Thursday, November 1, 2012

Could Dr. Mullis Have Been Right?

Dr. Kary Mullis said, in his autobiography, that scientists were the new priests.

"Scientists who speak out strongly about future ecological disaster and promote the notion that humans are responsible for any changes going on are highly suspect. Turn off the TV. Read your elementary science textbooks. You need to know what they are up to. It's every man for himself as usual, and you are on your own. Thank your lucky stars that they didn't bother to change their clothes or their habits. They still wear priestly white robes and they don't do heavy labor. It makes them easier to spot."

Given what he later says in his most recent TED talk , we can assume he has changed his mind about ecological disaster.

 "Our antibiotics are running out. And, I mean, the world apparently is running out too. So probably it doesn't matter 50 years from now -- streptococcus and stuff like that will be rampant -- because we won't be here. But if we are -- (Laughter) we're going to need something to do with the bacteria."

However,  I still think Dr. Mullis may have had a point. Consider this paper, for instance:

"Academic achievement correlates poorly with clinical performance of physicians, so it is probably more important to select college students for medical school admission who will be superior physicians than to select those who will be excellent medical students."

Basically, the paper states that medical schools are pretty worthless at training doctors. The schools cannot figure out which candidates are going to become good doctors because it is poorly related to the criteria considered in the selection process. So there are two possiblilities:

1) Our educational system is mostly worthless.

2) The paper is wrong.

Having hope that #1 is not the case (although it very well could be), I decided to do some more research. Here is another source:

"Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias."

The conclusion of this paper is that most research only serves to confirm bias. While the paradox of the paper probably being biased will be left alone, it raises an interesting question about the selection criteria paper. Perhaps the result that scores and grades do not predict quality of clinical care is merely a confirmation of prevailing bias that these criteria do not predict quality.

In this case, we will be throwing away perhaps some of the best future doctors on the notion that their credentials should not be believed. Your humble author, for instance, scored a 35 on the MCAT, earned a 3.5 at a top 20 school, volunteered at a hospital, shadowed a physician, worked in a lab, was a teaching assistant in biology, and did not gain entry to medical school, despite having applied -- expensively, mind you -- to 27 different schools. Could my entire experience be the result of a bias in the minds of highly qualified, money-grubbing pseudo-scientists that academic credentials are meaningless predictors of clinical quality?

Of course, the other possibility is that our education system is worthless and that these pseudo-scientists are probably not nearly as good at their jobs as some random janitor no one knows about. Either way, the story is interesting.

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