Mar 30 2009
Here at Science-Based Medicine we’ve been getting a lot of letters from medical students. This is a good thing and a bad thing. I’m glad people see us a a resource for SBM, but I’m unhappy that medical students: 1) need us; 2) don’t have someone to approach on campus. Let’s explore some of the more subtle ways cult medical practices infiltrate medical education.
In order to give all of their students experience in outpatient medicine, most med schools must reach out to the community. Sure, some med schools have big enough clinics to support an experience for all of their students, but that’s the minority. For their internal medicine, pediatrics, and family medicine rotations, med students often spend time at private doctors’ offices. These offices are minimally vetted, and I’d venture to guess that the vetting does not include checking for non-standard practices. In fact, schools are so desperate for spots, that almost any office will do. It’s good for students to see how medicine is practiced in the “real world” but that real world often involves cult medicine practices. Along the same lines, many practitioners are not up to date on the most recent best practices. I remember a family doc I worked with who used to give huge doses of intramuscular steroids to people for seasonal allergies. This isn’t the best idea, but I was a student. Who was I to tell him how to practice medicine?
We don’t police our colleagues very effectively—we have surrendered that duty largely to the courts. However, if doctors want a medical school affiliation, it seems a small price to allow the school to come in and see if the office practices medicine according to the standard of care. In addition to checking for the most minimal quality standards, it would rule out docs who are offering voodoo in place of medicine.
There are dozens of medical student groups out there—some supporting peoples’ choice of specialty, some with religious or cultural affiliations, and other simply for fun. It’s not unusual for these groups to bring in speakers. There is generally a collegial atmosphere at medical schools—for example, I am staunchly pro-choice, and a friend and fellow student was staunchly anti-abortion, and belonged to a Christian medical student group. We sparred frequently, including having dueling letters to the editor in the Chicago Tribune, but we also often had a beer together and hung out. We understood that we would not agree on this issue and that we would each fight hard for our position.
What happens when this collegiality breaks down? I’ve heard of instances where medical students have spoken out and been slapped down by their fellow students. This is a very common tactic of cult medicine groups—since they can’t win on facts, they cannot tolerate dissent. If a student is harassed for speaking out against CAM on campus, who is she to turn to for support? Will she receive support from her dean? Will she be asked to make nice with the people promoting harmful practices?
At a recent meeting of the American Medical Student Association, a bill was introduced to officially recognize naturopathic students as “medical students”. Medical students are just starting their journey to become doctors are are vulnerable to this “inclusiveness” message. The bill was thankfully voted down, but this helps illustrate how deeply the alties are working.
We are at a crossroads in medical education. Proponents of made-up medical practices are infiltrating the academy at every level, and trying to convert medical students at a vulnerable time. When they are called out, they cry foul. The tactics are quasi-religious. Those of us in medical education have a grave responsibility. We must train doctors who are compassionate and who understand the difference between science-based medicine and everything else. It’s time to be less inclusive in our curricula. It’s time to have coursework that specifically addresses made-up medical practices, explains why they are wrong, dangerous, and unethical. It is time to take the offensive. It both delights and saddens me that this blog is one of the centers for the defense of medicine. It shouldn’t have to be that way. That being said, we will continue to be a resource for those interested in keeping the science in medicine, and will hopefully help birth some additional resources in the near future.
If you are a student or educator and are concerned about made-up medicine in your institution, feel free to email us. We share emails among ourselves but with no one else, and we will not write about your situation without your explicit permission. It’s time we all joined the battle.
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