The Student-As-a-Customer Model Will Be the End of Academia

When I flunked a biostats course (and, by flunked, I mean I got a C), someone suggested to me that I approach the professor and asked what I could do as extra credit to get a B. If the C stuck, I’d have to take the course again one year later, and who has time for that?

A year later, there I was, front and center of the biostats class, writing my notes and paying attention. I’d go on to get an A in the course, but not without the professor stopping in the middle of the first lecture to look at me and ask me in front of everyone why I was there. “You know how it is,” I told her. “You get one C and everyone at the best school of public health in the world freaks out.”

Indeed, that was my point of contention with people who were shocked that I got a C. First of all, I had lab-confirmed influenza the day of the midterm. I showed up with a fever and stupidly took the exam, and, second of all, I did so because I come from an academic culture where you don’t ask for extra credit and you don’t argue your grades. You get what you get and you make the most of it.

It was good practice for the real world, where bosses don’t take excuses, and neither does my wife.

I knew they could run. I didn’t know they could fly!

I first started noticing something was up when I met some of the high school students in the town where I worked as a medical technologist. They were bright kids, and a few of them were looking to go to medical school. One of the local OB/Gyn physicians brought several of these kids to the hospital for a tour. As I gave them a tour of the lab, one of them asked me why I didn’t go to medical school.

“I don’t like people that much,” I told her. “This is where I belong. And, besides, I’m working on an MPH so I can work at a health department.” Upon hearing this, the students launched into a description of all the extracurricular activities she was involved with to make herself a better candidate for medical school. Mind you, she had not even graduated from high school yet.

When she was done, the physician talked to her about how she needed to do more. This was surprising to me as she seemed to have completely filled her schedule with stuff to do. “You should look into working here in the lab,” he said. “You’ll learn some good stuff and get experience in this environment.”
“Whatever it takes,” she replied.

A few weeks later, I noticed a man and a woman talking to my boss. It turned out that they were the girl’s parents, and they were there to argue with my boss on why a 16 year-old couldn’t work in the lab. My boss explained that there were no positions open, and that she had to have an official position to work with all of the private information handled in the lab. (Some of the lab tests to be performed are right on the label of the tubes of blood we collect, and the labels also have the patients’ names.)

They wouldn’t listen to reason and were quite rude.

Fast-forward a few years later, and I’m sitting in Colombia (South America) as a visiting docent at a local university. Suddenly, a parent and his child walk out of an office, screaming at the professor something about the school stealing their money. The professor later explained to me that the student flunked organic chemistry and could not continue the program until the following year. “I did everything I could to help him, but he was late to class, late to office hours, and he kept playing with his phone instead of paying attention,” the professor said. “And now his father is angry that the tuition was somehow wasted.”

Then fast-forward to the last year and a half of my doctoral education, when I was the lead teaching assistant for a couple of courses. The number of students who were dissatisfied with the professor and me because they didn’t understand the material was, to put it mildly, troubling. They even carried out their threat of revenge via the course evaluations. (The leadership really loves course evaluations.) One student even complained that one of the professors I worked with — whose first language was not English but speaks English well — was unintelligible. And me? I wasn’t “flexible” with their needs… Needs that apparently included being on Reddit during the class.

And I won’t even tell you about the one student who I caught doing his taxes during a lecture.

You’re a mean one, Dr. Ren

The most recent example of things turning upside down in academia comes from one of the recent students I tried to tutor. We set up an appointment to meet online for a lesson in epidemiology. Twenty minutes after the session should have started, the student had not shown up. I emailed them to tell them that I was not waiting anymore.

Ten minutes after that, about 30 minutes after the lesson should have started, the student emailed me to tell me that they were having technical issues in logging into the system. Another ten minutes later, they emailed me again to tell me that they finally logged into the system. Their main argument as to why they had technical difficulties was a lack of experience in using the system.

In an email to the student the next day, I explained to them that they should have taken the time to log in with plenty of time to understand how the system worked. I also explained to them that I had shuffled around other students since this particular student needed a lesson quickly. Finally, I pointed out the lack of professionalism shown by just kind of not being prepared.

Always be prepared.

Well, this didn’t go over so well with the student. They kind of blew a fuse and decided to leave some pretty bad feedback. Didn’t I know that it was not their fault that they didn’t prepare? Didn’t I know that they didn’t bother to log in ahead of time to make sure they understood how everything worked, especially if this was their first time doing it? Didn’t I know that I was supposed to wait, sitting on my hands for a whole hour while they were AWOL?

Not only did I respond to the feedback, but I also emailed the student and told them that they had basically burned a bridge. The world of public health is quite small, and I’m sure I’m going to meet them in person at some point… And they better not even bother introducing themselves to me. I’m done with them.

Just doing it for the MD

Then there are the students who didn’t get into medical school on their first try, so they’re making themselves “better candidates” by getting a master of public health degree or even a doctorate. I understand why they are doing this, but it troubles me a little bit because they could very well be taking away a slot from someone who sincerely wants to be a public health worker. Now, this is not to say that a physician with an MPH is a bad thing, or that they wouldn’t be a public health worker.

What I am saying is that, usually, everything students learn in an MPH or even a PhD program is lost when they go through medical school. There is only so much the brain can absorb, and not everyone can absorb the knowledge from a bachelor’s, a master’s and a medical degree… Or a bachelor’s, a master’s, a doctoral and a medical degree. But students still try, and they still cry their eyes out when they get a B in a course because, somehow, medical schools won’t let them in with a B in a master’s or doctoral-level course.

(Pro tip: You don’t want to go to a medical school that will not accept you with a B or even a C here or there.)

