The old Skeptical Raptor is taking a bit of a break over the next few days to recharge his batteries for all of the pseudoscience that will be coming out in 2020. In lieu of new content, I will be republishing the top 10 most read articles on this blog during 2019. Here’s number 4 – yes, physicians study vaccines.
And here we go again debunking another uninformed trope – do physicians study vaccines? The anti-vaccine religion likes to claim that they don’t, but it’s one of their most ignorant, illogical claims about vaccines. Well, maybe I’m being harsh, since there are like 1,000 claims they make about vaccines, all completely and utterly wrong.
The ignorant trope that the anti-vaxxers make is that physicians don’t take classes in “vaccines,” so they don’t know anything about them. Of course, the Dunning-Kruger infected anti-vaccine zealots think their 30 minutes “researching” on Google makes them experts on vaccines. That would be like watching a 30 minute YouTube video on repairing a Ferrari engine, and thinking that you are an authorized Ferrari mechanic.
On the other hand, a fake Ferrari mechanic isn’t going to do much harm except to the privileged internet billionaire, while a fake vaccine expert harms children. And when I write “fake vaccine expert,” I mean about 99.99% of the anti-vaxxers that spout their benightedness to their internet sycophants.
Let’s talk about whether physicians study vaccines. Most of you will know where this is going.
Do physicians study vaccines? Education
Before we start, we need to make something clear – despite what the anti-vaxxers believe (it’s a religion, so belief is all they’ve got), there isn’t some course called “Vaccinology 701” in medical school. There are some graduate programs that offer master’s level courses in vaccinology, generally for public health professionals that focus on geographic regions, such as Africa. But it’s generally not a medical specialty or Ph.D. program directly.
The knowledge about vaccines is based on some combination of different fields of science and medicine:
- immunology – the study of the immune system
- biochemistry – the study of chemical processes in biological systems
- cell biology – the study of the structure and function of the cell
- virology – the study of viruses and virus-related diseases
- microbiology – the study of microorganisms, which include viruses (which is often broken out into a separate field of study), parasites, and bacteria
- physiology – the study of functions and mechanisms of living systems, generally, in this case, humans
- epidemiology – the study of patterns and distribution of diseases and medical conditions in a population
- pharmacology – the study of the mechanism of action of drugs and medications
- public health – the study of the science of preventing disease and promoting human health through organized efforts
- statistics – a mathematics discipline that focuses on the collection, organization, analysis, and interpretation of data
- pediatrics – the branch of medicine that involves the treatment and care of infants, children, and adolescents
That’s just a sampling of the fields of science and medicine that are involved in the research and development of vaccines. Vaccinology is a “synthesis” of all of those fields of study. For example, an epidemiologist is an expert in the field of epidemiology, but they probably have substantial education and expertise in some, or maybe all, of the other fields.
And like I’ve written before, vaccine researchers probably have hundreds, maybe thousands, of hours of study in most of these separate fields. It’s not just a few minutes of “research” on the internet.
So when someone asks whether physicians study vaccines, the answer is yes, but not in the way that the anti-vaxxers believe. Let’s take a look at a typical physician who just graduated from medical school.
Before someone enters medical school, they generally have a science education that I’m going to guess is far beyond the pseudoscience-believing anti-vaccine crowd has received. Here are the prerequisites for incoming medical students – this varies slightly by the medical school, so this is an average:
- General biology – 2 years with labs
- General chemistry – 2 years with labs
- Organic chemistry – 1 year with labs
- General physics – 2 years with labs
- Statistics – 1 course
You can be an English Literature major and do all of these courses, but it’s probably easier to just be a biology or chemistry major to get all of these courses completed.
Once again, none of these courses are in “vaccines” but they form the basis of knowledge of the more specialized fields of study that I listed above. Nevertheless, this is an intensive field of study and potential medical students generally have to have superior grades in each of these courses.
Then, if they’re lucky and worked very hard, this is what they get to study (I’m eliminating strictly clinical courses, like cardiac life support) at an average medical school:
- Human anatomy (two courses)
- Biochemistry and applied biochemistry (two courses)
- Human genetics (one course)
- Embryology (one course)
- Histology (one course)
- Microbiology and infectious diseases (two courses)
- Immunology (2 courses)
- The nervous system (1-2 courses)
- Cell biology (one course)
- Science of Medicine (nine courses over 2 years)
- Pharmacology (one course)
- Pathophysiology of disease (2 courses)
Plus, each medical student has to take up to 6-10 additional electives in their field of specialty, which not only builds on this “basic” (not so basic) classwork. This is all mostly done in the first two years of a four-year program.
However, this is just difficult, very difficult, classwork in complex sciences. I know that anti-vaxxers believe in their hearts that they can duplicate this education with their Google University education, but they’d be wrong. Again.
But that is just the beginning – there’s a lot more to the fact that physicians study vaccines.
Do physicians study vaccines? Training
The second two years of medical school include what is called the clinical clerkship. This is the time whereby medical students (whether in medical or osteopathic schools in the USA) actually begin clinical training. They work in emergency departments (watch the old TV medical drama, E.R., which gives a semi-accurate depiction of medical students working in the emergency department of a fictitious Chicago hospital), surgery, and many other clinical specialties.
