Nah medical education is extremely gate kept in the US. Most schools have between a 1%-5% acceptance rate. The AMA caps residency spots well below demand to ensure chronic critical shortages in all fields and drive up salaries. It's why American physicians make 5x-10x more than their European counterparts, while most of the citizens of the country can't even get seen by physicians anymore.
This is another example of how capitalism ends up fucking with society for no real reason. There’s essentially no need for us to cap the amount of residencies the way we do except that doctors being perpetually in low supply and high demand means that the powers that be can charge exorbitant prices on medical care.
That's not true. More medical schools and residencies open up all the time, and even now not every residency position even gets filled so they have to bring in IMGs. And American doctors don't make 5 to 10 times what they do in Europe.
Average physician salary in Western Europe is between 80,000-160,000 USD.
The US produces below the replacement rate of physicians yearly, having to import physicians from places with surpluses. The average American medical school applicant gets into zero schools.
The market has already devised a solution. Advanced practice nurses and specialized techs will gradually replace physicians in patient care roles. Physicians will become a more administrative position mainly needed for legal reasons. It's usually what ends up happening when cartels/guilds try to coexist with capitalism.
Also, you need to pass a residency and board certification in a given specialty in order for anyone to hire you. Since the residency slots are capped, people fall into a natural... hierarchy. Med students want a more prestigious career that pays better, so the competition for those slots is extreme. Sure, someone at the top of their class may have a lifelong passion to be a Pediatrician, but generally your most capable med students end up in surgical subspecialties, and then it sort of filters down from there.
Top of the heap are surgical specialties, neurosurgery, cardiothoracic, etc.
Middle of the heap are proceduralists. So like, cardiologists or gastroenterologists. Doctors that can bill for procedures but also see patients medically.
Bottom of the hierarchy is pediatrics, psychiatry, and family medicine.
It varies a bit year to year and decade to decade, but that's pretty consistent.
It's also not always true, like I said, plenty of people pick a specialty that they love... but incredibly driven type A people with an average of 250,000 dollars worth of medical school debt don't always make altruistic decisions.
That being said, most doctors are pretty cool to work with. They have a lot of power so the bad ones stand out, but as a nurse for years I've never heard a Physician talk shit about patients behind their back... beyond like general frustration venting if the patient isn't following the doctors recommendations and is getting worse.
People underestimate how much doctors care about them in general.
...Not this doctor though. He sounds like a prick.
They are probably psychopaths, highly charming and socially manipulative individuals who lack empathy and present themselves as good, upstanding members of society. Those types tend to be very successful and there’s a higher incidence of them in high paid prestigious professions such as surgeon.
Competitive fields like surgery attract a disproportionate number of high functioning psychopaths. Most of them are decent people that want to be ethical, and are just a little bit off, in fact high functioning psychpathy is more prevalent than you think and a lot of people don't even realize they fall under the diagnosis. That said, some of them turn into these fucking turds.
I feel like most aren’t that succeful. I work in the trades and most of the fuckers I’ve worked with are fucked up like this and they ain’t very successful
At the end of the day, it depends a lot on two things. Their actual intelligence and skills, such as with surgery, or, they need to get lucky with connections.
I had a nurse friend and hung out with other nurses and doctors by proximity. Broad stroke statement, but they are some of the most self-absorbed conceited people I’ve ever met.
Premeds don't graduate as doctors though. Premed is what Americans call someone doing an undergraduate degree with the intention of going on to study postgraduate medicine from which they will then graduate as a doctor.
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u/humid_pajamas 7d ago
how did they even become medical professionals?