KLG, who as you may recall is a professor of medicine, sent this note from a long-standing colleague:
From my postdoctoral mentor, who was the first woman to get tenure in a Hopkins Basic Science Department:
There is some rather sad news from Hopkins. The Department of Biological Chemistry will be shut down on June 30th, as part of a consolidation (basic science extinction) plan. All the faculty (even emeriti) who have to have an appointment in the department were reassigned to other departments. I am now in Cell Biology. Biophysics in the medical school was merged with Biophysics at Homewood (main undergraduate campus). Physiology and Pharmacology were combined. I’m not sure whether the faculty kept their lab space in the department or whether that has been “rearranged.” Past graduates of Biological Chemistry should still list the Department of Biological Chemistry as their affiliation. I know, it’s the pits.
The Department of Biological Chemistry in the Johns Hopkins University School of Medicine was established as the Department of Physiological Chemistry in 1908. We had our 100th anniversary in 2008 with an international 3-day event. And when I say “we” I mean it. This is not a trivial thing. It will have repercussions the bean counters and other cowards will never feel. Just another brick falling out of the wall.
IM Doc’s reply put this development in the context of the ongoing devolution in medical education:
They have finally joined the crowd. This has been going on for the past 5 years at both of my alma mater. The anatomy and biochemistry dept were closed in med school in 2022 – and both closed at residency program or at least severely curtailed in 2023. Medicine is basically dead. The kids will never learn how to take care of patients.
https://www.nejm.org/doi/full/10.1056/NEJMp2414384
This is from this week NEJM. It describes what you mentioned. It seems to me this whole movement to minimize basic education started about 15 years ago – where else but Harvard Medical School.
No longer we’re students doing gross anatomy, biochem, pathophys etc.
Rather, they did rotations where all the various components of an organ system were done at once. So the courses suddenly became known as THE HEART, THE LUNGS, etc. The anatomy, phys, Pharma, etc for each organ system were all done at once during these rotations.
Very stupid idea. It is very difficult to discuss universal things like chemo and inflammation among many others in this type of system. I mark the decline in curiosity, knowledge base, etc to the past 10-15 years when this became widespread and whole departments were canned or subsumed.
With this, the EMR, and UpToDate, a kid in medical school could not even have a chance to be what clinicians of yesteryear were. And we can all tell. I have conversations with them every day. The knowledge base is profoundly limited. The foundation is cluelessness. We old guys just sit in the lounge every day and shake our heads.
I hate to be this negative, but it is indeed really that bad. The NEJM and others have realized the impending disaster largely caused by shit like this they have been pushing. Their screaming about it now is hilarious and tragic but far too late. The die has been cast.
US-based readers take warning.
I am lucky enough that the US doctors I still see when I visit are over 40 but not over 60, and in independent practices. That means they are old-school well-trained and probably have at least 5 and maybe 20 years more of professional life (they have also set up their practices so as to reduce interaction with insurers, so they are less likely to retire early due torture by corporate or insurance bureaucrats).
I infer very few Americans are in that boat. And in addition to lower medical competence among recent MD is the problem of nearly all doctors being in some sort of corporatized medical practice, and those are increasingly shoving diagnostics on to wildly low-skill nurse practitioners. This ought to be a crime. Why it isn’t is beyond me.
We do not give medical or financial advice, Nevertheless, I strong suggest, if you have the energy to travel, to start exploring medical tourism options. There are many procedures for which the cash pay price overseas is cheaper than a US copay. And you don’t have the risk of surprise charges, which are stressful even when you prevail in beating them back. Better to have pre-identfified some alternatives in case you have an urgent but not emergency need for intervention, than necessarily go the inertial route of US care.
