Semmelweis' Purported Reputation

[Sandor]

Hi All,


(NB: I orginally wrote:
"A lot of lip service is given here in Budapest to how good of a school Semmelweis is.")

Now that I done some thinking about it, I would like to substitute any Hungarian med school for Semmelweis. As I have often heard that Semmelweis/Pecs/Debrecen/Szeged med schools are so thorough/rigorous/high quality that they are highly acclaimed in the West. So for the puporses of the rest of my post, please substitute "Semmelweis/Pecs/Debrecen/Szeged" for Semmelweis.

Thanks.

Question for all of you that are either attending a Hungarian med school or planning to:

I have Scandinavian students (usually of Hungarian origin) tell me, that Semmelweis enjoys a fantastic reputation in Sweden and Norway. In fact, they inform me, better than their domestic med schools. Local Hungarians are also quite enamoured with Semmelweis. Preaching to me how it is world-famous etc etc ---- but besides this 'Semmelweis is great' cultural meme perpetuated by Hungarians and Hungaro-Scandinavians --- is there any hard proof that Semmelweis is respected outside of Hungary? Any rankings? Anything at all?

I mean I would love for it to be true. But I think this is just a fatalistic self-delusion. Considering the lack of good facilities, medieval teaching methods, and entirely subjective examination method - not to mention the (lack of) English linguistic ability of some of the faculty -- hence, regarding Semmelweis' super international reputation, as they say, 'that dog won't hunt.'

BTW those of you attending Pecs, Szeged or Debrecen feel free to chime in but don't bother with which Hun. school is better --- cuz we all know there aren't any major differences when it comes to getting residencies etc etc

BTW II Also let's forget about the ALL HUNGARIANS ARE GENIUSES meme as well. i.e. My Hun. prof. discovered such and such and is considered a God by the Hungarian Academy of Sciences. So passé.

BTW III Hard proof is what is needed. Not: "My teacher said that his cousin said that his professor said that people from Semmelweis are the best prepared docs in the world and everyone knows that and blah blah"
(This is typical Hun. reponse)

FYI If I am not mistaken, Szeged is the only Hun. university that made it on this list: http://ed.sjtu.edu.cn/rank/2004/top500list.htm


Have at it please!

[cristagali]

Hi Sandor. Are you a language teacher? Or medical school teacher? Anyway, There are lots of scandanavian students studying in Hungary. but I haven't heard such glowing reviews from them. They are just as frustrated with the system as you stated in your post. It is a different system than the west..and it will take years (10-20) before it's even on par with Western Europe. Again, any student who comes here knows this in advance. However, maybe their enthusiasm stems from the fact that coming to Hungary was their path to becoming a doctor!! It was for me. There are some great docs here, whose English is perfect. THEN..there are some docs here who really don't deserve to be teaching and are quite arrogant and old school. And you are probably right, the Hugarian schools are more or less clones of each other, with a few isolated differences. Maybe because Simmelwies is in Budapest, which really is a nice city. yes it's dirty...but they're trying!! Rome wasn't built in a day!! Anyway, the Szeged ranking is primarily based on the equation that the China school uses to compile the info. if you have... or have HAD.. a nobel laureate on staff, you get huge points!! and then those points are deducted slowly year by year (ie, worth less in equation) So even though its been 70+ years since Albert St. Gyorgi, Szeged still benefits from his reputation. Hence their top 100 ranking. At my school, they are trying hard to 'catch up". They were recently named a Center of Excellence by the European Commission, and will have formal core rotations next year for their students in the US. This will help bridge some of the educational divide and hopefully speed up some changes within the clinical departments here. Anyway, the Hungarians are a quirky, homogenous folk, who are trying to find their way in this new world order. I admire them and thank them for letting me achieve my dream here. So let your scandanavian students cheer on. It can't hurt anybody..can it?

[Sandor]

Originally Posted by cristagali

Hi Sandor. Are you a language teacher? Or medical school teacher?

Hi!
None of the above.

Originally Posted by cristagali

It is a different system than the west..

Respectfully...No. It is not just 'different' -- it is substantially and objectively worse. Failure to recognize that does not solve the problem.

Originally Posted by cristagali

They were recently named a Center of Excellence by the European Commission, and will have formal core rotations next year for their students in the US. This will help bridge some of the educational divide and hopefully speed up some changes within the clinical departments here.

That sounds good hope that works well for you.

