Like most folks (I imagine), I don't care what colour a doctor is or how rich or poor they were, or where they came from, as long as they know what they're doing and can solve my medical problems. Oh yes, and it's really nice to be able to understand what they're saying as well. Physicians who are truly competent, curious (imagine, a doctor needing to be curious), and more compassionate than ego-driven have been hard enough to find--and now this. What I smell about this is 'compliance.' As if (many--most?) doctors aren't already compliant and worried about CPSO audits, imagine what the new grads of dumbed-down med school will be like. Jump? How high? A new shot of gene therapy? Sure, just tell me which arm to put it into. This is the moment, it seems, when real doctors need to break out of the corral and say "hell no", this isn't right. Maybe figure out some collective action to take? Thank you, Dr. Les, for doing your part in that. As always, your essay is gutsy and thought-evoking.
My main comment is to emphasize everything you have said and pass it on. I know there are some colleagues that are listening just way to many are silent. I did write the college about CAN Meds 25 with a complaint and no reply. I was even more succinct than you were"emphasizing social Justice over Medical Expertise. I only optimism I have is that I don't think our Health care system can get any worse and still cal it a system. It really saddens me because I won't live long enough to see the recovery of our "Profession". A lot of what we are saying is certainly worse in The USA and CANADA than the rest of the world that I know. You mentioned MAID; we don't have MAID in Ontario. (98% are euthanasia.
So-called MAiD is now the 6th leading cause of death in Canada. Sad, disturbing, outrageous, despicable... and perhaps the most damning indictment or our flailing "health care' system in which obtaining proper and timely palliative care is impossible for many who are suffering.
Oh Dr. Les you are spot on! It is absolutely a train wreck in the waiting. It scares the crap out of me to ever need a doctor. And if I do, can I have your phone number? :) Considering how many just prescribe some toxic drug or 'refer' you to a specialist so they can order some crazy ideas of their own, today is not about 'health' at all (not always of course but too many do). I call it the Disease Management System. And I can only imagine how this cohort will 'practice'. God help us!
the natural order is inverted. we are no longer striving towards a moral order. who is the Dean of this new medical school ? it is shameful. DEI carried to extremis.
Leviticus 26:19. I will break the pride of your power; and I will make your heaven as iron, and your earth as brass.
We've seen this movie before. The Hippocratic ideal was abandoned in the first part of the twentieth century, led by American and Canadian physicians in the thrall of eugenics, which had its culmination in the horrific atrocities perpetrated by German doctors during WWII. In the aftermath there was a re-grouping in Geneva, and a reaffirmation of Hippocratic guardrails... but we've steadily retreated from that reaffirmation, and I suspect we're headed once more to catastrophe, and again, unbelievably, led by doctors over the cliff.
One advantage of retaining a conventional stream of medical-school intake at Rye High is that LMCC pass rates and other measures of success will probably not be any worse among the equity seekers than among the plain-vanilla dumb white guys who can’t tick any boxes but who also can’t get into any other medical school in Canada. Ryerson would be the Last Chance U —Ryerson? For meds? C’mon, man! — even without the equity stream. So when the naysayers point out that only two thirds of Ryerson’s grads pass the LMCC and many don’t march in CARMS, the university can point to its stats that the equity group didn’t fare any worse than its regular group. So there!
The scary thing you should be aware of is that there has been a general lowering of standards to get THROUGH med school as well as INTO med school. So don't count on the blue-haired non-binary "them" failing "their" LMCC. Once they get in, they'll probably end up being your doctor. God save us all...
This has been the case for years, and only getting worse... once in , it's impossible to get someone out. I gave a very mediocre trainee a scathing review of his terrible clinical performance after spending multiple shifts with him in the ED; he complained about his evaluation, and in the ensuing process I found that it was ME who was held to be the problem, at least initially... despite the fact that I've won several clinical teaching awards over the years. It's almost impossible to turf incompetent trainees from the profession... as you say , they all become "doctors."
I ran into exactly the same issue myself when I failed incompetent students or residents. I quickly found out that the system has inverted so it became me and the other physicians who were under the microscope, rather than the trainee. And I quickly found out why other departments' education heads would say to me privately that they were glad that I was brave enough to fail the learner. How many times did I hear something like "thanks - I would have liked to fail them but it's just too much trouble".
