Why medical schools discourage entrepreneurs

As a medical student looking to explore entrepreneurship, I quickly came across Shiv Gaglani’s October 2013 article in Entrepreneur, entitled “Why Medical Schools are Pumping Out Entrepreneurs,” in which he the highlights similarities and differences he sees between medical students and entrepreneurs. I was struck by his proposed differences — he does not share his take on their origins, so I have come to delineate my own view.

Medical students are not by nature risk averse, obedient, individual-driven, and lacking imagination. Rather, these traits are fostered by nurture: they are acquired, the product of modern undergraduate medical education. Incoming medical students are faced with several obstacles and unfavorable incentives to engage in an entrepreneurial mindset and activity early in their medical education, if not before:

1. Disincentive: conservative, traditional learning pathways. To be considered as serious candidates for admission to top medical schools, applicants must “check off” a variety of formational activities and experiences during their undergraduate years to include in their medical school applications. This pre-med “checklist” mentality gradually diminishes one’s capacity for imagination leading up to medical school enrollment. Then, in the first two years of the average medical school curriculum, students are primarily learning through memorization rather than through experiential discovery, further solidifying this sense that medical training is a path to conform to with restricted room for creativity or invention. Medical students are eventually encouraged to think individually during their clinical years, but by this time one’s dopamine-reward circuit and the School’s clinical grade expectations are best fulfilled by the regurgitation of memorized medical knowledge rather than by creativity or ingenuity.

2. Obstacle: time. It comes as no surprise that medical students are constantly studying or spending 80 hours per week in the hospital. There is seemingly an infinite amount of medical knowledge to be learned in the classroom and on the wards, and we sacrifice sleep, exercise, and relationships to consume as much as we can from the fire hose. But what would every entrepreneur, successful or not, say is crucial to developing an entrepreneurial mindset and skillset? Time. Time to succeed, and certainly time to fail (and often). In medical school curricula, there is no dedicated time for us to get our “hands wet” in entrepreneurial activity.

3. Disincentive: money. The enormous amount of debt that most medical students incur during medical school, added to the heavy pre-existing debt from undergraduate education for many, discourages risk tolerance. We feel compelled to power through medical school to begin to earn that reliable income promised to us to pay down our debts: that delayed cash flow is at the forefront of most students’ minds. And, largely, medical school faculty and administration draw their incentives from number of manuscripts published, grants, set salaries, and other health system politics that discourage involvement in, and incentives for, programmatic or institutional entrepreneurial activities.

The obstacles and disincentives found in modern medical education prove difficult for entrepreneurial medical students to overcome. I’ve met several with entrepreneurial mindsets, including Mr. Gaglani of Osmosis and Alex Ryu of LifeGuard Games, and know there are many more out there: must they take time off from their medical training, leaving the very environments that could benefit most from their creative thinking and tenacious activity?

Modern medical education, and its future physicians and current patients, suffers when they do. We must move alleviate the aforementioned obstacles and disincentives and incorporate into the medical curriculum exposure to and training in entrepreneurship principles to better equip the physicians of tomorrow to tackle the pervasive problems within health care today.

Jonathan O’Donnell is a medical student and can be reached on Twitter @jonodoc.

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