Yes, there are some very bright physicians who go into research, and they need all of the skills learned in those programs in order to make sense of all the projects they’ll be involved in. But they’re far and few in between, and perhaps there should be dedicated programs to produce “research physicians” instead of physicians with a master’s and a PhD whose concepts they’ve forgotten over the course of medical school, residency and fellowships.

But That’s Just Me

Again, maybe it’s just me. Maybe it’s always been the case that college and graduate students have brought in their parents into discussions with professors about grades. Maybe my parents just didn’t love me enough, so they let me make my own mistakes and own them. Maybe.

But what if there really is something going on and helicopter parents have become the norm? What if, God forbid, the students really have become more delicate and something as trivial as a bad score on a test or a grade less than an A really does pose some sort of existential threat to them? Where will that lead us?

A quick aside… I do realize that there are students who are living with mental health conditions that are exacerbated by things such as the stress of having to redouble their efforts just to pass a class. And I realize that, many times, colleges and universities are not well-equipped to help them, so they end up bringing in their caretakers into the equation. Often enough, those caretakers are their parents. I’m not addressing those students. They’re not the problem.

The problem are the students who are perfectly capable of dealing with the world around them as demonstrated by their social media activity and their list of extra-curricular activities. Suddenly, students who participate in running marathons and raising money for charity are unable to deal with the stress of an exam, and they crack… And they lash out at everyone in sight, most often the professor.

So What Do We Do Now?

How can we reverse this trend, if it is indeed a trend? How do we make sure that college and beyond are opportunities for young adults to hone their real-life skills and learn how to deal with adversity, how to work in teams and how to know which bridges to burn? I really don’t know. It really does seem to me that this is a bit of a tsunami that is going to take some time to sort out.

In the meantime, I’m going to continue to work in training my colleagues, not teaching my students. I’m going to pass on knowledge and wisdom, not just show how to repetitively and mechanically do a menial task. As I told a student the other night, they need to know how to calculate the numbers in a biostatistical analysis and to understand if the results they’re getting make any kind of sense. Because, in the words of my old boss at the lab, “I can train a monkey to push a button. I want to mentor you to do good work.”

You’re Gonna Need a Bigger Bait

I’m learning to discern between constructive comments and comments that are engineered to get a reaction out of me. It’s part of the maturation process, from what I’ve been told.

Now, I don’t ignore all comments. Sometimes I’m bored and respond. But I’m getting better at it. For example:

“The President of the US. Bush junior, tried to seal the VSD forever! He did that because they knew that the Thimerosal litigation, would be payouts in the 100’s of million’s in damage for each child. They admitted in the Simpson Wood transcripts, that they would not be able to defend against lawsuits with the current science that was available at the time. The sad fact is that they said, they were concerned about the lawsuits, not one was concerned about the American children that they admitted was way over taxed with ethyl-mercury. They admitted they had nothing, and then they decided they did nothing wrong! That was till the stripped minutes reappeared, and then they had to admit to their own committee that they were going to deceive them and the ACIP. You are defending child poisoning DEVILS! That sold their soul’s for Pharma money and fame. The 17 yr Senior CDC scientist whistleblower, has painted a picture of an out of control very scared agency that has made the biggest mistake in medical history. That will in 16 yr’s reduce our Nation children that can work, by half. Worse will be the fact that 1 in 2 is bad but since there is a four to one ratio boys to girls, 82 % of all American boys will be mild to severely mentally retarded.”


This was a comment left on the blog about three months ago by a known antivaxxer. He’s been banned from commenting here, but his comments still go into moderation. The dude is convinced that there is some sort of linear relationship between vaccinations and neurological disorders, which is par for the course for these nuts. I’ve ignored his comment all this time.

Just look at the comment. It’s so disjointed. It’s so bizarre.

How can you possibly respond to this without getting yourself into a tangled mess of stuff? I mean, there’s no way to reply to this bufoon without you yourself looking foolish. Trust me. So learn to discern what to respond to and what to ignore, even from your friends. Life is better that way.

The entirety of the evidence

It’s been a rough few days for the antivaxxers. The measles outbreak associated with Disneyland has really put them on the spot when it comes to their refusal to vaccinated. Some say that they are protecting their freedom to do whatever they want to their children (aka their “property”). When it is explained to them that they are to do what is in the best interest of their children, they shift the goalposts and say that the vaccine is what caused the outbreak. When it is then explained to them that the vaccine strain is not the strain found in the outbreak cases, they then say that the vaccine doesn’t protect against the strain in the outbreak. They’ll quote CDC documents stating that the genotype of the vaccine is different from the genotype of the outbreak. When it is explained to them that there are different genotypes but that the vaccine covers all serotypes — and, thus, that genotypes and serotypes are different things — they fire back with some nonsense about “big pharma” and/or reptilian overlords.

Our human nature tells us to look for the patterns that matter to us and ignore the others. We’re very biased in that sense. We don’t like to be wrong because we’ve been taught that being wrong is bad. Being wrong gets us in trouble, laughed at, or might even kill us. So we look for the things out there that we can cherry-pick and mold into supporting our assertions. Even when we know in our hearts that we are wrong, we still plow through and try to get others to agree with us. Continue reading

A word of advice to the young ones

There was this girl back in college who I really, really liked. I would bend over backwards for her and acted like an absolute fool around her. Looking back at it, it was quite pathetic, but it wasn’t anything unexpected of a teenager. (I started college at 16.) One day, she looked at me and told me that she would have dated me if it wasn’t for a couple of things. She said she preferred her men to be “slim” and “athletic.” (I was anything but “lean and swarthy.”) She also said that she preferred them to drive pickup trucks and look like — wait for it — Ben Affleck.

Maybe if I grew a beard?
Photo credit: / / CC BY-SA

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