Old foundations
Training still rewards recall when the job now demands judgement.
Medical education, the authors argue, has barely shifted while the clinician's work has been transformed. Undergraduates still memorise detail like the Krebs cycle, most of it forgotten by the first day on the wards and rarely needed again. They contrast the old walking-library doctor with a patient who now arrives carrying symptom-checker apps, chatbot answers and wearable data, which turns the consultation into a negotiation rather than a pronouncement. Drawing on Lawrence Weed, Vinay Prasad and the Topol review, they argue for reweighting towards evidence over mechanism, alongside data literacy, risk communication, bias awareness and human factors. They also show how textbook archetypes entrench bias against women and minority patients.
Three takeaways
- Teach curation and judgement, not the memorising of disposable facts
- Textbook archetypes embed bias that harms women and minority patients
- Teaching methods deserve the same trial rigour as new drugs
Reflection
Questions for this chapter
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