I agree with this post. I’d add that from what I’ve seen of medical school (and other high-status vocational programs like law school, business school, etc.), there is still a disproportionate emphasis on talking about the theory of the subject matter vs. building skill at the ultimate task. Is it helpful to memorize the names of thousands of arteries and syndromes and drugs in order to be a doctor? Of course. Is that *more* helpful than doing mock patient interviews and mock chart reviews and live exercises where you try to diagnose a tumor or a fracture or a particular kind of pus? Is it *so* much more helpful that it makes sense to spend 40x more hours on biochemistry than on clinical practice? Because my impression of medical school is that you do go on clinical rounds and do internships and things, but that the practical side of things is mostly a trial-by-fire where you are expected to improvise many of your techniques, often after seeing them demonstrated only once or twice, often with minimal supervision, and usually with little or no coaching or after-the-fact feedback. The point of the internships and residencies seems to be primarily to accomplish low-prestige medical labor, not primarily to help medical students improve their skills.
I’d be curious to hear from anyone who disagrees with me about medical school. I’m not super-confident about this assessment of medical school; I’m much more confident that an analogous critique applies well to law school and business school. Lawyers learn the theory of appellate decision-making, not how to prepare a case for trial or negotiate a settlement or draft a contract. MBAs learn economics and financial theory, not how to motivate or recruit or evaluate their employees.
As far as *why* we don’t see more discussion about how to improve technique, I think part of it is just honest ignorance. Most people aren’t very self-reflective and don’t think very much about whether they’re good at their jobs or what it means to be good at their jobs or how they could become better. Even when people do take time to reflect on what makes a good [profession], they may not have the relevant background to draw useful conclusions. Academic authorities often have little or no professional work experience; the median law professor has tried zero lawsuits; the median dean of a business school has never launched a startup; the median medical school lecturer has never worked as a primary care physician in the suburbs.
Some of it may be, as Isnasene points out, a desire to avoid unwanted competition. If people are lazy and want to enjoy high status that they earned a long time ago without putting in further effort, they might not want to encourage comparisons of skill levels.
Finally, as Isusr suggests, some of the taboo probably comes from an effort to preserve a fragile social hierarchy, but I don’t think the threat is “awareness of internal contradictions;” I think the threat is simply a common-sense idea of fairness or equity. If authorities or elites are no more objectively skillful than a typical member of their profession, then there is little reason for them to have more power, more money, or easier work. Keeping the conversation firmly fixed on discussion *about* the profession (rather than discussion about *how to do* the profession) helps obscure the fact that the status of elites is unwarranted.
I agree with this post. I’d add that from what I’ve seen of medical school (and other high-status vocational programs like law school, business school, etc.), there is still a disproportionate emphasis on talking about the theory of the subject matter vs. building skill at the ultimate task. Is it helpful to memorize the names of thousands of arteries and syndromes and drugs in order to be a doctor? Of course. Is that *more* helpful than doing mock patient interviews and mock chart reviews and live exercises where you try to diagnose a tumor or a fracture or a particular kind of pus? Is it *so* much more helpful that it makes sense to spend 40x more hours on biochemistry than on clinical practice? Because my impression of medical school is that you do go on clinical rounds and do internships and things, but that the practical side of things is mostly a trial-by-fire where you are expected to improvise many of your techniques, often after seeing them demonstrated only once or twice, often with minimal supervision, and usually with little or no coaching or after-the-fact feedback. The point of the internships and residencies seems to be primarily to accomplish low-prestige medical labor, not primarily to help medical students improve their skills.
I’d be curious to hear from anyone who disagrees with me about medical school. I’m not super-confident about this assessment of medical school; I’m much more confident that an analogous critique applies well to law school and business school. Lawyers learn the theory of appellate decision-making, not how to prepare a case for trial or negotiate a settlement or draft a contract. MBAs learn economics and financial theory, not how to motivate or recruit or evaluate their employees.
As far as *why* we don’t see more discussion about how to improve technique, I think part of it is just honest ignorance. Most people aren’t very self-reflective and don’t think very much about whether they’re good at their jobs or what it means to be good at their jobs or how they could become better. Even when people do take time to reflect on what makes a good [profession], they may not have the relevant background to draw useful conclusions. Academic authorities often have little or no professional work experience; the median law professor has tried zero lawsuits; the median dean of a business school has never launched a startup; the median medical school lecturer has never worked as a primary care physician in the suburbs.
Some of it may be, as Isnasene points out, a desire to avoid unwanted competition. If people are lazy and want to enjoy high status that they earned a long time ago without putting in further effort, they might not want to encourage comparisons of skill levels.
Finally, as Isusr suggests, some of the taboo probably comes from an effort to preserve a fragile social hierarchy, but I don’t think the threat is “awareness of internal contradictions;” I think the threat is simply a common-sense idea of fairness or equity. If authorities or elites are no more objectively skillful than a typical member of their profession, then there is little reason for them to have more power, more money, or easier work. Keeping the conversation firmly fixed on discussion *about* the profession (rather than discussion about *how to do* the profession) helps obscure the fact that the status of elites is unwarranted.