Med schools are full. Why are we running out of doctors? | Dr. Rafael J. Grossmann | TEDxPortsmouth

[@rowenveratome]

If each resident worked 40 hours a week instead of 80, hospitals (or other institutions) could hire twice as many residents. This would help with the bottleneck. It would also help to make doctors emotionally adjusted human beings. I generally have bad experiences with doctors. They're usually so busy / stressed that they don't even have time to genuinely pay attention to any questions I have during the appointment

[@ThisIsToolman]

My wife is a retired RN nurse manager. She will tell you hospitals are cheap. The only thing they can do to reduce expenses/increase profits is to reduce staff and this what they do. So, to hire two doctors to work 40 hours would be twice as expensive. I don’t like the government being involved but maybe there needs to be a federal law that prohibits medical personnel from being forced to work over 40 hours a week and to limit the number of patients seen.

[@rowenveratome]

@Yummy Spaghetti Noodles That's such a good way of putting it

[@rowenveratome]

@@ThisIsToolman Yeah. If the economic incentives in place don't lead to an effective system, laws might be needed.

[@LonnardTree]

One thing to note…residents need to work 60-80 hours a week at least for one to two years. If you think 80 hours a week is bad, 20 years ago the limit was 110 hours, and before that there was no limit. 40 hour work weeks are for doctors when they become Attending Doctors, depending on the field. If you are having issues with feeling like your needs aren’t being taken care of, ask to speak to the Attending Physician in whatever field of medicine you are being treated for. Now this is all only the case at hospitals, as many Internal Medicine doctors form private practices with a group of others, there are many Oncology private practice, almost all dermatology is private practice, and most orthopedic docs have private practices. You will always see Attending Physicians at private practices. Hope this helps. God Bless

[@msbeautifulcore8881]

@@ThisIsToolman they too busy regulating licenses

[@GaryLevin]

Thank you Dr. Grossman for eloquently explaining the challenges. Early retirements, medicolegal stresses, med school indebtedness, harassment by medical boards, declining reimbursements in primarycare, pediarics, intrusion of allied health practitioners do not make up for fewer doctors (real MDs)

[@beccanertia619]

Wow, I had no idea. I have so much more understanding for doctors now. Here I am, getting angry I have to wait 3 months for a visit, or that my visit was only 10 minutes and they can't remember everything we talked about last. They are exhausted. It's too much to expect. This is insanity.

[@pankajchandwani21]

Forgetting is a way to make an appointment fail it's done by muslims and hindus and atheists doctors but never by Christian doctors

[@rohanjacob779]

Thank you for saying that. It means a lot. Wish more people in the world could think the same. 🙌🏻

[@mamabeebe8592]

One of many sad realities that discourages our finest young scholars from becoming medical doctors. We are literally and figuratively digging ourselves a grave here.

[@pankajchandwani21]

There's no such thing as healthcare unless the doctor is catholic and knows about cryptic dessiminated tuberculosis

[@giuseppenativo2123]

@@pankajchandwani21 there's no such thing as universal healthcare. Youngs want to become doctors and not just to make money, for the most.

[@Chan-cy2ks]

I did not realize that other countries did not require residencies in order to practice, I thought it was standard practice everywhere, but after hearing that it’s actually more standard for graduated physicians to immediately be able to start practicing, it really makes me wonder why our system is designed the way it is. I think he makes a really good point when he talks about how the lay public doesn’t really have a good understanding of how the whole system works, and he does a great job communicating just how complicated and stressful it all is, from medical school apps, to the match, to SOAPing, and how that is contributing heavily to our physician-shortage. As a 2nd year medical student, the thought of SOAPing is so scary to me, and I think Dr. Rafael is correct when he says that students that end up having to SOAP in a different specialty than what they’re interested in going into are at a huge disadvantage for their long-term career goals. If graduating 4th year medical students, aka new physicians, were able to begin practicing medicine immediately out of school, and residency programs were optional just in order to specialize, we would hugely cut down on our physician shortage AND the stress/money/complications that come with the Match. Maybe the problem is that we are actually pushing physicians to specialize with these required residencies. If we were allowed to practice right out of the gate, there might be a significantly larger portion of graduates who choose NOT to specialize, and to immediately begin practicing as a general practitioner, and even more, maybe some who don’t match into their desired specialty residency and would otherwise SOAP in an entirely different specialty would choose to begin practicing instead, which would cut down on our shortage of practicing doctors, even if just for one year while they waited for the next Match. Maybe some would even decide to stay unspecialized and never do a residency program, cutting off at least 3 years of time that they technically could not practice medicine. Or, maybe we allow residents to continue practicing general medicine WHILE they are specializing. It seems like there are so many ways we could improve our shortage situation and the Match process that would benefit everyone.

