My point was that medical school culture hasn't changed. It's been brutal for years.

The main difference between those going to med school and the 90s and now in my opinion is a mix of the expectations by students that the increase in level of difficulty should be comparable to the transition between high school and college, or college and graduate school. It's not, and it never was. High expectations have always been the rule.

However, for the past 25 years, there have been many more immigrants or children of immigrants that work their asses off competing harder and raising the bar.

The medical schools should not lower the bar to make it less stressful. Instead, we need more medical students to matriculate to P.A. programs and nursing programs, where they can do just as much good helping many of the same patients, sometimes making similar salaries. Eventually there will be more medical schools, which will help some. Or, maybe some of these doctors that feel that they had to go through too much can work their way up and teach so that they can give their students an easier individualized and sensitive education and see where that leads.

However, imo it should always be extremely difficult to get in and to succeed. That's the point. I don't think people should commit suicide. They should just quit.

There is little evidence that hazing leads to better outcomes. Nor, does making medical school technically difficult leads to better outcomes. The US takes longer to train its medical professionals then most other places leading to more expensive care, and a overall deficit of doctors.

As somebody who works with pathologists, I don't find the academic part of medicine more difficult then say physics - but the pay is substantially different. This artificial labor shortage is protected by the systematic failures discussed in many of the HN comments.

None of these things are defensible.

I only have a very shallow understanding. I think the term 'resident' comes from actually living at the hospital. A resident was expected to care for a single patient from beginning to end. They needed to be available at all times to handle that specific patient's needs.

There are deep challenges with continuity of care. How does one person hand of treatment to another person?

Imagine you and I are both working on a project. There's only one computer, you use it from 6AM to 6PM, I use it from 6PM to 6AM. We can only work on one feature at a time. How do we coordinate that handoff every day? That alone sounds like a huge pain. With a doctor, everything can super time critical, and requires just as much depth of understanding. You may have a an understanding of something that i didn't understand in the handoff. building a project, we roll back my code talk some more and do better the next day. With doctors, maybe somebody dies.

I know it's a convoluted example. I imagine most stuff is routine and can be passed around safely. But it's only routine until it isn't, and there's no way to know up front. As much as developers hate being treated like cogs, it seems like it would make doctors lives quite a bit easier. Just seems like a super hard problem. And if you don't get it right people could die. So, like, that sucks.

You meant to reply to a different comment?

Vague, long winded, round about way of saying, maybe it's not self inflicted. Continuity of care is hard. Maybe fewer patients or other responsibilities would help. Ultimately, in my shallow understanding, residents just sort of have to be there to take care of their patients, because passing patients around is dangerous.