Pimping as a Practice in Medical Education

EnglishDrs McCarthy and McEvoy1 discussed a great divide among medical students regarding whether pimping is viewed as an important educational activity or a means to humiliate and demean. The authors correlated the manner in which pimping is conducted to the student response, but the student’s mindset may also explain the anxiety that many students experience. Mindset theory, as described by Dweck and Leggett,2 involves 2 dichotomous views with which learners view their intelligence. Learners with a “growth mindset” see their intelligence as malleable and are more likely to face challenging questions with anticipation and value the struggle to answer even if they are ultimately wrong. Learners with a “fixed mindset” see their intelligence as predetermined and their failures as proof of their limitations. Paradoxically, individuals with tremendous talent may develop a fixed mindset by virtue of having their identity consistently tied to their intelligence as opposed to their effort in learning. Learners with a fixed mindset may have exaggerated emotional responses to potentially formative situations that challenge them because of the risk of damage to their self-concept. For the gifted learner with a fixed mindset, appearing smart becomes a performance with its maintenance taking precedence to actual learning.3 Importantly, mindset is malleable and a growth mindset can be fostered by tying affirmation to intellectual effort as opposed to ability.4 The implication for pimping should be a modification toward lines of questions that emphasize thinking strategies as opposed to knowledge content, and tailoring feedback to reflect effort as opposed to simply accuracy. Viewed through the lens of mindset theory, pimping may continue to be an important tool for medical education as well as an opportunity to free some learners from unnecessary anxiety regarding their intellectual ability. EnglishIn an Editorial, Dr Reifler wrote that “the term [pimping] is saddled with negative and malicious connotations, regardless of the intended meaning.” For this reason, medicine should reject the term pimping in medical education. When Reifler stated that pimping has “nothing to do with finding customers for prostitutes,” this is correct—it has to do with a trafficker finding exploiters of trafficking victims. A trafficker, or “pimp,” organizes “the recruitment, harboring, transportation, provision or obtaining of a person for the purpose of a commercial sex act.”Pimping is violence and it is associated with the significant medical and public health issue of sex trafficking. EnglishTwo recent commentaries addressed pimping as a practice used in the training of medical students.1,2 I wonder if the authors, and the medical community at large, are aware of how startling and demeaning this practice sounds to those outside the medical profession. In general parlance, the word has nothing to do with teaching or honing skills: Webster’s dictionary defines it as the actions of one who “panders or procures . . . solicits for a prostitute . . . or lends himself to some corrupting or corrupt activity.”3 What is it about the practice of questioning medical interns that overlaps with that sense of pimping? Drs McCarthy and McEvoy stated clearly that “one consequence—sometimes intentional—is that the pimped learner can be humiliated.”1 In this sense, it sounds more like hazing.