It's not uncommon to hear older physicians and younger physicians arguing about whose training was more difficult.

經常聽到年長的醫生和年輕的醫生爭論誰的培訓更困難。

But how does medical school today actually compared to medical school in the past?

但是，現今的醫學院與過去的醫學院相比，究竟如何呢？

Let's find out.

讓我們拭目以待。

Today we'll explore the common arguments regarding whether medical school is more difficult today than it was in the past.

今天，我們將探討關於現今的醫學院是否比過去更難的常見爭論。

At the end, we'll decide once and for all if it's harder now versus back then.

最後，我們將徹底地決定現在跟過去比哪個更困難。

We're planning to make more videos comparing what residency and life as an attending physician are like today compared to previous decades,

我們計劃製作更多影片，關於現在的住院醫師和主治醫師的生活與過去幾十年的比較，

so make sure you're subscribed so you don't miss out.

所以請記得你已經訂閱我們的頻道，以免錯過我們的影片。

Let's start by discussing how hard getting into medical school is today compared to previous decades.

讓我們先討論一下，與幾十年前相比，現在要進入醫學院有多難。

According to data, the average matriculation rate between 1961 and 1981 was approximately 45% with some years having rates as high as 60% and others having rates as low as 35%.

據數據顯示，1961 年至 1981 年期間的平均入學率約為 45%，有些年份的比率高達 60%，有些年份的比率則低至 35%。

If we compare these numbers to the most recent data from the AAMC and AACOM,

如果我們將這些數字與 AAMC 和 AACOM 的最新數據進行比較，

the matriculation rate in recent years is approximately 36% for MD applicants and 31% for DO applicants.

會看到近年來的申請 MD 的入學率約為 36％，申請 DO 入學率約為 31％。

Based on the numbers, we can see that a smaller percentage of pre-meds that apply to medical school today get in each year.

根據這些數字，我們可以看到，現在申請醫學院的預科生中，每年被錄取的比例較小。

These numbers don't tell the whole story though.

但這些數字並不能說明全部問題。

There are many other factors that determine acceptance into medical school including your GPA, MCAT score and extracurriculars.

還有許多其他因素決定醫學院的錄取綠，包括你的 GPA、MCAT 的分數和課外活動。

Although data from previous decades is difficult to find, the trend in recent years has been that GPA and MCAT scores for matriculants have been steadily increasing.

雖然很難找到幾十年前的數據，但近年來的趨勢是預科生的 GPA 和 MCAT 分數一直在穩定上升。

In 2001, The average GPA for matriculate was 3.6 and the average MCAT was 29.6.

2001 年，預科生的平均 GPA 為 3.6，平均 MCAT 為 29.6。

This equates to roughly a 508 on the MCAT today.

這相當於現在 508 分的 MCAT 成績 。

If we compare this to the most recent 2021 to 2022 application cycle, the average GPA for matriculants was 3.74 and the average MCAT was 512.

如果我們將此與最近的 2021 年至 2022 年申請週期進行比較，預科生的平均 GPA 為 3.74，平均 MCAT 為 512。

In addition, there's a greater emphasis on soft skills and extra curricular activities in medical school admissions over the past several all years.

此外，過去幾年醫學院招生更加強調軟技能和課外活動。

Although decreased reliance on hard metrics like GPA and MCAT can be seen as making medical school admissions easier,

儘管減少對 GPA 和 MCAT 等硬指標的依賴被認為這讓醫學院入學更容易，

it also increases the time that students must spend on extra curricular activities.

這也增加了學生必須花在課外活動上的時間。

Although these aren't usually hard requirements for getting into medical school,

雖然這些通常不是進入醫學院的硬性要求，

students are expected to participate in volunteer work, research and leadership roles.

學生被期望要參與志願工作、研究和擔任領導角色。

They are also expected to gain clinical experience through physician shadowing or other clinical roles as well as receive glowing letters of recommendation from their teachers and mentors.

他們還被期望能透過當實習醫生或其他臨床工作獲得臨床經驗，並從他們的老師和導師那裡收到熱情洋溢的推薦信。

Medical schools want to see students who are well rounded which can often make the requirements less clear cut.

