I’m delighted to present this conversation I had with
: author at the Sensible Medicine Substack, world-class medical educator, and all-around doctor’s doctor. I first met Dr. Cifu at the beginning of medical school, sometime in the autumn/winter of 2012, and was fortunate enough to have him as a teacher at various points throughout my training. I’m especially grateful that I’ve been able to continue learning from him after graduation. I also owe Dr. Cifu a debt of gratitude for convincing me to start this Substack!In this conversation (timestamps below) we discuss the current state of medical education, some radical proposals for reform, admission standards, standardized testing, medical student quality, clinical use of A.I. in the clinic thus far, and the future of medicine in a world of rapid technological change.
See below for links to Dr. Cifu’s personal website, Substack, podcasts, and books.
A partial bio —
Adam Cifu, MD is a general internist and professor of medicine at the University of Chicago. He divides his time between clinical practice, medical education and scholarly work related to evidence-based medicine. He is the author of over 125 peer reviewed articles and two books: Ending Medical Reversal: Improving Outcomes, Saving Lives (2015) and Symptom to Diagnosis: An Evidence Based Guide (4th Edition, 2019)
Dr. Cifu received his M.D. degree from the Cornell University Medical College in 1993 and completed his residency training at the Beth Israel Hospital in Boston before joining the faculty of the University of Chicago in 1997. He cares for patients in the Primary Care Group and attends on the inpatient general medical service.
Enjoy!
Timestamps:
00:00 - 06:28: Introducing Adam Cifu, M.D., PGY-32. Some reminiscences. I make excuses about not working out enough since having kids and he rightly calls me out for being an undisciplined weakling.
06:28 - 09:02: Current problems in medical education.
09:02 - 20:00: Grading our current med school admissions process. Proposals for revamping medical school admissions and curricula.
20:00 - 32:04: Balancing merit and ability vs. other factors in admissions. Can we have a genuinely diverse physician workforce—including ethnicity, socioeconomics, sex, etc.—without sacrificing quality and a commitment to excellence? And if so, how?
32:04 - 47:32: Are there ups and downs or other trends in medical student quality over time? Medical student incentives. Changes in medical training over the years. Balancing “rigor” vs. efficiency in training. Ego and pride.
47:32 - 1:01:48: Standardized tests. Creating more flexibility in medical school curricula for different types of students. Digression about my OB/GYN rotation.
1:01:48 - 1:09:25: Artificial Intelligence in medicine. Has Dr. Cifu used AI in clinical practice?
1:09:25 - 1:20:15: Will physicians be replaced in the future? Will technological advances eventually render our profession obsolete? What will doctors be good for in the future? What is the essence of the profession?
1:20:15 - 1:25:10: If you had to specialize instead of being a generalist, what specialty would he choose? Discussing emergency medicine.
1:25:10 - 1:27:55: If you had to be in another line of work besides medicine, what would it be?
1:27:55 - 1:35:40: If you had to practice medicine somewhere other than Chicago, where would it be, and why? How to keep the practice of medicine interesting.
1:35:40 - 1:40:40: Relating to death.
1:40:40 - 1:49:56: Wrapping up. Dr. Cifu’s current work. Making medical writing more accessible; Substack vs. traditional medical journals.
Websites:
Media:
Books:
Symptom to Diagnosis An Evidence Based Guide, Fourth Edition
Ending Medical Reversal: Improving Outcomes, Saving Lives, which he co-authored with
.
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