How Smart are Medical Doctors?

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OK, I know that’s a slightly contentious phrasing of the question 😉

I mean, is being a medical doctor an intellectually demanding job?

Traditionally this is obviously true. Doctors have had to spend years learning a lot of information (about the body and its symptoms) and spent those years in education surrounded by other clever and ambitious people.

Now that more of this information can be looked up in databases, more diagnoses rely on automated equipment (driven by radiographers etc.) and more treatments depend on prescribing a course of drugs designed elsewhere (by pharmaceutical researchers) does doctoring still have the same profile? Or is it more about interpersonal skills (bedside manner, reassurance). Is being a good doctor becoming more like being a good nurse?

This question was posted on Quora  and answered by Liang-Hai Sie 

Let me answer as a retired doc who had had 40 years of experience with clinical (not research) work as a doc, for decades also working with a lot of young bright eyed docs who were part of our house staff.

Those who have graduated as a MD at least have a IQ of 120 to 130, so you need some intelligence, but need not be a genius.

As for the junior doctors, those having graduated with honors are often so occupied doing everything so perfect that they lose sight of the practical way of running things, so aren’t finished until late in the evening often 10pm which can’t be good, the less brilliant colleagues usually finish between 5 and 7 pm, so are better able at not spending lots of time by trying to be perfect.
I would gladly take a smart enough but not brilliant practical doc to work with me or be my partner.
having a lot of information on the web doesn’t mean a doctor needs no knowledge at all.  To look something up (where can one find useful information, what information does one need etc.) one will need basic knowledge, a lot of information at your fingertip, imagine having to look up everything on every patient, won’t work, and won’t inspire any confidence either.  The art of practicing medicine fortunately is not just following a recipe.

and by Emily Altman

In order to order all those tests that supposedly tell doctors all the answers, you have to have at least a differential diagnosis of what possible illness or condition the patient may have.  That means you have to know how to examine the patient and know what factors are important in the medical history/family history and review of systems.  Then having ordered tests (if necessary, because a doctor may know what the problem is without needing tests or equipment) you have to put the information together to come up with a diagnosis, determine what treatments would benefit the patient and then administer those treatments.

The ability to learn and synthesize learned information (if we can define smart by those terms) is tested many times along the way from high school to post-residency/fellowship MD.  So, yes, we do have objective proof that doctors (and I am proud to be one) are smart.

Doctors are the proverbial sight for the three blind men and an elephant that you are proposing with pharmaceutical researchers and automated programs and devices. That’s because they know how to put information together and not base their judgments and decisions only from the standpoint of a pharmaceutical researcher or an MRI machine.

Nurses do know a lot about diseases and how to take care of patients, but their education and training is not geared towards diagnosis and proposing a treatment as much as patient observation and administering the treatments.  And I might add I learned tons from nurses, especially as an intern in the ICU with experienced, smart nurses who knew exactly what they were doing and were a tremendous asset.

As for programs and devices, just remember the GIGO Law.  It’s truly garbage in garbage out.  If you give a program random facts about a patient, it will come up with a list of possibilities, but it cannot decide what the problem is.

Photo credits Technology image created by Creativeart –

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