醫學院希望看到全面發展的學生，這通常會讓入學要求沒那麼明確。

Next, let's talk about medical school itself.

接下來讓我們來談談醫學院本身。

How does medical school today compared to medical school in previous years?

現在的醫學院與幾年前的醫學院相比如何呢？

Medical students today have much more information to learn compared to previous years.

與之前相比，現在的醫學生有更多的資訊需要學習。

According to a 2011 article, the doubling time of medical knowledge in 1950 was approximately 50 years.

根據 2011 年的一篇文章，1950 年醫學知識的翻倍時間約為 50 年。

In 1980, it was seven years in 2010, it was 3.5 years.

1980 年是 7 年，在 2010 年則是 3.5 年。

And today medical knowledge is believed to double every two to three months.

而現在，大眾認為醫學知識每二到三個月就會翻新一次。

Although there is a lag between the primary literature and the information that is added to medical school curricula,

儘管原始文獻與添加到醫學院課程中的信息之間存在滯後，

students are still learning much more information today than in previous years.

與往年相比，現在的學生仍然學到了更多的內容。

Despite these vast increases in knowledge, medical school is still the same duration that it has been for decades.

儘管知識有了這些巨大的增長，但醫學院的修習時間仍然和幾十年來一樣。

Students complete two years of pre-clinical coursework followed by two years of clinicals.

學生需要完成兩年的臨床前課程，然後是兩年的臨床課程。

This means that students have to cram much more learning into those four short years.

這意味著，學生必須在這短短的四年裡吸收更多的知識。

That being said, the way that today's medical students learn is very different than it was for students in the past.

話雖這麼說，現今的醫學生的學習方式與過去的學生有很大不同。

We have a much better understanding of how to optimize learning now.

我們現在比較知道如何優化學習過程。

People have developed countless methods to be more efficient with studying.

人們開發了無數方法來提高學習效率。

From the Pomodoro Method to the Feynman Technique and Spaced Repetition, we have hacked our study strategies so that we can learn more and less time.

從番茄工作法到費曼學習法和間隔重複，我們改變了我們的學習方式，這樣我們就可以學習更多但花更少的時間。

Even on this channel, we have a variety of resources to help you learn more efficiently in our study strategies and tips playlist. Link in the description.

甚至在這個頻道上，我們也有各種資源可以幫助大家利用觀看我們的學習策略和技巧播放清單中更有效地學習。影片連結在說明欄中。

Speaking of which, there are also far more resources nowadays to help students learn information in medical school.

說到這裡，現在也有更多的資源可以幫助學生在醫學院學習知識。

There are comprehensive question banks with thorough explanations.

有全面的題庫和詳盡的解析。

There are extensive libraries of flashcards covering everything you need to know for the USMLE step exams and shelves.

還有大量的圖卡庫，涵蓋了 USMLE step 考試和 shelf 考試所需的一切知識。

There are even resources that use pictures and funny stories to help you memorize all the small details about microbiology and pharmacology.

甚至還有一些資源使用圖片和有趣的故事來幫助你記住有關微生物學和藥理學的所有小細節。

And if those aren't enough, the explosion of the internet over the past couple of decades mean that all the information you could want is at your fingertips.

如果這些還不夠的話，過去幾十年網路的爆炸式增長代表你想要知道的所有資訊都觸手可及。

In the past, medical students had to flip through their textbooks or notes to find the information they needed.

過去，醫學生必須翻閱課本或筆記才能找到所需的知識。

Nowadays, you can take out your phone, put your question into Google and have more information than you could possibly want on whatever topic it is that you're trying to learn.

如今，只要拿出手機，把問題輸入谷歌，就得獲得遠超過自己想要學習的知識還要多的資訊。

Beyond the amount of information and resources, however, there's also the fact that many schools nowadays are transitioning to pass-fail curriculums.

然而，除了大量的資訊和資源之外，還有一個事實現況是，如今許多學校正在過渡到「通過/不通過制」的課綱。

In fact, within the last year, USMLE Step 1, which has long been the most important test in determining your competitiveness for residency, has also become pass-fail.