Originally Posted by cristagali

Anyway, the Hungarians are a quirky, homogenous folk,

I think you meant heterogenous.

Originally Posted by cristagali

I admire them and thank them for letting me achieve my dream here. So let your scandanavian students cheer on. It can't hurt anybody..can it?

Again. Respectfully, I couldn't disagree more. No need to thank them. After all you are paying them.

Regarding people cheering on the schools, that is what drives me crazy --- doctors and/or med students are arguably rational. That is, they believe logic/science to solve problems, right? Then why is there such blind faith in something that clearly does not exist? Namely, the outstanding Hungarian medical school education.

[cristagali]

Hi Sandor. Obviously there is no way I will change your opinion and I'm not here to be a lobbyist for the Hungarian health System. You seem to be an intelligent person and I just can't believe that you do not appreciate the differences that many societies have. Do you think the Hungarians enjoyed 400 years of Hapsburg rule? And then to top it off with 50 years of communist rule. They had very little choice and seem to have done quite well perserving their unique identity under such dire circumstances. The health system is a direct result of being behind the iron curtain fof 50 years. It will take time and money. EU membership should help speed up the transition, but as stated earlier, it will still be 2 decades before hopsitals here look like a US hospital. But in the US, 40 million people don't have health insurance..is that a "better" system? And yes , they are homogeneous people, with the same sayings, food, names, etc. no matter what part of the country you are in. Should I hate Norwegians because they eat whale? Their culture. A fur coat in Moscow? Won't blink an eye. Fur coat in New York..watch out for the paint. British eat pork and beans for breakfast!! I hope you get my point. The health care system is a reflection of what is culturally tolerable at this time. Would an American feel uncomfortable in a Hungarian waiting room..probably... because they are used to something different. Do you still live in Hungary? Things are changing for the better, but it will take time. Come to Debrecen, you won't recognize the place from 5 years ago. Housing subdivisions with $200,000 homes the norm,.. BMW,Land Rover, jaguar, dealership(S)!! A new standard is being set, and the Hungarian people, over time, will expect, demand, better...AND this will include the health sysytem too. Dr's and hospitals will have to compete for patients (customers) If a patient has a choice between ghetto hospital ward or the new birthing wing at the other hospital, which will they choose?? you know the answer..as Ronald Reagan said its the trickle down effect of economic stimulus. To survive, docs and hospitals will have to provide better and more modern services, or the patients will go elsewhere. it will work..just give it time. szia 8)

[Sandor]

Originally Posted by cristagali

I'm not here to be a lobbyist for the Hungarian health System.

That's good.

You seem to be an intelligent person and I just can't believe that you do not appreciate the differences that many societies have.

1st point: Thanks
2nd point: If you are saying that I am not a cultural relativist, then you are right. I am not. B/c while I can 'appreciate the differences that many societies have' --- I can also judge good from bad. More importantly, good from bad, when bad sees how good is being done. (i.e. Hungarian medical education)

Do you think the Hungarians enjoyed 400 years of Hapsburg rule?

I am sorry but that is totally irrelvant.

And then to top it off with 50 years of communist rule. They had very little choice

I dunno about little choice. The Hungarian Communist Party was made up of...surprise...surprise...Hungarians.

The health system is a direct result of being behind the iron curtain fof 50 years. It will take time and money.

We agree here. But where I depart from is that the self-delusion that many a Hungarian/ex-pat med. student in Hun. suffers from only further serves to handicap them, especially when one observes this as blind faith in a horrible educational system touted as being one of the world's best.

it will still be 2 decades before hopsitals here look like a US hospital.

More like another 2 or 3 generations to recover from the Communist hangover IMHO.

But in the US, 40 million people don't have <a target=new href=http://www.valuemd.com/doubleclick/click.php?mgr=aspcode.net&id=52>health insurance</a>..is that a "better" system?

1st this is totally irrelvant to my initial post but if you are asking me if the US system is better than the Hungarian. The answer is an unassailable and resounding 'YES!'. Look at any social/health indicator and Hungary falls far below the US. (Longevity, Cancer rates etc etc) --- I am guessing that you don't have a good grasp of Hungary's healthcare system --- one that is rife with: incompetence, corruption and extremely inefficient and expensive.

And yes , they are homogeneous people, with the same sayings, food, names, etc. no matter what part of the country you are in.

