (a more reasonable standard, as you mention in your video). After a student met this, they could put their name in the hat for an ortho spot. Obviously there are lots of logistical issues that would need to be overcome, but for the sake of the thought experiment, I’m curious of your thoughts. Would the quality of students who match ortho be any better or worse than they are now?
Great question - and I think the only real answer is “who knows.” We have a criterion problem in medicine. What I mean is, there’s no consensus on what, exactly, a good doctor is. But if we can’t agree upon what a good doctor looks like, it’s impossible to say that ANYTHING we do in residency selection is better or worse.
In theory, a lottery is the fairest way to allocate a scarce resource. In reality, it still perpetuates old systems of advantage, for the very reason you mentioned: you have to surpass some standard to become eligible for the lottery.
Interestingly, lottery-type systems have been used in medical school admissions in the past. In the Netherlands from the 1970s until 2016, some medical school positions were assigned by weighted lottery (with probability improved by grades). But it’s notable that all these systems get dismantled. The idea of leaving something like this to chance just doesn’t sit right with people. My sense is that it’s easier to stomach losing in a system that has some rhyme and reason than it is to lose because of chance alone.