Returns on investment

For the crew at mission control in Eugene, I have officially passed Anatomy. With a Z score of a whopping +0.2. Simply stunning. That means I was slightly above the median score. Sadly, however, I didn't honor, for reasons discussed previously. I don't think I've ever had a class with such a low (study time)/(grade) ratio. I must have put in nearly 70 hours a week, more in exam weeks. I have, however, learned, that outlines, even exhaustively thorough ones, aren't as useful to me as a textbook with real english prose to read. I just do better when there are full sentences. I
wish, however, that the phrasing were less dry. I know, it's not 'scientific', but with history books it's so much easier to remember what you read because the phrasing can be varied and interesting.

I also took my one and only exam in Epidemiology and Biostatistics. It was a pretty dull class, but one of the most useful I'm told. It was a very qualitative, nearly non-mathematical version of biostats. I can at least understand more of what I read in the primary literature now.

We are also taking a new class called Critical Issues in Health Care, which is mercifully only once a week, and is 'inter-disciplinary', which means there are nursing and social work students in there with us. There is still a 3:1 ratio of medical to nursing students however. The class is supposed to make us aware of issues in american health care delivery. The first class didn't tell me anything I didn't already know, which is that things are pretty well screwed up. The lecturer for the first three lectures is some bigwig at the Missouri Foundation. He's a big proponent of a single payer system, and promised more polemical tubthumping next week. It's axiomatic among medical students at least, that a single-payer system is generally a bad idea, though I'm insufficiently familiar with its implementation in other countries to judge. I'm interested to see if this gentleman has any data to substantiate his position, or if he's just giving his opinions as fact. If the last lecture is anything to go by, I'm not too sanguine. The essence of his talk was that things have been broken since the 1930's, and fixing them isn't very feasible. He also talked about how our system is heavily weighted towards tertiary, high tech, expensive intervention based medicine rather than preventative primary care. He also talked about the fact that primary care docs are becoming increasingly hard to come by...

I have some major bones to pick with his last assertions: Why do you think that newly graduated physicians are drawn to choose tertiary specialties? For myself, my contracts with Total Higher Education Lenders influence those decisions heavily. My classmates and I borrow $65K a year, most of it at 6-8% interest. The principal alone is $260K for all 4 years, but at the end of a residency, the total will be in the 450K range. The ability to repay that in a timely manner most definitely is a factor in planning a career. If school were cheaper, there would definitely not be the disincentive to choose primary care. I'll have to update this as the class progresses because it'll be interesting to see how the various lecturers approach the problems in our system.