Bad acorns grow into rotten oaks

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Or so it would seem when it comes to bad medical students becoming less-than-stellar docs, according to a new study in the New England Journal of Medicine (subscription req'd. Here's a link to a writeup of it in Forbes, which you don't need a subscription to read online). From Forbes:


    Doctors who had exhibited unprofessional behavior in medical school were three times more likely to be disciplined by a medical board than students who had not had such problems in medical school, the study found.


    But doctors who had exhibited certain types of behavior in medical school were even more likely to be cited by a medical board: Those who behaved unprofessionally in school were 8.5 times more likely to be disciplined while those with a diminished capacity for self-improvement were 3.1 times more likely to be disciplined, according to the study.


    The students were deemed irresponsible if they were late for rounds, didn't show up for the clinics they were assigned to, or didn't finish taking care of a patient.



And the things they end up being disciplined for as docs "use of drugs or alcohol, negligence, sexual misconduct, fraud and failure to meet continuing medical education requirements." And many of them are repeat offenders. So, it makes sense to try to nip this in the bud in med school. But what to do for today's former irresponsible students-turned irresponsible doctors? Somehow, I don't think there's much CME can do to help develop that sense of professionalism (especially if they're already skipping out on their CME requirements) once they've been in practice a while. Is it possible to reform these people?


As Bard Parker says on A Chance to Cut is a Chance to Cure:


    My program director always told us that a residency program can't purge someone of their personality disorders. Goes along with the conventional wisdom of being unable to change someone after you marry them. This has been my anecdotal experience as well. In Georgia the quarterly report from the medical board has the names of physicians placed on the naughty list during that time period. Occasionally I will recognize a classmate's name and recall what a buffoon/screwball/jackass he/she was. Could have saved the board a lot of time.

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