[@MrBrelindm]

The US Army offers such a program. I have two half-sisters who availed themselves of it. The US Army paid them a monthly stipend to live on while attending an accelerated program offered up by a collaboration between Kent State and Akron U (and the DOD). Upon graduating their active duty status began and they both (along with their husbands too) went to do their residencies at the new Walter Reid Hospital in Bethesda. When their initial 8 years of service is up they are debt free and can go anywhere with their specialties.

[@cocofingerfamilysong]

yeh

[@burrito_slayer4516]

How do you apply 😂

[@MrBrelindm]

@@burrito_slayer4516 ask your recruiter about it. They'll have the 411

[@bgs03548]

Dept of Defense. Interesting. They’re essentially working for the DOD. Good luck ever getting out of it even after they’ve earned their keep. Once you’re conscripted you’re owned. Wait and see.

[@k8tina]

My son is looking into doing that with the USAF or Navy (whichever has better opportunities for his specialty). Talk to the recruiters.

[@michaeldillon3113]

In the UK we have a terrible problem . The UK only trains about half the doctors it needs despite the fact med schools turn away thousands of well qualified applicants per year . We train about half the doctors that Greece and Cuba do . The NHS has always relied on bringing in doctors from poorer countries in order to function. This is disgraceful and something the WHO disapproves of . Ironically it is often poor areas in the UK that are very short of doctors - ironic because the NHS was essentially set up to give the poor access to healthcare .

[@ashketchum5622]

French Med student in 7th year here. Education is free. We are paid from the 4th year and on like 300 euros a month for part time. From that point we are doing things for the hospital as assistants like sitches, prescribing simple meds or exams. Then we all have assured residencies, since it's calculated that way, even though it might not be the speciality we want. Sure, we're not paid well for the 80h/week but we don't have 400k debts. And to think at some point I wanted to leave France after high school after I heard about the us specialist salaries. But it's not worth it. Since you end paying your debpt almost a decade after residency

[@Jess-kn8vl]

I worked in Urgent Care, and already at least 10 years ago many of those Doctors left the regular clinic setting due to the politics of healthcare.

[@GoodbyeRubyTu3sday]

I'm a doctor from Europe, working hours are long and can be quite stressful, BUT 80-100 HOURS PER WEEK??? That's just mental, shame on that honestly

[@michaelblasius7705]

The AMA has a distinct incentive to raise the barriers to entry to becoming a doctor. They limit the supply of doctors and lobby against allowing nurses to perform certain duties. Get the government out of our healthcare please.

[@Kyarrix]

Oh, I think we need to get the government into medical care more. Universal healthcare like every other advanced nation on the planet. Healthcare should not be a for profit industry. I've lived in two other countries where everyone had health care and doctors did not go hungry.

[@BrianMillsSkills]

@@Kyarrix Please no. I'm in the UK, we are waiting 16 hours for an ambulance, 6-12 months for scans, over a year for consultants. We have a 6.5 million patient backlog waiting for medical procedures. We have less doctors per head, less beds per head, less scanners per head, less nurses per head than the US, by a significant margin too. Doctors leave to the US for more money too. At the QMC in Nottingham, there's a surgeon we lost to Miami in the US, he was one of only two in the speciality, and there was supposed to be three of them there, now there's one. The UK government also caps the number of doctor training places at 7500 per year too. Universal healthcare is broken here. There is however a good private healthcare system here, which requires payment out of pocket or via insurance, it's what the politicians use and what anyone with money uses. I saw a neurosurgeon yesterday, his wait to see him was less than a week, and he offered an MRI scan within 48 hours there, he told me at the NHS hospital (taxpayer universal healthcare) it's running at least 6 months for the scan. He was also impossible to see on the NHS as you get no choice in the matter, you get what you are given with the state system. I chose him for his ability. I have friends in the US who are shocked at how bad the NHS is, you don't know how lucky you are over there. My girlfriend is American, and we plan on getting married. I offered to her to live here if she likes, but she's not interested, and after exploring the pros and cons I am in favour of us settling in the US instead. I also love the US constitution, even if I think the place is currently led by the most inept President in history. That will change over time though.

