I am, of couse, using science in the narrow sense of physical science. A broader definition of science would be the application of commonsense. It is in just this sense that medical training seems to be unscienific and mindless. I am aware that such a view will be dismissed as vague and uncertain. Traditional medical education has fostered in students the notion that uncertainty is a manifestation of ignorance and weakness.
Factual knowledge takes precedence over critical appraisal.
The inevitable denial and avoidance that result when the limits of rationalism are exposed in clinical practice are reinforced by patients who may expect them to be certain. This vulnerability is made particularly acute in psychiatry when patients try to express their desires and self-destructiveness and describe their abuse and past traumata. Clinical schools have sometimes said they want to recognise the importance of cultivating creativity and paying closer attention to students' emotional development. Unfortunately, guidance in developing techniques to handle issues raised by uncertainty do not feature prominently in most curricula. It was never realistic, however, to expect that the introduction of social science and medical ethics to undergraduate training would encourage the necessary adjustments to thinking and practice.