Gatekeepers

I recently had a friend visit who is working 80+ hours a week as a resident to be a surgeon, and he said they used to make them work 100+ hr/week (apparently they're growing more sensible). When he included that they often work 26 hours in a row, I couldn't help but wondering what on earth could be the rationale. I surely wouldn't want a doctor examining me after working over 12 hours, let alone 20.

I've decided it's simply a case of professional hazing. The doctors-that-be had to go through hell, so the neophytes have to as well. Though I think it goes beyond doing what's been done to you (as in the cases of abuse or high school hazing), a part of their sadistic motivation includes adhering to a demanding rite-of-passage that allows those who have completed it to feel superior to those who have not.

Now I don't think that all doctors suffer from some sort of insecure solipsism (like not all dancers have eating disorders), but I do think that a fair share of them do and that their gatekeeper policies are ludicrous. My main problem is the lack of justification that these extreme measures improve performance. In "Human Competence," Gilbert (p. 195) gives an interesting take on how doctors lack much of a feedback loop to measure their performance at all.

I will admit to my bias (yet again). From a doctor telling my wife that, "teachers don't take their kids to Disneyland," to often waiting inordinate amounts of time for a doctors appointment (even when I was the first patient of the day), I haven't always had the best interactions with our medical friends.

Looking at the broader context of gatekeeping, most professions require some schooling followed by a demanding exam of sorts. I'm skeptical of many of these practices as well, for the same reason that I doubt they are the best predictor of competence in the field (likely stemming from my disdain for rote memorization and standardized testing in educational settings). Education is an exception to these trends. Traditionally there has been little if any gatekeeping in the profession, likey because positions were hard to fill anyway. In recent years many states have implemented exams that teachers are required to pass, with two major differences from other professional gatekeeping practices: the requirements are imposed from an outside source (legislators, state school boards, etc.) rather than from the profession itself, and the difficulty of the tests are laughable.

So what's my point in all this? I'm not sure. I guess simply that gatekeepers across the board seldom act rationally.