Everyone told me medical school would be hard. I thought I was prepared, but nothing actually prepares you for medical school like being in medical school. I was accustomed to working long hours, the constant stress of exams and little sleep. What I wasn’t accustomed to was the absolute dearth of creativity in the coursework.
Of course, first year isn’t supposed to be all that exciting. There’s the usual buffet of basic science courses: biochemistry, genetics, physiology and anatomy. For many students, it’s a throwback to college, but at double the intensity and speed. Often, there’s not much time to delve into any topic in too much detail. By the time I’ve actually begun to become interested in the intimate details of lipid metabolism, we’ve already moved to some other topic, leaving little room for deep thinking. Instead, success on exams is based on memorizing dizzying amounts of information. This has been the hallmark of medical education for years: memorize and regurgitate. But, it’s not without reason — practicing medicine does require an almost encyclopedic knowledge of symptoms, diseases, treatments and drugs.
But what else does it require? Many would say something along the lines of perseverance, empathy, composure and honesty. These traits conjure up the image of the good doctor, wearing a crisp white coat and wielding a trusty stethoscope, ready to diagnose and treat. But what trait is conspicuously lacking?
Why is it that creativity is praised — even demanded — in other professions, but is so sorely missing in medicine? This isn’t to say that there aren’t creative doctors. In fact, medicine has a long and abundant history of creative doctors who discovered new diseases and experimented with novel therapies. However, modern medicine is increasingly making a push towards standardization. On one hand, it makes logistical and practical sense: it ensures repeatability and efficiency in an ever changing health care landscape. Standards of care are vitally important to delivering good care to a large number of patients. However, as Dr. Ofri argues in her New York Times piece How Creative is Your Doctor?, this standardization can also enforce a mechanical approach to medicine and patient care.
Dr. Ofri argues that this rote style of medicine can have detrimental patient outcomes because it pushes doctors to view patients as a checklist of symptoms. In doing so, they ignore the nuances of each patient’s situation which can be crucial to making a correct diagnosis and creating an appropriate treatment plan. Where does creativity play a role in all this? Dr. Ofri believes that it takes a creative doctor to be able to individualize treatment and provide holistic care. Creativity and a willingness to question can also help doctors connect disparate ideas in medicine. Medicine isn’t just about science, contends Dr. Ofri. Instead, it involves a complex interplay of societal and economic factors that can’t be accounted for in a standardized approach. To tackle these issues, she believes that doctors need more than just textbook knowledge — they need a dose of creativity.
Creativity isn’t just important in good clinical care. It’s also essential in pushing the boundaries of medicine. As medicine progresses, we cannot ignore the integration of health with technology. Compared to the nimble and ever evolving tech field, the health care field often comes off as exceedingly traditional and resistant to change. But, as we move forward, the medical field will inevitably have to adapt as new technology shapes how medicine is accessed and delivered. Dr. Scott, a radiation oncologist and a speaker at TEDMED 2012, believes the people best equipped to herald in these changes are innovative doctors. They’d be able to draw from a variety of talents and experiences to address problems in health care with a fresh perspective. Dr. Scott argues that in order to understand and connect all of the moving parts in medicine, we need minds that are willing to seek out different modes of thinking.
Dr. Scott isn’t alone in evaluating the role of creativity in medical practice. Several other doctors have also started to speak out in favor of incorporating innovation and creativity into the medical education system, and medical schools have started to notice. Some schools are now offering humanities classes in an effort to diversify their course load. But, what Dr. Scott fears, is that the current medical system weeds out creativity even before students make it to medical school. He’s concerned that even the medical school admissions process encourages students to be risk averse as they vie to maintain a 4.0 GPA and a carefully curated list of extracurricular activities to impress admission committees. Thus, medical school hopefuls are often afraid to take interesting, but challenging courses for fear that it will jeopardize their admission chances. The rigid admission requirements also deters bright, innovative students from pursuing medicine because the culture seems stifling and uninspired. In short, by the time students have been accepted into medical school, they have already been partly groomed to conform to an arbitrary ideal of what a doctor should be.
It doesn’t get much better in medical school. Many schools still prefer the memorize and regurgitate method for the pre-clinical years, which leaves much to be desired in the way of critical thinking. In addition, the punishing pace of medical school classes means little time or room for other pursuits. Although some schools are actively trying to encourage diversity, there is still overwhelming pressure to conform to the status quo. Where does this leave students? It leaves some burned out and disillusioned with the medical education system. Students are tired of jumping through more and more hoops in a system that rewards obedience rather than intellectual discourse. A dose of creativity might be just the right remedy, but simply adding a humanities class to an already long list of required courses seems like a cosmetic fix.
Maybe, what we need isn’t just more courses and classes telling students what a doctor should or shouldn’t be. Maybe instead, what we need is an environment that encourages exploration. One. that allows students to create and innovate, as well as discuss and question.
Image credit: Photograph by Charlie Wollborg, used with permission under Creative Commons.