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I taught middle school science in Houston for five years. I decided to leave the traditional public school system for many of the same reasons the author makes about his experience. This was over a decade ago so it's sad to hear the same problems persist.

Alternatives like charter schools have not always fared well, but some, like YES College Prep (http://www.yesprep.org/), are serving low income areas and achieving profound success. They've been able to replicate a model where teachers, students and parents all buy into the same mission: that all students must gain acceptance into a four year college or university to graduate. YES began with the hard work a few enterprising teachers who became tired of a broken system - not much different from a tech startup in a way.

I've often felt if the teaching profession was prestigious as, say, law or medicine, we could eventually solve the problems in education. That's not to say we don't have problems with our legal system or healthcare - but it'd be hard to argue there is a shortage of good lawyers or doctors. Imagine if we had no shortage of good teachers... But we don't pay teachers well, there are stigmas ("Those who can't...) and a lack of long term benefits outside of the daily joy of interacting with young people and helping them grow - we'd all be crazy to leave tech to go teach, right?




I've often felt if the teaching profession was prestigious as, say, law or medicine, we could eventually solve the problems in education.

Indeed: "In all of the systems we studied, the ability of a school system to attract the right people into teaching is closely linked to the status of the profession. In Singapore and South Korea, opinion polls show that the general public believe that teachers make a greater contribution to society than any other profession. New teachers in all of the systems studied consistently reported that the status of the profession is one of the most important factors in their decision to become a teacher."

http://mckinseyonsociety.com/how-the-worlds-best-performing-...


Actually, we do have a shortage of Doctors, especially Primary Care. Caps are set in place by Medicare to limit the number of residents in an academic program. Academic hospitals would love to increase their slots but Medicare won't allow that. I think last year something like 23k students applied to residency programs and only 6k got accepted. What happens to the rejected 17k students as they wander aimlessly to figure out what next? Re-apply next year?

I think the cap is set by Medicare because they pay the Residents salary across the nation.

6000 students * $60k resident salary = $360,000,000


Medicare has nothing to do with it. The AMA doesn't want doctors flooding the market. They are a very powerful union.


Here's an interesting piece of info from the AAMC: https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html


So, am I to assume there are laws in place to prevent a residency program from paying the salary themselves to bypass Medicare restrictions?


These are the same hospitals which charge markups of tens of thousands of dollars per patient. If the Medicare number of residents was really suboptimal, then more residents should allow them to treat more patients and make more money.


This is disingenuous. Medical schools would increase resident caps even without the bonus money from Medicare if there was a reason to do so. Reasons go beyond just the Medicare funds that go for those slots.


Could you articulate more? Why aren't Academic Hospitals allowed to increase the cap limit on Residency programs?


They are most certainly allowed to increase the cap. They don't have the money to. Texas is putting state money into state-run academic hospitals in order to increase the number of slots open, and at least one non-profit academic hospital here (Scott & White) is using their own money to increase the number of residency slots they have.


I don't think its true that they're allowed to increase the cap. These quotes suggest otherwise.

"Physicians and medical students from across the country are urging Congress...to lift the cap on the number of available residency slots." http://www.ama-assn.org/ama/pub/news/news/2013-02-03-urge-co...

"The BBA resident limits have imposed significant limitations on the ability of teaching hospitals and medical schools that sponsor and conduct graduate medical education programs to respond to the needs of the communities they serve." https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html


Medicare funding drives GME availability, but that is only because it represents the lion's share of the funding for it. Universities in Florida and Texas[1], the two states with the biggest shortfalls in residency slots, are taking steps to address this by finding other sources of funding or creating partnerships with non-academic hospitals to have med students do their residencies there.

I may be mistaken, but I don't think the federal government even has the power to restrict the number of residency slots.

[1] http://www.medpagetoday.com/PublicHealthPolicy/MedicalEducat...


Its not a hard cap, its a cap of number of residencies that will be supported by federal funding through Medicare:

http://www.advisory.com/daily-briefing/2012/08/30/why-reside...

A large majority of residencies are funded this way due to the very high cost of residency. As a result, many private institutions won't increase residency numbers on their own due to funding.

The main issue is the cost of residency is massive and is prohibitive for private money to fund anyone's residency.




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