Not at all true. While regional differences are subtle, they do exist. They manifest themselves regional vis-a-vis accents as well as in cuisine --- e.g. there are several different types of halaszle = fish-soup

Should I hate Norwegians because they eat whale? Their culture. A fur coat in Moscow? Won't blink an eye. Fur coat in New York..watch out for the paint. British eat pork and beans for breakfast!! I hope you get my point. The health care system is a reflection of what is culturally tolerable at this time.

I cannot follow you here.

A new standard is being set, and the Hungarian people, over time, will expect, demand, better...AND this will include the health sysytem too. Dr's and hospitals will have to compete for patients (customers)

That is point. That this is not being induced b/c (excuse the slight) of many people like yourself --- satisfied with with sad excuse for a medical education and insisting that it is what it is not: first-rate.

Szevasz!

[cristagali]

I think we both have our positions and should leave it at that. I am a native English speaker. Coming to Hungary is not the OPTIMAL route for me to study medicine. However, it is a good route, one that I have survived, will soon graduate, have passed MY country's medical board exam and will be integrated into my country's health care system as...guess what...a doctor, with all the privileges to practice medicine... as if I graduated from Harvard Med. No differences my friend. Ain't life grand! Pissing all over the Hungarians, who have now been a democracy for ..how long?..14 years?..that they can't just knock down all the buildings and replace them with skyscapers and put a CT and MRI on every corner? I'm not sure what you expect? I know of No one who says Hungary has the world's best, or even world class health care system. Does a TV with cable in every hospital room make it a "better" system? yeah, they need to upgrade and modernize. maybe my experience is unique. AT Debrecen, we have a spanking brand new radiology department 2004, new dental school 2004, new pediatric wing 2005, every clinic has a remodelled wing, etc... I joke..we have so much money, they are actually putting bricks over the dirt pathways (you know what I mean). OK, Hungary is not for everyone, but you make sound like we are in Maldova or Albania (sorry guys)! I think you need to come back for a visit. And if you hate Hungary so much..change your name to "Mike".. b/c Sandor is about as Hungarian as you can get! szia 8)

[Sandor]

Originally Posted by cristagali

I think we both have our positions and should leave it at that. I am a native English speaker. Coming to Hungary is not the OPTIMAL route for me to study medicine. However, it is a good route, one that I have survived, will soon graduate, have passed MY country's medical board exam and will be integrated into my country's health care system as...guess what...a doctor, with all the privileges to practice medicine... as if I graduated from Harvard Med.

Excellent.

Pissing all over the Hungarians, who have now been a democracy for ..how long?..14 years?..

If you call telling the truth about my compatriots pissing all over them -- then so be it.

that they can't just knock down all the buildings and replace them with skyscapers and put a CT and MRI on every corner? I'm not sure what you expect?

This has nothing to do with skyscrapers nor with CTs/MRIs --- what this has to do with is the collective cognitive dissonance experienced by many a ex-pat med. student in Hungary as well as the local population.

I know of No one who says Hungary has the world's best, or even world class health care system.

If you will bother to remember, the original posting was about the percieved quality of Hungarian medical education vs. reality.

money, they are actually putting bricks over the dirt pathways (you know what I mean).

I know precisely what you mean.

OK, Hungary is not for everyone, but you make sound like we are in Maldova or Albania (sorry guys)!

Dear 'Native English Speaker' -- Moldova is not spelled 'Maldova'.

I think you need to come back for a visit. And if you hate Hungary so much..change your name to "Mike".. b/c Sandor is about as Hungarian as you can get! szia 8)

I hardly hate Hungary. My criticisms are fairly objective and easily understood i.e. Hungarian med. schools are thought to enjoy a fabulous level of education when this cannot be true. Due to some of the factors mentioned in my first post. BTW I do live in Hungary and would guess that my insights into Hungarian life are at least an order, if not more, of magnitude greater than yours

PS While we are on the subject of names, crista galli is spelled with two L's not one

Csa!