[@DrJoy-cw7lt]

The AMA lobbies hard but they don’t regulate healthcare. I work as a doc every day and have never been a member of the AMA.

[@alexwyler4570]

The guy did not get his degree in America, so he does not know enough to talk about the system. The talk would have more gravitas if he was an American graduate.

[@mypointofview1111]

The healthcare system in the USA is beyond broken & has nothing to do with providing good healthcare. It's about making as much profit as possible from patients, companies using healthcare cover as a benefit for their employees. Healthcare is a human right not a lifestyle choice. All humans will need medical treatment at some time in their lives, none of them should have to go bankrupt or sell their home to pay for it. Universal healthcare isn't some politically driven agenda, its a measure of a civilised nation. A civilised nation cares for EVERYONE regardless of income, race, education or employment status. It's called giving a damn about yourself and your neighbour

[@iammichaelstarks]

Dr. Grossman this is a great talk!

[@daviddevlogger]

Everyone has a story, true success takes time. I pray every hardworking person reap the fruits of their labor.

[@billgoodman9103]

Limiting Doctors keeps the cost of seeing a Doctor high. It all boils down to MONEY and control.

[@pankajchandwani21]

That's the reason why doctors don't teach anyone about diseases rather just teach lifestyle changes

[@pankajchandwani21]

And the biggest issue is cryptic dessiminated tuberculosis

[@pankajchandwani21]

@Yummy Spaghetti Noodles doctors want less number of doctors we need more catholic doctors

[@JoeARedHawk275]

@@pankajchandwani21 Bro are you good? You sound high

[@pankajchandwani21]

@@JoeARedHawk275 kind of

[@MedschoolMom]

As a medical school student myself, I can attest to the truth of Dr. Grossman’s presentation. With such a worsening shortage of physicians, why do we make it so hard for new physicians to enter the profession? Just getting into medical school is so difficult, then medical school itself has been one of the hardest things I’ve ever done, and if you make it through all that, you still might not get a residency. And that’s on top of the huge financial burden placed on aspiring physicians. Some will likely be paying off the debts for decades, especially those in lower paying specialities. I agree with Dr. Grossman’s assessment that we need to make some fundamental changes to the entire system. Here’s one change we can make right now. We need many more residency programs added across the country to ease the bottleneck Dr. Grossman described. I see two major barriers to creating new residencies: 1) Regulations by states make it extremely complicated and difficult to get a residency program up and running. We must ease these regulatory burdens if we want to see change. Then unnecessary roadblocks the government has placed in the way of aspiring physicians is unethical because it is ultimately hurting patients who need care. 2) Many institutions don’t want to put in the work to start and run a residency program. I can totally understand physicians' hesitancy to bother starting a residency considering the aforementioned regulatory hurdles, as well as all the new work they’d need to assume on top of their already extremely full workload. I do think in many ways residents can help ease some of the physicians’ workloads. And the best way to ease the strain on doctors long term is to get more of them trained. Plus I’m sure nurturing new aspiring doctors can be very rewarding. Still, it takes a lot of passion and a lot of hard work by an already overworked group of people to set up a new residency. We need to make it much easier for them if we want to see change and improve patient care. To not do so is causing patient harm and is against healthcare ethics of non maleficence.

[@DrJoy-cw7lt]

The thing I see the most is physicians quitting or retiring early.

[@FreeAsABird53]

Thank you so much for providing this insight. Spared me the process. Will look outside of the US for a medical program.

[@astridthepastrid]

it's just so sad that this is his "Dream" when its common practice in so many other countries. All the wasted potential of trained graduates who just want to contribute to society who cannot work. Why is the system so broken?

[@Lucuskane]

Learning of the pipeline in high school, was very demotivating

[@Billyboy4209]

Tore my acl two months ago and I still Have two weeks to wait still to see the specialist theater will send me to see a surgeon… I have good health insurance and live in an area where you would think a dr would be easy to find.

[@Billyboy4209]

I should add he didn’t sell me on anything..

[@Winnepausakee]

In NH I wait until late November this year for an app"t for clearly a problem with my thyroid. The primary care folks are under water with the client load. One cannot make app't with specialist. Must be "referred". More than one person has suggested I go to "emergency" and that "they" would refer me, but I think that an abuse of emergency staff's time. So, I wait with no idea what is the problem but it is wearing me out...