事實上，在過去的一年裡，長期以來一直是決定一個人是否具有成為醫師的競爭力最重要的測驗，USMLE Step 1 考試也變成了通過/不通過制的考試。

The goal of these changes has been to decrease stress and burnout among students as research has shown that student well-being is enhanced and academic performance is not negatively affected by pass-failed curriculums.

這些變化的目標是減少學生的壓力和過度疲勞，因為研究表明，學生的福利得到了提高，學術表現也不會因過去課程被當掉造成負面影響。

That being said, due to the nature of these curricula, students may need to spend more time on extracurricular activities such as research and leadership roles in order to stand out for residency applications.

話雖這麼說，由於這些課程的性質，學生可能需要花更多的時間在課外活動上，例如進行研究和擔任領導角色，才能在醫師執照申請中脫穎而出。

This means that students have to spend more of their time participating in these extracurricular activities while simultaneously studying for classes and boards.

這表示學生必須花更多的時間參加這些課外活動，同時還要修習課程及執業考試。

In addition, just because medical school curriculums and Step 1 are pass-fail doesn't make them easy.

此外，光只有醫學院的課程和 Step 1 考試是通過/不通過制並不會讓學習過程變得容易。

Students must still put in significant time and effort in order to pass while still managing their other activities.

學生仍然必須投入大量時間和精力才能通過考試，同時還要管理他們的其他活動。

As such, it can be difficult to gauge how much time to put into medical school classes versus studying for boards versus extracurricular activities.

因此，要衡量投入醫學院課程、為了執業考試讀書和課外活動的時間很困難。

Achieving the perfect balance between all of these responsibilities can often feel near impossible.

在這些責任之中實現完美的平衡常常讓人覺得幾乎是不可能的。

Another factor that we've talked about many times on this channel is the rising cost of medical school.

我們在這個頻道上多次談到的另一個因素是醫學院的成本上升。

In 1978, the average medical student graduated with approximately $13,500 worth of debt.

1978 年，普通醫學生畢業時背負了大約 13,500 美元的債務。

When adjusted for inflation, that's around $54,000.

經通貨膨脹調整後，約為現今的 54,000 美元。

In 2000, this number jumped up to $124,000.

到了 2000 年，這個數字躍升至 124,000 美元。

Now in 2022, the average medical student graduates with approximately $240,000 of student loan debt.

現在到 2022 年，醫學生畢業時平均背負大約 240,000 美元的學貸債務。

That's almost five times what it was just 40 years ago.

這幾乎是 40 年前的五倍。

Given current interest rates in the amount of time it takes to pay back the loan, the average physician ultimately pays between 365 and $440,000 for their educational loans plus interest.

考慮到償還貸款所需時間的當前利率，普通醫生最終要為他們的教育貸款加利息支付 365,000 至 440,000 美元。

Although this doesn't make medical school more challenging from an academic standpoint, it does add an additional psychological and financial stress on top of training to become an effective doctor.

雖然從學術的角度來看，這並沒有讓醫學院更具挑戰性，但它確實在成為一名有效醫生的培訓之上增加了額外的心理和經濟壓力。

That being said, there are more options available today to help you pay for medical school.

話雖如此，現在有更多選擇可以幫助你支付醫學院的費用。

In the early 1960s, it is estimated that approximately 83% of a student's total spend was from family contributions, and only 31% of students incurred educational debt.

在 1960 年代初期，據估計，學生總支出的大約 83% 來自家庭的捐獻，只有 31% 的學生背負學業債務。

This means that most students likely came from wealthy families who could afford to pay for medical school.

這表示大多數學生可能來自有能力支付醫學院費用的富裕家庭。

Today, approximately 76-89 percent of medical students have educational debt due to the accessibility of financial aid, grants, scholarships and student loans.

如今，由於經濟援助、助學金、獎學金和學生貸款的可及性，大約 76-89% 的醫學生背負著學業債務。

Medicine is much more accessible to students from less privileged backgrounds.

