Medical School Ethics & Public Financing

Accountability: Schools accepting public money should protect the public interest: Defamation/data-banking of doctors who are whistleblowers is not in the public interest. Avoid schools and hospitals which attack whistleblowers. After you are admitted, compare schools/hospitals: Study the way students are treated by re-visiting those you prefer. Choose an institution with no history of abusing medical students, interns, or residents: Check the internet for cases of dismissal without due process. If students decline to discuss these issues, you have your answer. Schools change, slowly, as deans change. Use the internet to find the suicide rates. Trace the career of the dean, the department chairmen, their subordinates, particularly the assistant dean. Check their biographies. With discretion, inquire where the deans and assistant deans went if the school was involved in allegedly abusing students or housestaff. Beware of hearsay, as all truth is incomplete in these matters, as these are not easy decisions. As a reference, study how to use the internet to look up what a few members of the Duke faculty did in the case of the lacrosse team: Did a few members of the faculty rush to judgment? Are those people still there? Where did they go? Do the same for the conflicts of interest at other universities, particularly in psychiatry and pharmacology: Google alleged conflicts of interest in research-funding, pharmacology, psychiatry, double-billing in the university hospitals, Medicare fraud, whistle-blower abuse, etc., because the few individuals who will cheat the government may cheat others, including you. With the internet you can quickly see where they are.

Check the 'green book' on requirements for certification in the different specialties. You may want to change specialties after internship. For some fields an internship outside that specialty is acceptable.

Check the funding: Medicare may not pay for your change of specialty at the residency level.

Study some of the ~243 cases on this web site with regard to contracts and by-laws as you decide where to enter practice. If you are unsure where to go, delay the decision by working locum tenens.

Be careful about hospital by-laws written by Horty Spirnger. In many cases the "hospital is no longer your friend." You want incentive for extra work/extra liability as well as due process in peer-review should you decide to leave your first job, open your own office in the same town, etc. Always hold at least 2 hospital appointments.

All politics is local and variable. Consult a lawyer to protect you from an unfavorable contract or by-laws. Semmelweis Society is preparing its own lawyers to write sample by-laws and contracts.

Always have at least two licenses, and when possible two sites of work in case the local politics of the profession changes unpredictably after a few years.