September 28, 2007

So Doctors Are Allowed To Breast Feed

A ridiculous story about a female medical student needing to go to appeals court to get extra time  during the medical licensing exam so she could breast feed her kid.

Here's why it's ridiculous.  If she had ADHD-- which does not exist as a physical entity but is considered an illness-- then she could get extra time.  But because it's a baby-- which does exist, but is not considered an illness-- then she is entitled to nothing.

Maybe this woman is using breastfeeding as an excuse, I don't know, I don't care.  It's breastfeeding-- does it occur to no one that that might be comparatively more important than, say, ADHD? 

Ah, but doesn't the medical board have a valid point?

Board attorney Joseph Savage said he would appeal the ruling, which he said compromised the test's fairness and could force the board to grant extra time to other test-takers with distracting medical conditions, such as men with prostate problems.

You're right, it does open the door to this.  But the problem isn't the woman who wants to breast feed, it's the inanity of an exam where such unrelated issues actually start to matter.  Why should the Boards take all day?  Don't give me the pat answer, "that's they way it is" or "doctors need to go through such grueling days, it builds character."  Is there no more effective way to test knowledge then to see who bores slowest?

Leaving aside the question of whether the licensing exam is actually valid-- that it tests what it says it tests, basic medical knowledge; and ignoring for the moment whether a score of any kind in any way relates to your potential as a doctor; and keeping silent on whether the exam can be "gamed" (I taught for the Princeton Review for USMLE I and II for 5 years)-- why does the exam need to be all day? 

It's amazing to me-- absolutely amazing, and by amazing I mean violently enraging-- that we are so apathetic that no one questions why the exam needs to be that long, that our minds find it easier to jump to whether there are alternatives to breastfeeding-- arguably the last holdout in our collective descent into narcissistic alienation.


Overall: AgreeBut ... (Below threshold)

September 28, 2007 3:55 PM | Posted by Steve: | Reply

Overall: Agree

But are you actually saying that ADHD doesn't exist? I agree that it's wildly over-diagnosed, but it exists. Now PTSD, there's something that may not exist.

Alone's response: by exist, I mean has physical pathology. Certainly the syndrome exists, but can you create a set of exemptions for a cluster of behaviors that "exist" only by one person's say so? i.e. it only takes one doc to say you have it-- and you do.

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Um, actually <a href="http:... (Below threshold)

September 28, 2007 4:29 PM | Posted by Jim Lipsey: | Reply

Um, actually she's already taking an ADHD extension. And one for dyslexia:

Currier will be allowed to take the test over two days, instead of the normal one, because she has dyslexia and attention deficit hyperactivity disorder, and the board has agreed to give her 45 minutes of break time each day. Currier wants an additional hour of break time each day.

Alone's response: I'm with you-- she more than likely is milking it. But my comments apply more generally to the issue of a) tests which likely have no validity (or reliability); b) breastfeeding, which somehow is considered a luxury or boutique parenting procedure, like homeschooling.

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Breast feeding is a medical... (Below threshold)

September 29, 2007 8:15 AM | Posted by Jayme: | Reply

Breast feeding is a medical condition? The baby is a tumor? Hey, at least she's not wanting to bring the baby into the testing room and breast feed in front of innocent people.

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Does this mean she will spe... (Below threshold)

September 29, 2007 9:25 AM | Posted by Anonymous: | Reply

Does this mean she will spend twice the time with her patients that other physicians do? Nah....

Alone's response: Actually, yes-- she's going into pathology.

"Surgeons know nothing and do everything.
Internists know everything and do nothing.
Psychiatrists know nothing and do nothing.
Radiologists know everything but don't care.
Pathologists know everything and can do everything, but it's usually too late. "

Or something...

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Aside from the fact that th... (Below threshold)

September 29, 2007 10:43 AM | Posted by Common Reader: | Reply

Aside from the fact that the a day-long test is retarded, a breastfeeding mother who can't breastfeed for a whole day is going to be in massive discomfort. I am surprised no one has fought this before on the basis of sex discrimination, since no man is going to have to take the test with rock-hard leaking boobies. Then the guys with prostate problems can fight for their side, and then everyone wins!

Alone's response: I took the test with a rock hard-- oh, wait...

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This situation resulted in... (Below threshold)

September 30, 2007 3:32 PM | Posted by YeahOK: | Reply

This situation resulted in litigation? L*A*M*E. I don't see the prob. I mean, yes, chick is milking all her problems for extra time (dyslexia? ADHD? Did she ride the short bus to medical school?), but I mean..who wouldn't? I'm sure she's adequately skilled to do what needs to be done.

Alone's response: probably (milking it), as suggested by the fact that she also has a PhD (those are two very different skill sets, let me tell you.) But again, what matters for me here is that there's a test that is so flawed that on the one hand, exemptions fro breastfeeding and ADHD are needed, but also so flawed that once you get these exemptions, your score is "counts" just as much as anyone else's. Does each exemption get you a different amount of time extra? No. So in other words breastfeeding needs are "worth" as much as an ADHD diagnosis=dyslexia=blindness, etc, I think you see my point. Oh, and that I hate how our society views breastfeeding as an "alternative" option. Soon carrying a baby inside your own belly (and not a surrogate) will be viewed as quaint, and a drag on productivity. My response is already prepared: bite me.