-Sandor

[cristagali]

The original cristagalli was already taken, so I had to settle for an 'updated' version..Sandor was already taken, too, so..... As "foreigners" our view of the Hungarian Health System is ...'will it prepare us for roles as physicians in our home country". Since 90% of us do work, ..with multiple job offers, including the good ol' US of A, they (program directors) must feel confident we learned something while here, and obviously we accomplished our goal of learning medicine and becoming doctors. So...sorry to say, the system... for us at least..works. So maybe thats why we feel some obligation to say positives things. Don't get me wrong..there are some shi$%y docs, who hate to teach here, but you know who they are, you avoid them and find the many others who enjoy teaching. It's that simple.
the problem with your diatribe is it is too general...Every health care system has its downsides, and NOT every Hungarian doc is incompetent, or a cheat, or an arrogant ***--le, as you seem to say. ( are you a doc?) Some foreign students hate this place, usually they are the ones transferring to Poland or back home b/c they failed. The ones who survived, don't cherish the experience, but we know we just rode one damn hard ride...and made it. So, we both made our points, ..you should become more involved on the local or even national level of implementing change in the system, to ensure an orderly progression towards a more modern transparent health care system. It sounds like you would keep their feet to the fire. Talking about it on the internet won't change much. Good luck to you . 8)

[Sandor]

Originally Posted by cristagali

As "foreigners" our view of the Hungarian Health System is ...'will it prepare us for roles as physicians in our home country".

You fail to differentiate between the Hungarian healthcare system and the Hungarian medical educational system --- (BTW both are in need of a lot of fixin')

Since 90% of us do work, ..with multiple job offers, including the good ol' US of A, they (program directors) must feel confident we learned something while here, and obviously we accomplished our goal of learning medicine and becoming doctors.

That is excellent. How good of residencies or 'job offers' as you put are people getting?

So...sorry to say, the system... for us at least..works. So maybe thats why we feel some obligation to say positives things.

No problem with giving anyone/thing their due, when they have earned it. My original thesis, which it looks as if it bears repeating, is that Semmelweis et al. by virtue of a made-up reputation is trying to punch above it weight.

Don't get me wrong..there are some shi$%y docs, who hate to teach here, but you know who they are, you avoid them and find the many others who enjoy teaching. It's that simple.

I see. How do you avoid them when you are assigned to them?

the problem with your diatribe is it is too general...

1) My argument is neither a diatribe nor too general. Here is what I wrote in my original post:

"Local Hungarians are also quite enamoured with Semmelweis. Preaching to me how it is world-famous etc etc ---- but besides this 'Semmelweis is great' cultural meme perpetuated by Hungarians and Hungaro-Scandinavians --- is there any hard proof that Semmelweis is respected outside of Hungary? Any rankings? Anything at all?"

Every health care system has its downsides, and NOT every Hungarian doc is incompetent, or a cheat, or an arrogant gluteal--le, as you seem to say.

I would like to know where I wrote that every Hungarian MD is incompetent, a cheat or an arrogant place to exchange gas. ???

( are you a doc?)

Nope.

Some foreign students hate this place, usually they are the ones transferring to Poland or back home b/c they failed. The ones who survived, don't cherish the experience, but we know we just rode one darn hard ride...and made it.

Good for you.

So, we both made our points,

If your point is that a lot of ex-pats grind slowly through a medieval system that should be changed while all the while apologizing for it, then you have made your point.

..you should become more involved on the local or even national level of implementing change in the system, to ensure an orderly progression towards a more modern transparent health care system.

Here it ain't gonna happen for a long, long while.

Talking about it on the internet won't change much. Good luck to you . 8)

You are right about that much.

Szia,

Sanyi

[cristagali]

As for Simmelweis (sp?), any school that's been around 200 years deserves some recognition. Maybe it just the Budapest attitude. You guys refer to us other towns as "villages", so maybe they are a little high and mighty...so what? You asked about jobs....mostly Internal Medicine and Family Medicine, but we have grads doing Ob-Gyn, Ophthalmology, even Dermatology ( these are in the states, not sure about other countries, but probably similar).

Avoiding the malignant doc on teaching rounds. Well, it depends which clinic. I'm doing my Ob-Gyn rotation right now. Certain docs just don;t want to mess with the "kulfoldi" students. I'll sit there waiting for rounds, reading my notes, hoping someone will want to discuss cases,, won;t happen, so I respectfully excuse myself, Go to Family Planning clinic downstairs, where I spend the next few hours doing pelvic exams and getting inserviced on transvaginal ultrsound b/c the doc is nice and welcoming and enjoys teaching. I learned a lot. I try to go to Oncology wing later, but they too, are pressed for time and ask me to come back, so I go to L & D and end up 2nd assisting twin C-section. Cool! So you see, the student here at DOTE, will need to be a little proactive, but he/she can have a nice experience here. it won't be spoon fed to you. Ok, I think we can end this on a lighter note. viszlat!