[@Monika-xy4ds]

This is the exact reason why I decided not to go to medical school even though I had an acceptance, I turned it down. Now on the CRNA track and don't have to worry about the MATCH into residency.

[@jadedmonk7001]

Great eye-opening talk. I had no clue about any of this and I'd originally dreamed of going into medicine. Now...🤔

[@alexs.2221]

Wow. My daughter is a Ph.D MD. Close to 40. Able to make some money after those days being a mother of 2 in a rural area of Canada

[@alexwyler4570]

Primary care just points you toward the doctor you need. Also what is needed is ob/gyn that can work as “ primary care “ physician for women. That was not addressed in the video. As a woman, you want an OB to help u deliver the baby. An experienced OB knows when to panic, a primary care physician will be nervous the whole time.

[@medicalemerson1053]

A good primary care only points you to the doctor you need if you really need it. A well trained recently graduated doctor should be able to treat most primary care needs. Maybe the problem is that most aren't well trained, but surely the primary care doctor has its value, not only as a "pointer"

[@indirajayaraman4758]

The human diet is a starchbased whole food plant based one. And salt and oil just a bit If we all ate this diet and exercised well we would not need many doctors. So instead of worrying about doctors we need to worry about the food we eat.

[@Minney-Me]

Disagree, the KETO diet is the better choice

[@mist12345678910]

Then why can we digest beef so much better?

[@neilifill4819]

The system is quite flawed. Worse, it has endured for a very long time, and it appears to create something of an elitist class among the matched and unmatched.

[@greghawkins1025]

You speak very good English. Thank you for teaching us.

[@jacobl8462]

The US residency matching system is so brutal. This literally makes physicians or med students from all over the world wasted mentally and physically, needless to say the cost.

[@ryanmalone2681]

I tried to find a physician in Nashville, nothing wrong with me, and most turned me away and one was available in 9 months. I was told that they often turn existing patients away if they get sick/. They’ll only see you for checkups! What’s the point???

[@PinkTigger33]

Right. I called my doctor when I was sick and wanted an appointment and was told to go to the ER for treatment. They had no appointments unless I wanted to wait a couple of months.

[@marielbatista2661]

I really wonder aside from the business/money part or it, what is the reasoning for making medical school so hard to accomplish…. In many other countries their med programs are shorter and their expertise can often surpass what they teach here…. So it does not make a lot of sense…. Sadly, its not like we have the best doctors in the world…. either.

[@stanleygiudici4013]

Analogous to hazing. "We went through it" they say, "so you're going through it".

[@marielbatista2661]

@@stanleygiudici4013 I can see what you mean

[@marielbatista2661]

@@sararah. I am not referring to the academics but the way the system is set up for them to practice…

[@Minney-Me]

@@sararah. not true at all... Ppl lives mostly depends on their diets and lifestyle 🤦🏿‍♀️

[@una4all1]

Note he said that major metropolitan/coastal areas don’t have these shortages. Bottom line is that pretty much nobody who grew up in say a medium sized city/suburb wants to spend 10+ years in extremely rigorous training (often in major metropolitan areas) just to move to the absolute middle of nowhere in a place with perhaps limited opportunities for their kids. They just don’t. Especially if they’d be getting paid just the same as what they could make in a more metropolitan setting. Way to fix this is to select people from these underserved areas to begin with (aka diversity) and hope that they return, creating good-faith (i.e. non-coercive) incentives for them to do so, or perhaps to establish a more robust locums system whereby docs elsewhere are incentivized to travel and serve these areas on some sort of rotating basis.

[@worldofdoom995]

Boomers keep getting older obesity rates keep going up. It's too much to keep up with.

[@B_Machine]

What's really upsetting is overpriced pharmaceuticals.

[@bryanshoemaker6120]

My friend has been a nurse for many decades and she recently switched over to training other nurses. She's been there for only 1 year and she's already put in her two week notice. She said that she's sick and tired of being threatened by her students because she's not giving them passing grades even though they are not completing the tasks handed to them. This is California Sacramento County.

[@Chrissy2230]

Wow, how sad. Is this teaching at a community College or Unitek Learning. Students don't realize the dedication and studying it takes to be in the healthcare industry. From a fellow nurse here in Sacramento County.