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So you don't buy Amen's SPE... (Below threshold)

September 30, 2007 4:09 PM | Posted by Velvet Elvis: | Reply

So you don't buy Amen's SPECT stuff? Haven't they pretty much isolated a handful of gene locations tied to ADD?

If you mean that it's behavior and not disease, I can sorta agree and I sorta don't care. I'm round peg having to compete in a world of square holes. Perhaps affirmative action would make more sense than accommodations? That way I could take the GRE and do mediocre and still get in anywhere I want.

Alone's response: (Disclosure: I know Amen.) But the scans don't show what caused you to be that way, only that you are that way. I'm not saying ADHD is not a physiological phenomenon-- all thought is-- but the origins seem to me to be weighted towards the environmental than the genetic. But whatever-- whether you have it or you don't, there are ways to help with difficulties in thinking. But my point vs. the exams is that they are a poor way of evaluating people. Whether you have ADHD or not shouldn't matter to the evaluation of a medical student in the exact same way and amount it shouldn't matter in the actual performance of a doctor. If one cannot design a test that validly evaluates medical knowledge independent of such external factors, then there shouldn't be a test at all. So am I saying I want no tests at all for doctors, let them just show up and start practicing? Well, theoretically class size in medical schools is small enough (100) that the school should be able to detect who needs to be booted and who can graduate. And graduation is a binary process--graduating with honors and "last" in the class end up the same. Ok, so residencies look differently on candidates-- but in the absence of tests, residencies would use other criteria, which they already use anyway-- interviews, letters, etc. I'm not trying to reinvent the wheel here-- how did they graduate doctors/physicists/historians etc 100 years ago? K questions?

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There are such things as br... (Below threshold)

October 2, 2007 6:35 AM | Posted by Stephany: | Reply

There are such things as breast milk pumps. Considering babies sleep for a few hours inbewteen feedings, and the person wasn't going to have the baby at her feet in a rocker, I'm pretty sure she could plan for the boring useless test, same as if she went out for a day and left the baby with Gramma to go to a museum where no one wants to hear sucking sounds and burps either.Regarding Amen & SPECT, I've met people who claim to know waht drugs to take for bipolar due to those scans. Anyone ever study breast fed babies and increased risk for mental illness? I've breast fed 3 babies, this isn't an anti-breast feeding comment. The one I breast fed from breast to cup is psychosis NOS now.

Alone's response: I don't mean to imply that breast feeding is grossly superior to bottles; just that it's amazing our society has marginalized what is a normal basic function. And of course the student didn't _need_ to breast feed, but even if she was only making it up to get extra time on the test, why would the Boards refuse her? Example:if I need to go to the bathroom, I can go.

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yeah.... (Below threshold)

October 3, 2007 9:01 PM | Posted by Stephany: | Reply


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Why would a medical student... (Below threshold)

October 10, 2007 5:30 PM | Posted by Caxi: | Reply

Why would a medical student take their child to an important exam such as this? Wouldn't it be best to pump the breast then hire a baby sitter so that the student could take the exam uninterrupted?

Alone's response: the short answer to your q is yes. But I find it interesting how many people have asked essentially the same question, a logic/logistic one: "why can't she just pump/sitter/etc." But they bypass the real issue. The question shouldn't be, "isn't there something else she can do?" the question is, "why are there artificial and needless blocks to a normal condition?" If there's someone blocking your driveway, you could go around him, take a bus, call the police, etc; but the real question is why should you have to do any of these things?

I'm operating under the premise that the test exists to evaluate knowledge, and nothing else; and that people shouldn't have to accommodate to the needs of temporary institutions-- these institutions are built to serve the people and need to accommodate them. And I'm also against all multiple choice exams.

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the absurdity of it all is ... (Below threshold)

October 11, 2007 10:10 AM | Posted by the absurd one: | Reply

the absurdity of it all is clear, but at the same time they do have to draw the line somewhere & it strikes me as less offensive to draw a stupid line and stick to it than to draw a smarter line that essentially blurs/disappears randomly.
If their line is that they only give accomodations for "illness," then they already aren't adhering to their own rule, since ADD gets specific accomodations whereas, say, schizophrenia and dsps would completely NOT GET SHIT. I know (& am pissed off) from experience. Thus the woman obviously should have been allowed to breast feed, not primarily because of common sense (and decency), as you point out, but because by disallowing her to do so they are merely taking an opportunity to invoke rules arbitrarily which they already routinely break as a practice.
make any sense?

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If breastfeeding test taker... (Below threshold)

November 3, 2007 6:46 PM | Posted by Common Reader: | Reply

If breastfeeding test takers have to pump, why don't we just give all the test takers enemas and cath them to eliminate bathroom breaks?

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