How do you tend to regard older applicants [to residency programs] who have made a career change?
Define older, any older than 40 entering a residency would unlikely be ranked, the job of residency is too hard.
–Suzanne Kraemer, M.D., Program Director Internal Medicine Residency, East Carolina University
quoted in the publication “Career Insights MD”, p. 30, Winter 2004/Spring 2005. Published by GradExchange Inc., website www.CareerMD.com
I have to say that I’m appalled that anyone at a state-funded, federally funded institution with a clear non-discrimination policy would even think it’s appropriate to state this in public, let alone in a widely distributed magazine.
Unless someone can explain to me why her opinion is justified, I will drop a little note to Dr. Kraemer and her dept. chief. I encourage any of you who feel the same way to act accordingly.
Best wishes to all out there in OPM land
meow
I wasn’t able to find the article from which the quote is extracted - the website wasn’t very navigation-friendly for my crunched time frame, anyway. I think Dr. Kraemer simply hasn’t had exposure to OPMs and needs to have her horizons expanded. I wouldn’t go slamming her with a million nasty e-mails but would instead entreat her to have an open mind about what people are able to do.
As a physician, I’d be doing a 40-year-old patient a disservice if I had preconceived notions about their physical or mental abilities… same thing applies here.
Now, I will tell you that at this point in my intern year I AM TIRED. And I may very well be MORE tired than some of my younger colleagues, I don’t know - everyone’s pretty frazzled but lord I am just bone-weary. Of course I am also counting the days (7) to a vacation… whew.
I do find that physicians who’ve approached their career path in “traditional” fashion don’t seem to appreciate that an OPM’s enthusiasm for the career change provides a lot of physical and psychic fuel for the tough road.
Mary
Here’s the link:
http://careermd.com/careerinsightsmd.shtm
It’s the Winter 2004/Spring 2005 issue, page 30.
Mary, I appreciate your advice to slow down and be polite. I was so mad when I read the piece, but you are right that the pro-OPM message will be heard best when presented clearly and positively.
Quote:
I think Dr. Kraemer simply hasn’t had exposure to OPMs and needs to have her horizons expanded. I wouldn’t go slamming her with a million nasty e-mails but would instead entreat her to have an open mind about what people are able to do.
Mary
Would you be that charitable if her comments were towards a larger and/or different group?
Kraemer’s comments reminds of the controversial remarks made by Harvard University president Lawrence Summers about women in science. The difference being over forty persons going into residency are an easier target simply based on numbers. Meaning there are fewer persons to speak up when such a comment is made. Or people who even care. There is a reason why those over forty are a protected class in employment. Someone in her position should be held accountable for such remarks. It comes down to being consistent. If she made a comment like this against another group, such as women don’t have the physical stamina for residency or why give her the residency she’ll just be pregnant in a few years anyway.What about the erroneous and derogatory remarks about intellectual capacity and certain ethic groups, and their place in medicine? Both of these are examples of widely held views in our not too distant history. Essentially inserting whatever stereotype about why “they” couldn’t handle residency, she would be taking a lot of heat for it and rightfully so. Why is this any different? The smaller the minority (in this instance those over 40 applying to residencies) the easier it is to marginalize that group and get away with it. She is advocating breaking the law. The fact that she was stupid enough to put it in writing, indicates either an entitlement to indulge the prejudice or she truly believes its okay to discriminate. How big does the group have to be before holding her feet to the fire is warranted? Chances are if she holds this belief about this group, she holds similar beliefs about other groups. If she’s ever sued over age discrimination and that comment is brought up, her position will be indefensible.
I’m certainly not attempting to justify her position or excuse her for an indefensible position. I’m simply saying that as with many other forms of ignorance, it’s worth thinking that she could be educated to think differently, rather than simply condemned for her prejudice.
Residents over the age of 40 remain a very rare breed - trust me, I should know. When attending physicians find out my age, their reaction is often actually sort of embarrassing to me because they make a HUGE deal out of my ability to do stuff that no one praises the 20-something residents for. I just don’t see that staying up all night and working hard are such huge deals… but clearly they find it amazing. And it’s not because they think someone in her 40s is ready for retirement, because often they’re the same age as me and they’re working pretty hard. But they remember back to the horrors of intern year, they apply that memory to how they feel at 40-something with job demands, family demands, etc. etc., and I think they just assume it’s more than any sane person would want to do.
So I stand by my exhortation to educate, not condemn, this person for her opinion. And of course if someone applied to her residency program and was turned down AND was over 40, they’d certainly have rich grounds for legal action!
Mary
This is too bad.
I don’t think this is an issue at my alma mater (USC). We have had several over 40 students. One matriculated after her sons finished their medical education, and she is now a clinical faculty in the dept of family practice. Several frequent posters here are 40’ish, and they are in successful residencies
I wish discrimination didn’t occur, but with hard work (and luck), it can be overcome. Hopefully, the more of us there are in the medical workforce, the more quickly we can show our maturity works for us in our practice, and not against us.
Has no one informed this woman that 40 is the new 30?
It never occured to me that people would think of 40 as being so old!