[@achristine80]

Medical Schools are full, and have plenty of graduates. Students leave school bright eyed and bushy tailed, ambitious to save lives, and in MASSIVE DEBT. After working 16-20 hour days to gain enough income to try to pay off that debt, these doctors become burned out. Many are never able to pay if off, and lose their practice licenses, not to mention ruin their credit. Many quit bc they realize the restrictions that “law” puts them under. There’s ridiculous regulations and protocols that make no sense when trying to save a life. Government bureaucracies who have no medical degree decide what doctors can and do. I worked in medical for 15 yrs, I quit nursing school because I realized the impact big pharmacy, tech giants and government have over healthcare. They don’t give 2 craps about healing patients. They care about money. It’s so corrupt.

[@bgardner312]

Im a Canadian living in Ontario and we have a shortage of doctors big time here!!! It took me 8 years to find a doctor taking new patients, I finally got one last year and my husbands doctor retired and my doctor is full already. My family physician packed up his practice in the 1990's and moved to the U.S..

[@melissaoconnell5648]

Well said, clearly demonstrated Dr. Rafael J. Grossman. Thank you for sharing your dream and all things willing let us rise together to see your dream come to fruition!!! The more who begin to see the barriers, the more who dream going beyond. I've had many family members work within the medical profession or at hospital settings and heard, witnessed the life long multiplying effects for the journey to be there to do the work and the stress of the doctors they worked amongst. Considering this is the mark of world class healing profession, the system itself is in need of a radicalization of teaching in treating their students with timely care, delivery, expertise, compassion and empathy as a demonstrated means of support. The means to deliver here and within - to know the difference and except nothing less. Power to you and all those who value quality health care practices - the world over.

[@Rkisosondi]

Another good question is, “why are the doctors we do have so horrible?”

[@AKP70]

In india, there is only 80,000 seats for mbbs degree student...out of 20,00,000 students who gave exams...😢

[@joanclaytonjohnson3630]

Perhaps if the students looked into this issue they would make a different decision on medical school. Perhaps if the schools went without money for a few years the system would change. Even if subsidized you have to have students. This should happen for many universities and their excessive expense compared to available jobs or income from said jobs. Sounds to me that S.O.A.P. is exactly what the institution wants. Way to control who gets what the institution wants.

[@parneetgill6526]

Eye opener 👀 loved how you expressed it ❣️

[@PetraKann]

Although they have identical qualifications, we need ti distinguish between doctors and Big Pharma sales reps

[@Cancelbuttons]

Offers no solution to the known problem.

[@ladyfree3492]

To be honest America should not lower its standards. Some of the doctors from all these other places he mentioned are so incompetent

[@videomakville]

Respectfully, I disagree with you. It turns out a large number of the doctors in America are from "all these places" you are referring to. There's a sliding scale of expertise and experience in all fields, including medicine. Just like there's a sliding scale of medical conditions. What this means is that you don't necessarily need a specialist to care for all cases. If the training obtained from the medical school is up to scratch (I expect the Americans will like to think so), then a graduate from that program after a year of internship should be able to work as a doctor at the primary care level. That helps the system solve the scarcity at that level as there's a steady supply of doctors. Those who then choose to, can enter into a residency program and specialize. It's even possible to fragment the specialization into 2 steps. One for the broad branches of medicine such as surgery, internal medicine, gynecology etc and get certified at that level. The second for doctors who want to sub-specialize after their first broad specialization. E.g a doctor who has specialized as a surgeon could then sub-specialize as a plastic surgeon, colorectal etc. Having to do 4 years of pre-med then 4 years of medical school, then 4-6 years of residency before you can care for a patient creates such a high barrier that scarcity is inevitable. I don't think it should be so. My 2 cents.

[@wooddoc5956]

Just read a bunch of comments and it's funny how many people think they have the answer to the problem. It's not the Feds, AMA, or Big Pharma. But it is dollars. Usually state dollars for state medical schools. So all of you "get government out of healthcare" types should call your representative and tell them to raise your taxes.

[@mathilde959]

Same problem in France 👋

[@alexandrugheorghe5610]

did you just say 400.000 dollars in debt?! 😮 holy shmoly

[@csharpe5787]

Because young doctors are not paying it forward and staying in the job as payment For the training they have been given.

[@LonnardTree]

It’s a simple answer with complex problems. The Federal Government is the entity that ultimately decides on how many residencies are allowed every year. The number is abysmally low, and being that our healthcare is a broken system ran by Pharmaceutical companies and lobbyists bribing government officials, it’s no wonder this is one of a million problems wrong with our healthcare situation. I speak from personal experience and knowledge on all of this. I won’t go on a long diatribe as it isn’t worth the time, but take it for what you want. If you want good healthcare and aren’t a doctor at a prestigious hospital or immediate family of one, then you either have to pay good money for it, or go through all the loopholes. I’m of course speaking about the 95% of people who aren’t of the elite class. Anyways, God Bless. Seek Jesus Christ, for He is the Ultimate HEALER!!!

