Big Picture Thinking vs Medical School Thinking


“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”..Albert Einstein


                   The most difficult section on the MCAT ( medical college admission test) for pre meds is the verbal section. The verbal section tests reading comprehension of non science material. Reading comprehension of non science material requires a certain intelligence that most medical students lack.                   

                      Medical school requires 2 types of intelligence and 1 type of character trait. It requires the intelligence to memorize vast amounts of information, the ability to integrate the material just memorized, and the character trait of obedience to authority. You have to be unquestioning. You can not go against convention and question the status qou. The people that do not want to change the world will be able to adapt to the medical school environment the best (unless you are research MD/Phd). Most medical students have no clue of world history, revolution or current events. Understanding current events is academically deleterious.  If they did, it would distract from the overwhelming amount of time needed to memorize vast amounts of medical facts. The personality types attract to medicine are not the type of people that are politically active. They are matter of fact and invest little time in wondering how society came to exist and how they can improve it. 

                        The people most miserable in medical school have a certain type of intelligence and posses a particular behavioral trait. The type of intelligence these people have is not detail oriented. It is the intelligence of big picture thinking. They can identify over arching themes in society, politics and economics. These people possess the behavioral trait of questioning authority. They are often idealist and are politically aware. They would rather debate the merits of socialism vs capitalism than debate the merits of thiazides vs loop diuretics. Analyzing complex social phenomena is their forte. They will enjoy talking to you about the details of universal healthcare policy but would not enjoy talking about the cardiac cycle. Somehow these people slipped through the admission cracks and ended up in medical school.

                          It is a rare event to meet a big picture thinking type of person in medical school. When I do it is like meeting a reflection of myself. Most of the time we are miserable. Big picture people are miserable in medical school because we feel caged. With so much going on in world we long to be in the action and help change the course of history. We would rather be at a protest than be at bedside. Both places are noble places to be, but we just prefer the protest.  I am glad that most people in medical school are not like Che Guevara (i don’t necessarily agree with Che’s actions but he is an example of a former medical student). It its best that they are not very revolutionary. You would not be able to study so much if you wanted to change the world. You would feel ineffectual. We need people that have the intelligence to memorize vast amounts of information and the docility to go with the flow. Our society depends on it. But society also needs big picture thinkers. The worst place for big picture thinkers is in medical school. 

                       Both types of people are intelligent. They are just intelligent in different ways. If you put them out of their element they will not thrive. It would be torture to place a science medical school gunner type in a creative writing session. It would also be torture to place a creative writer guy in a lecture about glycolysis.

16 Replies to “Big Picture Thinking vs Medical School Thinking”

  1. Hello, I’m enjoying your blog. Thought I’d share a funny story about Big Picture Thinking vs. Medical School Thinking here which illustrates the over regimented mush that a lot of med students’ brains turn into. I walked into our common room in hospital the other morning at 9am, exchanged greetings with a 3rd year student and he asked me “do you always start at this time?” I flippantly replied with a laugh “No, usually 7- I’m running very late- but decided on risk benefit analysis when my alarm went off this morning that being late was well worth a catch up sleep in! Haha!” to which his face assumed a mask of horror “Do you need to do a risk benefit analysis for all of your decisions in 4th year??” he seriously asked me, to which I was like “huh?” and then had to awkwardly explain to him I was joking and had simply meant that being late and running the risk of getting in trouble was worth the rare sleep in!

    1. lol..a potato. yeh pre med beats the creativity out of you. Im starting to think that the ability for creative thinking and the ability for rote memorization is inversely proportional. If you are a person that can do both consider your self lucky.
      An example of not being able to see the big picture is the fact that many medical students know very little about the health care debate ( universal health care vs other forms). Medical school just does not allow much time to be well versed in anything except medicine. This stifles the ability to talk about other topics.

  2. I got a perfect score on my country’s medical school entrance test verbal subsection. I don’t see much creativity in my classmates or in the classes themselves. I want to learn to integrate all of this into the big picture, but they only focus on the trees and not the forest of the overall patient condition. I’m trying to improve my rote learning ability but it’s tough. I have to repeat first year, so we’ll see if I can integrate both big picture and massive memorization intelligences. Is that really possible?

    1. Yes it is possible. Give it another shot. Once you get into the clinical years you will see that your big picture thinking will come in handy.When you have to connect with patients and make an overall diagnosis you will find your talents useful. You can do it!

  3. “It is a rare event to meet a big picture thinking type of person in medical school. When I do it is like meeting a reflection of myself. Most of the time we are miserable. Big picture people are miserable in medical school because we feel caged.”

    I read this and I thought: well, I have to write this guy. (And sorry in advance if I misspell anything, English is not my first language.)

    You pretty much described my medical school experience in a nutshell. Just to sum it up, I finished med school 4 years ago, got my MD and got the fuck outta there as soon as I touched my diploma. “There” being the medical profession as a whole. It was NOT for me. I couldn’t force myself to like it. I felt DUMB — and in high school I was one of the top students. I hated how dumb I felt during med school. That feeling of not living up to my potential and all. But I just couldn’t force myself to learn things that I didn’t care about. And during med school, I felt like everybody freaking loved that stuff and I, for some unknown reason, didn’t.

    Like many of us (us being the disgruntled medical students), I got pressured into med school because my dad is a physician. I live in Brazil. Here the deification of the profession is just as bad as it is in Asia. When I read your line on “My Kid is a Doctor” PDF saying it was a little creepy how they deifyed it, I thought to myself, “well, that guy is reading my thoughts”.