And these were generally white males or females that I failed. Imagine being the one who had to mark "F" on the summative evaluation of a transgendered, two-spirited native woman with one leg who has been exalted on the website of your provincial doctors organization as being the "new face of medicine". How many preceptors would be brave enough to do that? My guess is they are as rare as unicorns.
Good insight. Medical schools need to graduate almost everyone who gets in just to keep the pipeline full to meet the insatiable demand for free or insurance-subsidized care. (Some of this is surprisingly banal.) As long as almost everyone passed the LMCC, an external exam, the schools could be reassured that they weren’t allowing the incompetent to skate through. But this works only if the application process is highly selective for students who can ace hard, objectively graded science courses. Lots of advocates say that being good at physics and organic chemistry doesn’t make you a good doctor. I disagree but it’s beside the point. Acing physics and OC means you will probably pass med school by assimilating the prodigious amount of knowledge without falling instantly behind. The soft skills of doctoring can be taught. Believe it or not, the University of Toronto Med School no longer requires any undergraduate courses in math or the hard sciences, just one “life science.” And they make you spin your wheels for four years before you can apply.
But if admission standards are deliberately reduced for equity and diversity, you can’t be sure that everyone admitted can graduate. You have to be prepared that a third of the class might flunk out, just as in physics and engineering programs. Or you dumb down the curriculum and the comprehensive exams. The LMCC is a national exam that all meds graduands in Canada take but the Medical Council of Canada is composed of reps from the medical schools. If the schools want the LMCC to be loaded up to test less hard stuff and more indigenous propaganda and gender-woo, which is what they are teaching, it will be. This is true of the post-graduate specialty certifying bodies also, who are being nobbled by the social-justice warriors. The beat goes on...
McMaster was/is notorious for having softened its entrance requirements many years ago to select students more based on "soft" criteria and "people skills".
As nice as that sounds I had a 4th year student working with me in ER on a patient who was critically ill from having lost a lot of blood. The student was unable to calculate in her head what one quarter of 6 is. She said "I'll have to go get my phone" (to use her calculator function).
I certainly agree with Brian's comment except more so (note above). Several people will die but not many since the 5 year old is only an incompetent driver not an "evil" person who should no better!
Like most folks (I imagine), I don't care what colour a doctor is or how rich or poor they were, or where they came from, as long as they know what they're doing and can solve my medical problems. Oh yes, and it's really nice to be able to understand what they're saying as well. Physicians who are truly competent, curious (imagine, a doctor needing to be curious), and more compassionate than ego-driven have been hard enough to find--and now this. What I smell about this is 'compliance.' As if (many--most?) doctors aren't already compliant and worried about CPSO audits, imagine what the new grads of dumbed-down med school will be like. Jump? How high? A new shot of gene therapy? Sure, just tell me which arm to put it into. This is the moment, it seems, when real doctors need to break out of the corral and say "hell no", this isn't right. Maybe figure out some collective action to take? Thank you, Dr. Les, for doing your part in that. As always, your essay is gutsy and thought-evoking.
This is like a 5 year old driving a dump truck, someone’s going to die…
Brian, that is a whole other topic - those driving those big trucks/rigs - another terrifying reality. :(
My main comment is to emphasize everything you have said and pass it on. I know there are some colleagues that are listening just way to many are silent. I did write the college about CAN Meds 25 with a complaint and no reply. I was even more succinct than you were"emphasizing social Justice over Medical Expertise. I only optimism I have is that I don't think our Health care system can get any worse and still cal it a system. It really saddens me because I won't live long enough to see the recovery of our "Profession". A lot of what we are saying is certainly worse in The USA and CANADA than the rest of the world that I know. You mentioned MAID; we don't have MAID in Ontario. (98% are euthanasia.
So-called MAiD is now the 6th leading cause of death in Canada. Sad, disturbing, outrageous, despicable... and perhaps the most damning indictment or our flailing "health care' system in which obtaining proper and timely palliative care is impossible for many who are suffering.
Oh Dr. Les you are spot on! It is absolutely a train wreck in the waiting. It scares the crap out of me to ever need a doctor. And if I do, can I have your phone number? :) Considering how many just prescribe some toxic drug or 'refer' you to a specialist so they can order some crazy ideas of their own, today is not about 'health' at all (not always of course but too many do). I call it the Disease Management System. And I can only imagine how this cohort will 'practice'. God help us!
the natural order is inverted. we are no longer striving towards a moral order. who is the Dean of this new medical school ? it is shameful. DEI carried to extremis.