[@DrJoy-cw7lt]

Exactly

[@bukurie6861]

Thank you for talk! And school have different years programs in year for healthcare +specialization...Programs🤩📸And some of doctors any time can't take iniciative only and say:You go to another doctors🖐

[@france_tamilponnu]

Hi This is the same situation in France

[@edavenome]

But in UK I meet so many incompetent doctors. The young ones are incredibly incompetent , and even the old ones who think they are good, are not completely competent. I would say, about 10% of all the doctors are any good.

[@neon_necromunda]

Lots of them want that ludicrous consultant money here in the UK and didnt get into medicine with the priority being care before cash.

[@BigHenFor]

Really? They don't actually. If you notice you don't meet a lot of American doctors in the UK, because the money is so bad.

[@sd.x712]

Nice video 🖤

[@ronaldshiffman9120]

Our healthcare problem is us. We are obsessed with the gender bean counting of who gets into medical school - man or woman. First of all, 'doctor' is one of the most desirable 'careers/occupations' in our society. Why, then, are such a high percentage of MDs leaving their chosen profession or burning out? I am not going to answer that question. That is a problem for bean-mounters of the world to figure out before we implode.

[@miaballester3978]

Family Medical doctors and Internal Medicine doctors are in shortage because most opt to Specialize in other areas so as to profit more . Follow the money!

[@philandeswilliams1975]

💡It may benefit the PUBLIC to adopt appropriate changes to help new doctors, but it doesn't help the medical system KEEP PRICES FOR CARE AS HIGH AS POSSIBLE.🎯 👉🏿More doctors entering into practice each year may stagnate or BRING DOWN wages for doctors.🤷🏿‍♂️ 🤝🏿Who has the authority to make such changes and would they do so? And if not, why?❓

[@eltiogorgie10]

Excelent video talks.

[@mlwhepfiorino3392]

We need decent doctors in UK. GPs are really not good and nobody appears to hold them accountable!

[@kaushikdr]

This is interesting! If government is involved, they impose crazy expectations to become a doctor, but if they are not the doctors just do as they please?

[@BigHenFor]

@@kaushikdr No, they can't as they are contractors. The problem is that budgets and renumeration has been cut. GP as self-employed contractors have to follow the terms of their contract, and pay to run their practice. The hours are long, and as the money is worse, many GP's have retired, or don't want to work full time. It will not improve as the vacant practices are being taking up by American HMOs who are just interested in profit.

[@smrk2452]

I thought it was just that nobody wants to work anymore. Silly me 😅 But seriously, it’s too much. What you’re describing is similar to the struggle to get any job in America. The algorithm weeds you out before you even get a chance.

[@sactopyrshep]

The best health insurance is good health.

[@swmtothemoon6660]

Lol is this actually shocking? It's 2022 and we still haven't figured out how to give Americans proper healthcare. I'm waiting 2 months in constant pain just to see a rhumetologist. If I miss my appointment? 2 more months. Some of us have simply just given up.

[@jdhdavis]