Quote:
There is a reason why those over forty are a protected class in employment. Someone in her position should be held accountable for such remarks. It comes down to being consistent. If she made a comment like this against another group, such as women don’t have the physical stamina for residency or why give her the residency she’ll just be pregnant in a few years anyway.What about the erroneous and derogatory remarks about intellectual capacity and certain ethic groups, and their place in medicine? Both of these are examples of widely held views in our not too distant history. Essentially inserting whatever stereotype about why “they” couldn’t handle residency, she would be taking a lot of heat for it and rightfully so. Why is this any different? The smaller the minority (in this instance those over 40 applying to residencies) the easier it is to marginalize that group and get away with it. She is advocating breaking the law. The fact that she was stupid enough to put it in writing, indicates either an entitlement to indulge the prejudice or she truly believes its okay to discriminate. How big does the group have to be before holding her feet to the fire is warranted? Chances are if she holds this belief about this group, she holds similar beliefs about other groups. If she’s ever sued over age discrimination and that comment is brought up, her position will be indefensible.
I don’t like her attitude either–but would it really be illegal for her to decide not to take residents over the age of 40? Aren’t residencies considered training programs, rather than jobs? I know there are laws making it illegal to demote or not hire people based on age, but does anyone know of these laws apply to educational/training programs? I am just asking because I don’t know myself.
Also, I don’t agree with your argument that the reason we should oppose age discrimination is in order to be consistent. There ARE groups that are blatantly discriminated against as far as their being allowed to study or practice medicine. They just don’t happen to be the ones people normally have sympathy for! For example, people with criminal records or people who are substance abusers would have a very hard time gaining acceptance within the profession. My only point is that I don’t think you can just say that we must protect the rights of would-be-residents over age 40 SIMPLY because we must protect everyone’s rights. I think we need to come up with some better reasons for our position. And I do not think that age discrimination is exactly similar to racism or sexism. I am not standing up for it, I’m just saying that I believe it is naive to pretend that no one in our society questions the ability of people to do things as they age. In fact people do have these questions, and resorting to blanket statements about the immorality of discrimination won’t put the matter to rest. Legal retaliation should be a last resort in my view, not a first step. You never know how capable people are of genuinely changing their views until you at least try to have an open discussion with them.
I can’t pull up the webpage in question, so I don’t know what her actual comments were or how mad they’d make me if I heard them. I’m sure I’d be pretty irritated too. Still I agree with Mary Renard that it is worthwhile to try to change people’s attitudes by educating them.
There was a positive in that article-- most of the residency directors who were asked the same question were very supportive of non-traditional/OPMs, and gave good reasons for their support. I got the impression that the director in question didn’t give a lot of thought to her answers on most of the questions. I suspect she’ll be called on the carpet by somebody she works for. Still, in a way, I’m glad to know her true opinion. I won’t bother to apply there.
In any event, it was nice to see that her opinion didn’t seem to be that of the majority.
Epidoc
Yes, I got the link to work this time and the other program directors’ comments were much more what I would hope to read - career-changers are welcome, they bring a welcome variety to the program, they have experiences and insights that are real assets, etc. I particularly liked the PD who said “Older, ‘non-traditional’ applicants are in our pantheon of ‘best residents ever,’ so we welcome them.” 
I agree, the other PDs’ comments seemed much more well-thought out than Dr. Kraemer’s… not just on this question, but many others. I thought the various insights offered by other PDs to the question of older applicants were very helpful.
Mary
In fact, the other residency directors were so positive about older medical students as to be nearly inviting claims of discrimination in the other direction! So, a) this particular person is out of step, and b) in this sample is not typical.
That said, this residency director has made an incredible legal mistake by making this reply in print. And I don’t think the issue is education. She’s jeopardizing her hospital’s ability to provide care by exposing it to legal liability. It’s unprofessional in a way that goes beyond her effect on us and our feelings. So I think the issue is primarily legal and not educational or spiritual or whatever. Although, she’s doing everyone a favor by showing that her primary view of what makes a good resident is physical endurance–which implies a lot about what her program provides and expects educationally and intellectually.
And yes, it is my understanding that laws against age discrimination apply whether residency is viewed as education or work or both–the courts also have frowned on age discrimination in school settings as well as in work settings. Indeed, the very existence of this on-line community is predicated on several court cases that established this principle in a field that formerly blatantly and explicitly discriminated by age. The infamous “reverse-discrimination” suit by Bakke against the UC Davis medical school was actually brought by an older applicant who was being discriminated against by age. He used an anti-affirmative action angle–i.e., he sued based on the fact that he had better scores than students of color who were admitted; but as I understand it, other cases, including one brought by an older applicant who now works at the hospital where I study, used a simple age-discrimination angle and also succeeded during that same era.
That said, those willing to read the whole piece will be mainly heartened by the clear evidence that this particular residency director is in the minority.
Best regards
joe
Joe’s (w)right - the other residency directors were extremely positive, and I was pleasantly surprised to see that. Perhaps Dr. Kraemer’s comments stuck out so much because they were anomalous.
I do think it is worth trying a little positive education. Knowing a little about the legal background is very helpful.
Well, ok, that’s good to know about some of the precedents out there.
I think all I was getting at was that dealing with discrimination issue through the courts alone does not remove active discrimination from our culture. I don’t consider it a spiritual or educational issue so much either–certainly if someone is breaking the law they should be held accountable. I just mean that these age-biased attitudes are out there, and when one person puts their views in writing, there are probably plenty others who harbor the same thoughts but just are keeping them to themselves. Although as people are saying, there are lots of pro-non-traditional attitudes too.
Also, since she’s the director of a program, I do think she should be aware of discrimination laws and take them into account when she makes statements–if she doesn’t, she’s fair game for a lawsuit. However, not everyone who holds age-biased attitudes is in her position or vulnerable in a legal sense.