During this time, medical students gain precious clinical experience that has two purposes – first, they receive firsthand knowledge on how to diagnose and treat diseases, and second, they get an inkling on what specialty they may want to pursue in medicine.
With respect to vaccines, they get to see it all. They see patients with serious vaccine-preventable diseases – they know, not only from their classwork but also from this clinical experience. They can also observe precisely what happens post-vaccination, which is almost always benign and very rarely serious.
And let’s dismiss that other myth, right here and now. These young physicians aren’t being sequestered in the gold-lined conference rooms of Big Pharma to be brainwashed about vaccines. They don’t have a free second during this time, and they are obsessively focused on being good clinicians.
And let’s be clear about one more thing – despite the laughably ignorant claims of most anti-vaxxers, their “research” is not only deficient with respect to science education it is also not even 0.00000000000001% of this clinical experience.
After all of this is completed, a newly minted MD, DO, or DPM (a doctor of podiatric medicine), takes an examination to determine if they learned the scientific and practical foundations of medicine, then they apply to a centralized residency selection process (in the USA, this varies by country) by specialty.
A residency is one of the basic requirements for a physician to be able to practice medicine without supervision. These residencies range from three years, for general practice, to more than seven years for highly specialized fields like immunology, oncology, psychiatry, and many others.
There are dozens of medical specialties, but we’ll focus on pediatrics since they give the highest number of vaccines. A pediatrician needs to have at least three years of residency (some states still only require only one for more general fields of medicine, but it’s becoming rare) before they can take examinations that are required to be licensed as a pediatrician. I am going to overlook highly specialized fields of pediatrics, like pediatric oncology, which require many more years of residency.
During these three years of residency, the pediatrician has intensive and challenging clinical education and experience with children. They may work in numerous clinical settings – the emergency department, outpatient medical centers, pediatric intensive care, neonatal intensive care, obstetrics, and much much more.
This is not, mostly, a 40-hour week job. Although there are some limits to their hours, it’s way more than 40 hours.
They do everything from diagnosis to treatment. And yes, their rounds in a hospital will include intensive training on vaccines and the mythical “vaccine injuries.”
Again, this isn’t training you receive on the internet while downing a beer and binging Netflix. Pediatric residents must constantly be on their toes – they are constantly quizzed by attending physicians (who manage them, because residents really cannot make any decisions without being supervised) and senior residents.
Although many physicians will try to convince me that they don’t have to be 100% perfect, but I’ve seen residents reprimanded by attending physicians or chiefs of the department for minor mistakes.
It’s hard work, and I respect nearly every physician who has gone through this arduous training to be the experts that they are. Except for Andrew Wakefield – he’s worthless.
During this pediatric residency, vaccines are just part of the background training, like reading an EKG or diagnosing a broken arm. They are spending 10-15 thousand hours of examining children, giving vaccines, listening to parents, and treating minor and infrequent post-vaccination issues. They also know what to ask parents to determine if a child needs a legitimate medical exemption.
I consider myself a science of vaccines expert, because of the depth of my education in basic and specialized fields of biology. But I am not a clinician – after three years of residency, a pediatrician is not only an expert on vaccine science, they are experts in all clinical aspects of vaccines.
Do physicians study vaccines? Absolutely yes
So, let’s review.
A physician needs several years of basic biology, chemistry, physics, math, and other science during their undergraduate studies. Does the Google university expert have that? No.
A physician needs two years of specialized scientific fields of medicine during their first two years of medical school. Does the Google university expert have that? Don’t make me laugh.
A physician needs two years of clinical training during medical school that includes all of the knowledge that they need about vaccines. Does the Google university expert have any of that? I am literally laughing into my coffee while writing this.
A physician needs at least three years of clinical training in residency, where they gain much more knowledge of all of the clinical fields of vaccines applied to real-life children. Does the Google university expert do that? I bet they had no clue what is required to be an MD.
Sure, a pediatrician does not take a bunch of courses on vaccinology. But they have taken dozens of courses plus at least 5 years of clinical training to become independent physicians. That’s what makes them experts on vaccines.
All of this knowledge and training is based on scientific evidence, not wild and highly inaccurate claims on the internet. To become an expert on vaccines, it’s more than just reading the basically useless package insert, it’s years of education and clinical training.
No, pediatricians (and all other physicians) don’t take a course in vaccines. In fact, they have much much more than that.
- Physicians, for the purpose of this article, are medical doctors (MDs) or doctors of osteopathy (DOs). In almost all of the world other than the USA, osteopaths are not physicians. In the USA, DOs must undergo the same rigorous clinical training as MDs, they compete for the same residencies, and are licensed as physicians. Some DOs practice various forms of pseudoscience, but most do not. Also, doctors of podiatric medicine (DPMs) are also physicians, but they generally don’t give a lot of vaccinations.
- Nurses also have to go through a similar, intensive educational and clinical training program. But most of the anti-vaccine tropes focus on physicians, so I stuck with that.
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