In this video, the speaker correctly points out that there is a shortage of doctors. The situation is multifactorial. The US residency Match is featured as a primary cause or bottle neck preventing doctors from taking care of us. This is completely false. The speaker concludes that unmatched doctors fresh out of medical school should just go into practice in underserved communities to fix the problem. How ridiculous--untrained physicians? Medical students have learned a lot but they are not ready to work unsupervised. The speaker supports his ideas with several "facts," but lets have a look: 1) "1 out of 5 medical students do not graduate." According to the AAMCe, the drop out rate is 15-18% but over 90% graduate within 5 years. 2) "Residents work 80-100 hours a week." Its capped at 80. 3) "Brutal Hours." Sort of--depends upon if you like your job. Tired--sure but you can recover. 4) "The Match is the bottleneck of us having enough doctors." Simply no. The match aligns rank lists submitted by the candidates and the program. Candidates match at the highest program that ranked them. Candidates can fail to match and positions can go unfilled. The number of positions available has nothing to do with the match process, but rather each specialty and the ACGME accreditation process. 5) "The match is basically a lottery." Again wrong. see #4 or look it up. The speaker implies randomness by saying it is a lottery. 6) "Thousands are unmatched." Yes, but according to the AMA, 94% of candidates match. Each specialty is different in number of positions vs applicants. Surgical specialties tend to be the highest and primary care the lowest in competition. 7) "forbidden to practice." An exaggeration but yes. To practice medicine in the US you need medical school and at least a year of post graduate training. This is a good thing. 8) SOAP program. The speaker fails to mention that unmatched candidates can look for unfilled positions, try another specialty, try to match the next year, or in some cases take 1 year preliminary positions. Its a major stressor for sure, but candidates can move forward with other options. 9) The political statements--no details mostly unrelated. 10) costs to apply--its several hundred dollars; not thousands. But the travel can be thousands. This has been done virtual due to covid and saved funds. 11) Reviewing applications--I have never heard of this being automated. Yes there are human placed filters for competitive programs looking for high board scores. Grades are hard to interpret as each school is different. Letters and interviews are key. 4th year medical students can to away rotations to "audition" for programs. Yes there are biases for US graduates vs international. 12) Match day " could be anywhere.' Again--you would only match to 1 of the program you listed on your rank list and it will be the highest that ranked you. This means you could only rank programs in geographic areas you want to live and work. Related, some candidates do not match as they are too selective and did not rank enough programs. And again--solving this complex problem with unmatched medical students? There is certainly a lot more needed from that. The whole concept sounds like a residency but without the proper supervision and ACGME accreditation and resident protections. In fact, a major purpose of ACGME accreditation is to prevent residents from just being service providers--it has to be educational.

[@CommandFitnessCorp]

I am one such Doctor who has been condemned….unable to practice medicine due to the inability to match into residency after 3 years of applications after graduating medical school. You say “untrained doctors”, but are we not two years more trained then physician assistants?? I am HALF A MILLION DOLLARS IN DEBT to student loans with very little opportunities or mechanisms in place to ever pay that off without the ability to apply my trade of practicing medicine. I graduated in the top quartile of my class for GPA. The reason it has been difficult to match into a specialty is because towards the end of medical school I had a tragedy occur in which my girlfriends son was hit by a car and I was the responder who performed CPR on the boy I was helping raise. Despite regaining a pulse he was already brain dead and became an organ donor. My school basically demanded I take a year off to regroup and attend counseling (which turned out to be 1.5 years). I then returned and graduated. HOWEVER, I took the final licensing exam shortly after returning and failed because of all the time away from school. I had forgotten some of the minutiae that they test on during all that time away. I retook the test and passed (This is a common occurrence among med students). Unfortunately, I had too many red flags now to match in the residency despite having a compelling story. Residencies do not like significant periods of absence from schooling and they hate failures on tests. Had I only had one of those red flags, then I probably would have matched, but the combination resulted in my current unmatched status. I was likely screened out by a computer, with very few residencies having an actual human being review my application. Even though I have four years of medical school expertise that I graduated from, I cannot even practice as much as a physician assistant or nurse practitioner who both have only two years of schooling experience and no residency. He is correct that this is where the bottleneck lies, but the reason is due to money, tax dollars, and the number of positions available in residency. In medical school, we pay for the schooling via student loans that we are responsible for. Same with undergrad for a bachelor degree. However, in residency the funding to pay the residents their $60,000 a year and to pay for the program to teach them comes from the government. Each of those residency positions is paid for by your tax dollars. That’s why they are very reluctant to expand the residency positions available even though they are needed. Every year doctors who have not matched petition policy makers to expand these positions, but they are met with resistance. Legislators are reluctant to spend any more money to expand programs, and thus the unmatched are condemned and the country is left with a physician shortage. I propose that we allow the unmatched to pay for residency schooling on their own if they are willing via one last batch of student loans. We are already heaps in debt, so adding a little more is FAR SUPERIOR to the prospect of never being allowed to work as a doctor. Then the money would come from us and not from tax dollars. I guarantee nearly every one of the 11,000 unmatched doctors would have no problem paying for their schooling for the last three years they will need it. The default rate on doctors paying back student loans is less than 2%. Therefore, the government would actually make money on expanding these positions and allowing these doctors to complete their training.

[@stanleygiudici4013]

You sound like one who has gone through it.

[@OCEANSTARS2010]

I agreed with you 100%. I would not want to see an untrained physician just because I need a doctor. The speaker proposed unmatched doctors fresh out of medical school to go into practice in underserved communities so they can gain experience. It sounds like they practice on the poor. Does it sound ethical?

