Has medical training confused expertise with education?

On cultivating curiosity, independent thinking and range

Reading accounts of the lives of renowned Portuguese doctors from the past, I can’t help noticing that medicine was just one of the many things they did, and many of them didn’t even stick to a single specialty. Ricardo Jorge, known for his pioneering contributions to public health policies in Portugal, first worked in neurology and wrote literary and social essays alongside his scientific writing. Miguel Bombarda, famous for his achievements in psychiatry, was a founding member of the National League Against Tuberculosis and deeply involved in politics, becoming one of the most prominent figures in the transition from monarchy to republic.

Range and multiple interests were once celebrated, however that hasn’t been my experience in the present day.

Medical training is dominated by mastering foundational sciences, learning clinical frameworks, performing in structured simulation environments, and passing high-stakes multiple choice exams. These are valuable skills, but they focus primarily on the ability to recall and apply established knowledge. They leave little room for cultivating curiosity, exploring different perspectives, questioning assumptions, or appraising new ideas.

Succeeding in these circumstances requires a level of commitment and dedication that leads many to abandon other interests outside of medicine. Hobbies like playing an instrument, taking drama classes, or writing fiction are more often than not viewed as distractions rather than meaningful contributions to one’s personal and professional growth. As medical students and doctors lose touch with life outside of medicine, there’s a tendency to become increasingly part of a bubble, isolated from the very people we are meant to care for.

Reality is then seen through a narrow lens. Close friends are almost exclusively healthcare professionals, creating a heightened awareness of professional class struggles without much consideration for the realities of other parts of society. Patients are seen as “compliant” or “non-compliant” depending on whether they follow a prescribed plan or not, with very little regard for the actual circumstances that may have prevented them from doing so.  The white coat already sets doctors apart from patients, and that physical distance can easily become a profound gap in understanding – an inability to see the patient as a fellow person whose unique experiences, beliefs and self-determination are to be heard, considered and respected.

There’s a famous quote attributed to Abel Salazar, another notable Portuguese doctor, who said “A doctor who only knows about medicine, does not even know medicine”. Medicine is inherently a field that requires range, it is where science meets the humanities. Acquiring specialized knowledge and being able to apply it to complex clinical problems is essential, but expertise alone is not education. Education is about shaping attitudes, broadening worldviews and encouraging independent thinking. For that doctors need to be encouraged to take an interest in other fields, learn from other forms of knowledge, and explore different ways of being.

To truly care for patients, medical training can’t prioritize expertise at the expense of education. It must prepare doctors not only to understand anatomy, physiology and pathology, but also to learn from the people and the society they serve. We can’t prepare doctors for every clinical presentation they will encounter. We can, however prepare them to remain curious enough to keep learning from every patient they meet.