There is an assumption that is creeping into discussions about medical education, just like primary education: that memorization is outdated and doesn’t matter in the Internet era. That’s a mistake. The goal of education is to create an expert thinker. Memorization is at the core of that endeavor.
Practicing medicine requires constant problem solving. Every patient is different and requires a bit of improvisation. Just like in jazz, you can only ad lib when you start from a strong foundation. Countless studies show that expert thinkers and problem solvers have an extensive interconnected database of factual knowledge that is stored in long-term memory — not a device.
Yet the list of reasons grows for why we should teach doctors how to find information, not recall it:
It’s all on the Internet. Instant access does not equal instant knowledge. You’re not fluent in German just because you own a German-English dictionary. You have to grapple with a concept — storing it, recalling it, and applying it — in varied situations to have a deep understanding of it.
We need creativity and problem-solving skills. Professionals can never get to a higher level of thinking without knowing the basics. The stronger your foundation of knowledge, the more you have to draw upon for complex thinking in novel situations.
It’s no fun to memorize. In the short term, it’s not. But education is a long-term play. Professionals’ greatest source of motivation and fulfillment comes from mastering their craft. Uploading facts and knowledge successfully (challenging problems, spaced learning, connecting new facts to old ones) doesn’t suppress the love of learning–it fuels it.
Everything is just a click away. Studies show that practicing physicians rarely have the time to look up the questions that arise in their daily practice. If a doctor can find the time to check a fact, a dose, or an article in real time, that’s a small victory. There’s no time for a tutorial on anything and everything that walks through the door.
The Internet is phenomenal as a second brain — not a primary one. I use it constantly for fact checking, learning at the margin of my knowledge, and often discovering that I don’t know what I don’t know. But the Internet has not changed this truth: The best approach to an open book test is preparing for the closed book one.
Gurpreet Dhaliwal is a professor of medicine, University of California, San Francisco. This article originally appeared in the Wall Street Journal.
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