Exposure

Why's there much higher a hurdle to promotion now?

Alas, there are many good reasons on paper: Medical knowledge has vastly expanded and clinical practice is much more complicated nowadays than that 20 years ago. Moreover, there is a continuous attempt to improve the quality of care to our patients and it becomes more and more demanding before a doctor could call himself a fully trained medical specialist.

(This last sentence is so carefully worded that I begin to believe I have the talent to become an administrator. Alas, it is possibly the sugar-coated palatable translation of some inconvenient truth.)

But, I am not all for the younger generation (because of the obvious reason - I am not one of them). Let's think of it: Do the doctors nowadays have a longer training ?

On the face of it, yes. It was around 5 years two decades ago, but 7 to 8 years now.

But, 20 years ago, a physician trainee worked five-and-a-half day per week, usually had to do 5 overnight calls each month, and had no half-day rest after the call day. In those days, almost all clinical doctors worked over 65 hours a week - while less than 10% doctors are now working for such a long hour according to Shane Solomon before he left.

And, in 1980s, each physician trainee took care of 16 to 20 beds (as compare to 10 to 12 nowadays), and saw at least 20 patients in each clinic session (as compared to an average of 15 at the moment). If you compute the among of clinical exposure - in terms of both contact hour and patients seen - the training was quite the same between the two generations of doctors, just that it used to be more compact and intense.