來自貧困背景的學生更容易獲得醫學學位。

We cover the various resources to help students pay for medical school and our how to afford medical school video. Link in the description.

我們製作了幫助學生了解如何支付醫學院費用的各種資源以及我們如何負擔醫學院費用的影片。 連結在說明欄中。

Although it is difficult to find information regarding rates of depression and burnout among medical students over the decades,

儘管很難找到有關幾十年來醫學生憂鬱和過度疲勞的資訊，

there has been an increased emphasis on improving these in recent years.

近年來，人們越來越重視改進這些問題。

There have been long-standing stigmas within healthcare regarding mental health among medical students.

長期以來，醫療保健行業一直污名化醫學生的心理健康。

It hasn't been until the last decade or so that schools have started to take these more seriously and take actionable steps to improve them.

直到最近十年左右，學校才開始更加認真地對待這些問題，並採取可能的措施來改善。

This has been a big reason for the shift that we've been seeing to pass-fail curriculums.

這是我們看到透過通過/不通過制課綱轉變的一個重要原因。

Although it is difficult to draw objective comparisons between now and previous years due to the lack of information on the issue of underreporting,

儘管由於缺乏關於漏報的資訊，很難對現在和往年進行客觀比較，

there are certainly more resources available to students who are struggling today than there have been in the past.

與過去相比，現在苦苦掙扎的學生可以使用的資源肯定更多。

That being said, we still have a long way to go in terms of destigmatizing mental health and improving the well-being of medical students.

話雖如此，在消除心理健康污名化和改善醫學生的福祉方面，我們還有很長的路要走。

So who had it easier, medical students of the past or medical students of today?

那麼，過去的醫學生還是現在的醫學生更容易呢？

The answer is, we'll never know.

答案是，我們永遠不會知道。

There are countless factors that play into how challenging medical school is.

有無數的因素影響著醫學院的挑戰性。

It's impossible to account for every single one of them and that's not even factoring in all of the individual variation that exists.

不可能適用在每個人身上，甚至沒有考慮所有存在的個體差異。

You can have two medical students who attended medical school at the same institution during the same year at the same instructors and clinical rotations and they can still have completely different experiences.

你可以讓兩名醫學生同一年在同一所醫學院接受相同的指導和臨床工作，但他們仍然會有完全不同的經歷。

There are far too many factors to objectively say who had it easier.

有太多因素無法客觀地說出誰更容易。

The reality is that medical school was likely harder back then in some respects and easier in others.

現實情況是，當時的醫學院在某些方面可能更難，而在其他方面可能更容易。

Arguing about who had it worse only creates an us versus them mentality between older and younger generations of physicians.

爭論誰的情況比較糟只會在老一代和年輕一代的醫生之間產生敵對的心態。

Instead, we should just accept that getting into medical school and becoming a doctor is hard, regardless of the generation.

相反的，我們應該認同進入醫學院並成為一名醫生都是很困難的，無論是哪一代的人。

Just because you had to walk 15 miles in the snow every day, uphill both ways, doesn't mean that everyone else should.

僅僅因為你必須每天在雪地裡走雙向上坡的 15 英里，並不代表其他人也應該這樣做。

There are still many issues within medical education that need to be addressed,

醫學教育中仍有許多問題需要解決，

including the rising cost of medical tuition, burnout, the residency bottleneck and looming physician shortages to name a few.

包括不斷上漲的醫學院學費、過度疲勞、住院醫師執照瓶頸和迫在眉睫的醫生短缺等等。

It is only by fostering a collaborative relationship between all physicians that we will be able to take steps towards making things better for future generations of doctors.

只有所有醫生建立協作關係，我們才能採取措施為下一代醫生創造更好的條件。

Thank you all so much for watching.

非常感謝大家的觀看。

If you enjoyed this video, be sure to check out how to afford medical school or one of the videos in our study strategies and tips playlist.

如果你喜歡這個影片，請務必查看如何負擔得起醫學院的學費，或我們的學習策略和技巧播放清單中的影片。

Much love and I'll see you guys there.

非常感謝，我們別支影片見。