    Just so you know: here, in Brazil, there’s no such thing as “pre-med”. We go straight from high school into medical school (through a veeeery hard admissional test, if we are able to pass). Med school lasts 6 years. Then residence, like you have there. So, when I got into it, I was fucking SEVENTEEN. Yup. I graduated at 23. Everybody who gets straight from high school into med school graduates at that age, but few people are able to pull it off. Most spend 2, 3, 4, 5 years studying (on their own) for the admissional test before they get in, IF they get in at all — there are not many med schools here, so the competition is really, really tough. Hence, the prestige.

    So from 17 to 23 I was fucking miserable. I’m 27 now and I couldn’t be happier that I left. I have always loved humanities and arts — history, literature, portuguese, english, music — and always excelled at them. Writing, mostly. Now I’m pursuing a career in journalism and taking a creative writing course on the side, which I am loving to death. And I have more time to play music, which I love as well, although I am not that good — it’s just for fun (here I am!

    There, said it. I just needed to vent, lol. I have been wondering: how are you doing now? Did you finish it? Are you going to stay in the profession?

    1. Hey Fernanda! I have not been able to check the blog for a while. But this message is an awesome welcome back. I am so glad that you can relate. I am doing well. My perspective on the profession has changed slightly but not by much. I am still in the profession. I took some time off and i am just finishing up 4th year. I will be writing about my time off soon.

      How is you father taking your switch to journalism? It’s so funny that you picked up playing guitar lol. Thats the instrument that i started to learn in my time off also. You are much better than i am though. Keep it up, you sound great!

  4. I just wanted to thank you for describing my thoughts exactly and it’s so refreshing to read the comments and know there are people just like me in medicine. I am drowning, it’s just so hard for me to get the motivation to read it all. I’ll probably be leaving to pursue entrepreneurship as soon as I graduate. I still want to help people and be involved in health care but I know I just can’t do it as a practicing doctor. Are you still in medicine in 2017?

    1. Hey Sactusha! Thank you for the comment. I think you have a great plan. There are many other avenues for a physician outside of clinical medicine ( i didn’t believe it first but its true). I would suggest that you do at least a year or two of residency then decide to quit. The only reason i am saying that is it makes you even more marketable. But i totally relate to you. What year are you in btw? Are you in 4th yr? I took a long break from medicine and i am working for a healthcare company using my natural talents. I enjoy it but plan to go back and do a residency next year. I will make a post on it soon.

      PS…….whatever you pursue make sure that you are natural talented in it. You never go wrong pursuing your talents. Your talent is your superpower. It is your destiny. Find yours and pursue it. All the best.

  5. Hey, dust850 (what is your name?). It’s me again. The girl from the post above, February 5/ 2015, who went into writing. So how are you doing? What did you do in your time off? Btw, you said you used your natural talents finally, at this new job. What are they? I guess you never wrote about it in the blog. What would you be pursuing right now if your folks hadn’t pressed you into med school?

    Best regards.

    1. Hey Fernanda! Good to hear from you again. I actually took time off and started teaching. I am really really good at it. I found my talent. I wish i would have gone into it earlier. I can send you more details if you send me your email address at I am going to write a post about it very very soon.

      I am going to go back into medicine in a year. I have the last licensing exam to take. How are you? Are you still playing guitar? I remember you being a decent player. Give me updates. Have you gone back into medicine and what did you learn in your break from it? I look forward to hearing back from you.

  6. I can totally relate to this sir. I have gone from being a major in politics and philosophy to premed and I can really sense the difference in the ways of thinking between program cultures. I kind of felt indifferent and had a tough time assimilating myself. In my current program we almost never talk about society, and if ever they would be in jokes.

    My interest in medicine is mainly about diseases and their causes and treatments. Thinking of entering pathology. Though the journey, I worry, might be an alienating one.

    Thanks for sharing your thoughts in this post sir. Good day.

    1. Yup philosophy majors and pre med majors are in different worlds. Thanks for the comment my friend! Good luck with pathology. I really enjoyed that rotation. Pathologists are geniuses in my opinion. I will prob make a post about pathologist later.

  7. Two cents from a happy practicing big-picture pathologist, if anyone is interested. If after all drilling you are still interested in how biology works, and/or you are a visual person – you will probably enjoy pathology. Visual people might fit into Radiology too, but it involves a lot of small tasks. The best doctors I have ever seen are the big picture thinkers. Although it works better in more complex specialties like oncology. Primary care is more like teaching elementary school students, a lot of practical psychology for those who like it (tried, got very tired). Also consider include research (leading), teaching residents and management in any specialty – no one does it better than big-picture people. All the chances you will meet more like-minded professionals as you climb the ladder up. Getting through the med school is tough, but worth it – if you find your field. Besides, it helps to learn to apply your traits to every subject. Reading outside of curriculum whenever possible helps to connect the information to already known concepts without that much of memorization. It is ok to pass subjects heavy in drilling at the minimum. This mind works wonderfully in a long run. All the best!

    P.S.: Please don’t forget to show appreciation to detail-oriented people as you go to success – they are very big helpers and hard workers and often cannot climb that high.

  8. I totally agree!
    “P.S.: Please don’t forget to show appreciation to detail-oriented people as you go to success – they are very big helpers and hard workers and often cannot climb that high.” …..THIS IS GOLD THANKS!

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