Two thoughts:
1. The old joke, "What do you call the person who graduated from medical school at the bottom of their class?" "Doctor."
2. The ordeal of residency isn't about setting the bar "high", nearly so much as it's about, "well, I went through this shit, so you have to, too". (Source: I have several doctor friends. All of them think it's bullshit. All of them have been explicitly told that, in some form or fashion, by their colleagues, superiors, teachers, or otherwise.)
2. Humanity, where we've institutionalized pettiness, and not just once, but throughout history. :/
(Yes, many of the offshore medical schools are LCME-accredited and legit, and have trained some fantastic physicians, but broadly speaking, they're taking people who couldn't get into an on-shore school.)
"What do you call the person who graduated from medical school at the bottom of their class?"
What do you call an engineer who graduated from the bottom of their class?
The ordeal of residency isn't about setting the bar "high", nearly so much as it's about, "well, I went through this shit, so you have to, too". (Source: I have several doctor friends.
Medical doctors are trained to exhibit a level of competence. The 'bootcamp' approach is what we know at the present time to work best. Is it easy? No. Is it pretty? No. Do you have a better suggestion? ___
All of them think it's bullshit
All of them is still a small percentage of doctors.
(Frankly this argument is old and stale. Anyone who has a better plan for training doctors should speak up instead of rehashing it)
What other approaches have even been tried? I don't think, in the absence of meaningfully tried alternatives that have been shown to be lacking, that a proclamation of "best-ness" is particularly warranted. ("It's the best!" "Oh? What else have you tried?" "It's the best." cycles aren't responsive.)
I note you're a physician, as well. How much of your perspective on the matter is a result of your having been through a similar process?
I'm not. But I take the word of my physician friends — one of whom, a perinatologist, recently accepted a position at a prestigious teaching university — very seriously. They aren't just speaking from their experience. They're, if their explicit statements are to be believed, relating the experience of nearly every other physician they know.
Sure, that's still a vanishingly small fraction of the total physician population. At what point, then, does this chorus of, "This is not the best way to do this" become worth listening to, and not merely writing off as griping by the uninformed, or a minority of slackers with sour grapes?
My experience of going to Australian hospitals was 10x better.
In US it feels like doctors want to get as much money as they can from you while proving the lowest level of service possible. A very capitalist view to human life.
The TL;DL is that the medical field changes quite a bit in the years since Docters graduate, and depending on the types of work they are doing, it seems to be fairly easy for them to get behind with the latest consensus unless they make a concerted effort. To that effect, relatively new doctors often have better patient health outcomes than doctors that have been out of school for longer. This is, to some degree, obvious after stated, as any field that sees rapid change will have some percentage of practitioners that are out of date.
1: http://freakonomics.com/podcast/bad-medicine-part-3-death-di...
No doctor can be sued for a patient who doesn't see them, so raising prices high, and using it for insurance has the benefit of insuring patients who see you, while those who can't pay aren't your patients, so if they come to harm because they can't afford to see you, not your problem.
Interesting Wikipedia article.
And as I recall, the issue with medical colleges is more the residency, than the exams isn't it? I mean, that's why we trust doctors, because the bar is that high.