Where are the medical students?

Reading Lingual Nerve's recent posts about medical school, I started thinking again about the lack of medical student blogs. It's particularly notable relative to the number of law student blogs. I've discussed this disparity with some (disinterested) classmates, as well as distinguished faculty from other schools. And this issue has been noted elsewhere, too:

Try googling "law student blog," just for kicks. You'll get about 276,000 results. Try "blawg" and get 51,900. "Graduate student blog"? 72,200. "Med student blog"? A scant 16,000. There must be something unique about the law school experience, and the law in general, that makes people just want to TALK about it so much. And people do talk...

...Maybe it's because law school is just so goddamn all-consuming complicated, and expensive. But that's med school too, isn't it? Maybe it's because the study of the law changes your life in such profound ways that it's best to talk about it, to get everyone's perspective out in the open before people get into it so they know what they're getting into.

I object! Sure, law school changes lives in "profound ways" -- but any one period in young adulthood is going to be significant. Try delivering babies, diagnosing cancer, or telling someone your age that he's not going to walk much longer. You'd think it'd make for gripping reading, and cathartic writing. So where are they? Maybe med students don't need talk therapy -- we need meds.

I can accept that law students, are, as a group, more inclined to interact through the written word. Medical students are looking for meaningful personal interactions -- just look at how many instinctively rule out specialties like radiology, pathology, or anesthesia.

But can this alone explain the med student's reluctance to sit down and type what they learned in school today? What they saw on the wards? No, I think the reason more law students blog is: blogging is more conducive to success in law school. Postings on court cases lend themselves well to hypertext linking, to thoughtful discussion, to constructing arguments and backing them up. New legislation, or trial decisions, are immediately relevant to students and nonstudents, and the consequences can be constructively debated. I haven't seen too many law school exams, but I suspect that law students blogging about their classwork are synthesizing material in a beneficial way.

What medical students write about their experiences can be enlightening, challenging, and fun, but it's probably not going to boost board scores. Even "Guess the diagnosis" vignettes that pop up occasionally are too low-yield to really help (I could go through a CD-ROM full of X-Rays before the answer is posted to a blog).

This is not to say medical students aren't good at critical reading, or formulating arguments, or summarizing cases... it's just that honing these skills takes time away from studying. Patients don't need doctors who make brilliant arguments, or are up to date on the latest national health care proposals. They need physicians who cast a broad differential, make good pick-ups, and employ evidence-based treatments. We work at this by reading, sitting through lectures, and trial-and-error (with supervision!) on the wards. Internet conversation doesn't play a large role.

If it did, med student blogging would've taken off by now. Instead, I'm aware of only about 15-20 med student blogs, and a good fraction of those either focus on personal events or health policy. This is a paltry number, considering there are 50,000 med students in the US alone.

Med students on the net migrate to 'old-fashioned' web sites, mailing lists, and discussion boards. Questions (mostly technical or career-oriented) are answered faster, resources and helpful links are centrally located, and time doesn't get wasted addressing comments and updating the blogroll.

Something is lost this way, but if the med students need to talk about what they've seen, they talk about it -- with family, friends, fellow classmates and faculty. Our school provides enough opportunity for this, and so far no one else has felt the need to extend it to the blogosphere, risking HIPAA violations and lost hours.

Fortunately, there are a few med students writing because they want to. I thoroughly enjoy their posts, and deep down, I have a feeling blogging might improve my practice of medicine, too. It's just not something I can defend in an argument.

Cross-posted to LingualNerve.com