Instant Pre-Med

THERE are a lot of us this year. John B. Fox, of OG&CP, estimates that some 275 Harvard seniors are applying to medical schools, an increase of 100 from last year. Normally, about 150 freshmen enter as pre-meds, about half have their minds changed, and drop out, but are replaced by an equal number who have the opposite change of heart. So, normally about 150 go to medical school.

But this time the usual attrition processes have failed; most of those freshmen pre-meds are still with it. Add to them the number who normally decide, while here, to go into medicine, and you have about 225. Stack on top of that about 50 who have felt the zeitgeist, in the person of affable General Hershey, breathing down their necks, and you have 275. Since it usually takes at least two years to finish the pre-med requirements, the full impact of revoking other graduate school deferments could not be felt until this year.

Of course, the instant pre-med is hardly a phenomenon restricted to Harvard College. It may not be, proportionally, so large at other colleges, but it is substantial enough that house pre-med advisors are telling strong candidates to apply to a dozen schools (at $10 to $20 a crack)--and weak candidates to pray.

Most of the newcomers are biologists, chemists, biochemists, and even mathematicians and physicists, who were going their own way, quietly planning to go to graduate school and follow some line of research that interested them. Then they looked up and found a man in a uniform standing in front of them. And they didn't really feel like going.

For some of them, going into medicine will forever close off the line of work they enjoyed most; but some, probably most, will end up doing exactly what they had intended to do before. Which means they won't be practicing physicians.

AND THEREIN lies the tragedy of the situation. For the instant pre-meds have, on the average, more impressive academic records. Some medical schools will try to weed out "draft-dodgers," but, as usual, grades will prevail. Which can only mean that many of the pre-meds who were planning to be doctors, not researchists, will find themselves in February with a fistful of rejections--or clutching tightly the letter of acceptance from one of their "insurance" schools, and being damn grateful they have got it.

Since most medical schools have some sort of a quota system for awarding places between researchists and "regulars," the tendency won't be unchecked. But it will be there, and it will hurt. For a country that steals doctors from India, England, and Africa obviously needs all the practicing physicians its medical schools can produce.

It is true that the physicians and surgeons we do have are poorly distributed, and that substantial gains could be made immediately by a more efficient allocation of medical personnel and facilities. That can only be brought about, in a system of essentially private medical care, by manipulating market conditions, by offering regional subsidies. That, in turn, should be done by the federal government, but, as we all know, the energies and monies of the federal government are being expended elsewhere.

HOWEVER, even if we were suddenly to achieve, instantaneously, the most socially efficient allocation possible, it would not change the fact that practicing physicians, in most states, are dying faster than medical schools are producing them. This while we must have a two percent annual increase in doctors merely to keep up with population growth. It would not change the fact that seven states have no medical schools, four more have only two-year schools, and eighteen more have only one school.

There's just no getting around it; we simply have to have more doctors, more doctors who spend most of their time with people and not test tubes. But American society, in a self-defeating way became too typical lately, has not only failed to build more medical schools, but has created a situation where it is increasingly difficult for that sort of doctor to get into the medical schools we do have.

Ironically, perhaps, it is just those regions of the country, the South, the Midwest, and the Rocky Mountain states, which have given Johnson his strongest support on Vietnam that stand to lose the most. Ten years from now the Montana rancher (who's voting for Wallace because he wants Hanoi H-bombed) will watch his daughter die in child-birth as he is flying her, in his little Cessna, to the hospital in Butte, several hundred miles away. In his grief, he will rail because there was no doctor closer, but he'll probably never make the connection.