Leviticus 26:19. I will break the pride of your power; and I will make your heaven as iron, and your earth as brass.
We've seen this movie before. The Hippocratic ideal was abandoned in the first part of the twentieth century, led by American and Canadian physicians in the thrall of eugenics, which had its culmination in the horrific atrocities perpetrated by German doctors during WWII. In the aftermath there was a re-grouping in Geneva, and a reaffirmation of Hippocratic guardrails... but we've steadily retreated from that reaffirmation, and I suspect we're headed once more to catastrophe, and again, unbelievably, led by doctors over the cliff.
One advantage of retaining a conventional stream of medical-school intake at Rye High is that LMCC pass rates and other measures of success will probably not be any worse among the equity seekers than among the plain-vanilla dumb white guys who can’t tick any boxes but who also can’t get into any other medical school in Canada. Ryerson would be the Last Chance U —Ryerson? For meds? C’mon, man! — even without the equity stream. So when the naysayers point out that only two thirds of Ryerson’s grads pass the LMCC and many don’t march in CARMS, the university can point to its stats that the equity group didn’t fare any worse than its regular group. So there!
The scary thing you should be aware of is that there has been a general lowering of standards to get THROUGH med school as well as INTO med school. So don't count on the blue-haired non-binary "them" failing "their" LMCC. Once they get in, they'll probably end up being your doctor. God save us all...
This has been the case for years, and only getting worse... once in , it's impossible to get someone out. I gave a very mediocre trainee a scathing review of his terrible clinical performance after spending multiple shifts with him in the ED; he complained about his evaluation, and in the ensuing process I found that it was ME who was held to be the problem, at least initially... despite the fact that I've won several clinical teaching awards over the years. It's almost impossible to turf incompetent trainees from the profession... as you say , they all become "doctors."
I ran into exactly the same issue myself when I failed incompetent students or residents. I quickly found out that the system has inverted so it became me and the other physicians who were under the microscope, rather than the trainee. And I quickly found out why other departments' education heads would say to me privately that they were glad that I was brave enough to fail the learner. How many times did I hear something like "thanks - I would have liked to fail them but it's just too much trouble".
And these were generally white males or females that I failed. Imagine being the one who had to mark "F" on the summative evaluation of a transgendered, two-spirited native woman with one leg who has been exalted on the website of your provincial doctors organization as being the "new face of medicine". How many preceptors would be brave enough to do that? My guess is they are as rare as unicorns.
Good insight. Medical schools need to graduate almost everyone who gets in just to keep the pipeline full to meet the insatiable demand for free or insurance-subsidized care. (Some of this is surprisingly banal.) As long as almost everyone passed the LMCC, an external exam, the schools could be reassured that they weren’t allowing the incompetent to skate through. But this works only if the application process is highly selective for students who can ace hard, objectively graded science courses. Lots of advocates say that being good at physics and organic chemistry doesn’t make you a good doctor. I disagree but it’s beside the point. Acing physics and OC means you will probably pass med school by assimilating the prodigious amount of knowledge without falling instantly behind. The soft skills of doctoring can be taught. Believe it or not, the University of Toronto Med School no longer requires any undergraduate courses in math or the hard sciences, just one “life science.” And they make you spin your wheels for four years before you can apply.
But if admission standards are deliberately reduced for equity and diversity, you can’t be sure that everyone admitted can graduate. You have to be prepared that a third of the class might flunk out, just as in physics and engineering programs. Or you dumb down the curriculum and the comprehensive exams. The LMCC is a national exam that all meds graduands in Canada take but the Medical Council of Canada is composed of reps from the medical schools. If the schools want the LMCC to be loaded up to test less hard stuff and more indigenous propaganda and gender-woo, which is what they are teaching, it will be. This is true of the post-graduate specialty certifying bodies also, who are being nobbled by the social-justice warriors. The beat goes on...
This is not going to end well.
McMaster was/is notorious for having softened its entrance requirements many years ago to select students more based on "soft" criteria and "people skills".
As nice as that sounds I had a 4th year student working with me in ER on a patient who was critically ill from having lost a lot of blood. The student was unable to calculate in her head what one quarter of 6 is. She said "I'll have to go get my phone" (to use her calculator function).
And its just getting worse.
I certainly agree with Brian's comment except more so (note above). Several people will die but not many since the 5 year old is only an incompetent driver not an "evil" person who should no better!