[@zookeeper3502]

damn

[@MsCristina38]

Thank you for letting us know 😊

[@ellencooney5563]

Some leave to do research fulltime. Seems more run for political office than ever before. Some go where they are more challenged and appreciated. Some do KZbin fulltime. More options than in the past it seems. Some even opt for more lucrative entertainment industry.

[@manjurawat5084]

Motivation video A salute to this guy

[@RafaelGrossmann]

Thanks Manju

[@blank8479]

Simple answer because they are in school

[@optimusprimum]

We need a new computer programmers.

[@wooddoc5956]

Doctors don't do this or that and they don't care about anything and it's all about money!! J-freakin Christ! This is why I quit practice at 48. Talk about burnout, I would rather mow lawns than deal with you guys.

[@blinkingmanchannel]

What was the problem again??? The guy needs to drill into why and how the "system" limits the number of residencies!!! I clicked this one because I though the non-obvious reason for the obvious problem would be here. Who is he afraid of?!?!?

[@snoopylayla9652]

Is all about money.

[@rachitaggarwal1578]

Don't worry Indian doctors are comming

[@vincewhite5087]

Wrong about Canadian doctors

[@Kyarrix]

It's not a good look when a slide has a typo in it. I understand that English is not his first language, it doesn't have to be, but you would hope that someone on the production staff would catch it. MDs is the plural, not MD's

[@billwong6077]

I am an OT who is also a TEDx organizer. Organizers or team members with medical backgrounds is not always a given. For my own events, I will ask my speakers, “Make sure you are OK with your slides if you have them. I will give you feedback on readability and design. But, you have to give me sources on any claims you make on your slides.”

[@Kyarrix]

@@billwong6077 It's not a matter of having a medical background. It's a grammatical error that ideally should have been caught. In English the plural does not have an apostrophe, the apostrophe generally denotes possession or contraction. MD's would mean belonging to the MD. MDs would be the plural.

[@billwong6077]

@@Kyarrix if it is on the slide, yes it is on the team to fact check with the speaker. But that said, majority of the folks on these teams are volunteers. I gave a second TEDx talk 5 years ago. The team sugarcoated my speech script. As COVID became the way it is now, I really regretted every day for not being assertive! That is a more serious error than a typo on a slide.

[@DrJoy-cw7lt]

There is no way 49% of grads fail to match. That is an outright prevarication. I know it is greater than 90% when I matched 25 years ago. I know this is BS.

[@cpg8000]

You propose the USA begins prioritizing its people over profits/corporate/money? Hahaha. In your dreams. But, I’d love for that beautiful dream to come to fruition. It just won’t.

[@ravisonu4994]

Hello

[@michaelnoel8936]

🤬

[@anthonyharvey8571]

None sense

[@pankajchandwani21]

People are into blowing up money instead of investing that into their kids future

[@josephdarkhelmet9494]

Because Public schools have dumbed down our kids. There are severe consequences coming....

[@FreeAsABird53]

No thé adults are idiots. The kids may likely be America’s only saving grace.

[@sgrsoni44]

Because u people need indian doctors and engineer. :)

[@Mariahugo472]

My greatest happiness is the $64,000 bi-weekly profit I get consistently from my $15,000 investment despite the economic fluctuation 😊

[@Dyk949]

Mrs Charlotte is my professional assistant, I have been trading with her for 8 months now... I've really made over $200,000 from her strategies in trading of cryptocurrencies.

[@Carlosaug]

Wow 😯 I thought I was the only one who knows Mrs Charlotte Walsh. I have also been trading with her, she's such an amazing woman with good skills keeps me happy all week knowing I earn $15,000 extra income trading with her.

[@lauren5422]

@Marilyn Beverly Thanks a lot I just sent her a message and she responded nicely..

[@Joshuaaragon268]

Such kind of information we don't get from most KZbinrs, I just looked her up on google and she's a licensed broker, I am contacting her right away, thanks.

[@cocofingerfamilysong]

yeh

[@manjurawat5084]

Firs

[@spiridonlouis3276]

I spare you the video. Girls study medicine but then they get pregnant or can not handle the stress.

[@fedexpress14]

Still plenty of MISOGYNISTIC people out there.

[@FoolsGil]

You're ignorance is extra delicious. Why are you even here. Go watch a cat video.

[@xotennisxgirlox]

That has nothing to do with this