Blog | Monday, August 10, 2015

Are we in a medical economic bubble?


In the roaring 1990s I completed both 4 years of medical school and 3 years of residency. Day after day I read accounts of my contemporaries starting or joining Internet startups to great fanfare and loads of stock options.

There were many times I thought to myself, “Why should I continue on this slog?” I fantasized about pitching my idea for an Internet company that would wow investors by providing not only crackers, but slices of cheese varietals on those crackers for people logging into the website and entering a credit card number.

Stock options!

Glowing media coverage!

Super Bowl commercials!

In a scene reminiscent of the those go-go 90's, Chrissy Farr of KQED (public) radio in San Francisco reports that Stanford and University of California-San Francisco medical students are abandoning the traditional practice of medicine to join Internet companies in the hopes of creating the killer health care app.

Here's the data: “Bay Area-based medical students from Stanford and UCSF have among the very lowest rates of pursuing residency programs after graduation compared to the rest of the country. Stanford ranked 117th among 123 U.S. medical schools with just 65% of students going on to residencies in 2011, according to Doximity, a physician-network that generates data for the U.S. News Best Hospitals rankings. UCSF is 98th on the list, with 79% of its graduating students going on to residency.”

Pretty easy to pooh-pooh this — these med school graduates, for all their smarts, haven't had enough training (actually being in the hot seat) to know what practicing medicine in the current climate is like.

Maybe that's the point. They are not encumbered by notions of things being “the way they are.”

I envy their opportunity. Proximity is important, even in a digital economy. But if their companies don't pan out, I do wonder if they'll be able to “get back into” medicine. Residency is the orthodox pathway, and if a young physician leaves the straight and narrow path, medicine is a challenging profession to re-enter.

I also wonder what's going on at those other schools near the bottom of that list, i.e., why so many graduates aren't choosing residencies. Is it for the same reasons or due to another cause?

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is Interim President of the University of Oklahoma–Tulsa. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.