When I was in grade two, we had a class dedicated to learning how to use Microsoft Word. Later, it was how to input formulas in Excel and how to add transitions for PowerPoint presentations. One of my earliest art-related memories was clicking on the paint bucket tool in MS Paint for the very first time.
Probably this science of computing has been lost to time (and relegated to the archives of outdated school curricula). Instead of learning how to use marquees and bracket paragraphs with < b > and < / b > –and their more complex cousins –grade two students today intuitively learn to highlight words and wait for the formatting button marked “bold”. As most children learn by navigating a phone or tablet instead of an actual PC, even the shortcut ” Ctrl + B ” might come as a revelation. The more user-friendly interface appears in a nanosecond, and I don’t think anyone ever had to teach our current young generation. Certainly Rachel, a 4-year-old I met last month, was too young to sit in a formal computing class. Yet she knew how to operate my phone’s YouTube app in the few seconds I wasn’t looking.
Despite my nostalgia for the clunky HTML and basic coding tricks of our MySpace past, and the necessary computing classes that followed, I am neither unhappy nor sad. The progression of technology marches inexorable, as it happened in the past and will happen in the future. The late adopters which scoffed at automobiles could never have predicted the specific yet ubiquitous challenges of a malfunctioning Tesla. Even further back, Archimedes could imagine and write well enough on bouyancy, but it would take more than a thousand years before we can consider the laws of gravity –by which time Newton was looking at the stars for guidance, not the dusty axioms already taken for granted.
But tradition lags behind innovation, and maybe nowhere is slower to adapt than Medicine. Why look back to the typewriter and punched card computing, when the wave moves ever forward to zettabytes in a flash drive? While encoders and engineers have left behind the 1’s and 0’s in favor of cloud storage and new encoding languages (now utterly foreign to the casual user), medical students around the world are still regurgitating the all-pervasive “the mitochondria is the powerhouse of the cell” and getting quizzed on the Krebs Cycle every year. Every Damn Year.
Ophthalmologist and national hero Jose Rizal was already martyred when the term “mitochondria” was first published. When the physician Campbell invented the face mask to delivery oxygen, he probably never imagined the intricacies of modern mechanical ventilation, which gave birth to a whole industry and field of medical professionals called respiratory therapists. The breadth and depth of our medical knowledge outpace our capacity to digest them. New studies are published every day.
Between the time of great discoveries and the space age future of near-instant organ regeneration, there must be a way to pack up our curriculum and practice into must-knows and nice-to-knows and no-need-to-knows more painlessly. And quickly. Otherwise medical schooling will take on more years and more debt, and the PLE (and the USMLE, and the PLAB, and AMC, and so on and on) will bloat well past its utility in general practice. The argument for generalization isn’t just in the primary health care approach, it might also be in medical education.
Maybe there are just some things I don’t need to know, which I say with only a few years of practice under my belt. Maybe there are things I can let go, in favor of focusing on what actually matters: how to appraise evidence-based medicine, how to incorporate systems thinking even in clinical or specialist practice, and how to help build compassionate communities in care. On the black boxes of medical education, Senior (2014) writes on the big mystery of “patient education” –something I’d rather bring to light and embed in our brains, instead of the nth iteration of the latest in cutting edge hyper-specialist care.
BLACK BOXES refer to systems which can be viewed or used solely by its inputs and outputs, without any knowledge of its internal processes. Examples include engines (for most people), hedge fund management, and the human brain. In medicine, most related usage refer to medication-related warnings, but it has also been introduced in artificial intelligence, or the use of large-scale computational models to recommend treatment in personalized medicine or chronic disease. And in this log, it means the connections in thinking that we study too much –or too little. It means it’s time to reconsider what might be best left unlearned.
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POSTSCRIPT: WordPress now comes with an auto-generated excerpt, based on desired length. It is amazingly precise.
At 50 words and a “formal tone”, the excerpt reads: “The writer reflects on the evolution of technology and medical education. They express nostalgia for past computing methods but recognize the inevitability of progress. They question the traditional approach to medical schooling and advocate for a focus on practical, impactful knowledge and skills. This thought-provoking piece raises important considerations for the future of education.”
At 22 words, the revision reads: “The writer reflects on technology and medical education evolution, expressing nostalgia for past methods while advocating a practical approach. Important considerations are raised.” A little more bland, but still highly useful.
Until next time! ❤️
jari m 
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