Traditionally the term 'pimp' has had a negative connotation.
As a reference to someone who promotes and trades in indulgences of the flesh, the
word was not used commonly in civilized society.
These days the word is thrown about much more casually, partially due to the influence of
hip-hop lyrics on modern culture. Often people can be referred to as 'pimps' even though
they do not employ prostitutes. Even inanimate objects can be 'pimp' such as,
"Your ride is pimp."
In medicine, 'pimping' has a whole different meaning. 'Pimp' is used to describe
a more knowledgeable person questioning one with less experience to test that
person's knowledge. It is traditionally used in sentences such as,
"Dr. Stearns pimped me about the innervation of the hand yesterday," or "Are we going
to be pimped on rounds?" It is even done on television; the show "Scrubs" commonly
displays the chief of medicine, Dr. Kelso, pimping J.D. or Elliot.
In recent years, pimping has been frowned on by those in medical education. Asking
spontaneous questions is said to be anxiety provoking for medical students.
While the future doctors want to be sure they are learning what their professors think is
important, many educators
feel that pimping makes students construct negative associations
with experiences such as rounds or small group learning. The pimped students are given the
classic 'hero-goat' paradox. Answering the questions correctly causes the student
to be considered a hero while an incorrect answer turns the student into a goat.
While causing anxiety and creating a 'toxic' environment is not beneficial to anyone,
asking questions of medical students is very appropriate. Instructors need to be able to
assess knowledge and acquisition of concepts. Asking questions provides feedback to both the
instructor and the student. Professors need to know if their teaching style is working
and giving the students the information they need in a suitable manner.
Medical students benefit greatly from
pimping. They are bombarded with information and it is important to know what is the most
relevant. In addition, pimping provides a sense of inadequacy and, thus, motivation like no
other. The possibility of being the 'goat' gives students an impetus to study beyond
formal tests or other types of evaluation. Students need to constantly be challenged,
to feel that there is more to learn. In programs with little emphasis on academics such as HMS,
this type of stimulus is necessary to prevent stagnation
and a false sense of confidence, two characteristics found in some HMS students.
While not always referred to as pimping, asking questions in a sort of pop quiz format is a
time-honored way of learning. It is very successful so long as it is given and received in
the proper manner. Attendings and residents should feel free to pimp, just as long as they
are not demeaning or insulting. Students should be excited about being pimped and receive the
questioning and resulting feedback in a positive way. Pimping should be looked at as a
mutually beneficial opportunity for learning and used whenever appropriate.
What happens if instructors do not pimp? Students lose out to the politically-correct pressures
of society. The fact is that doctors may have to make decisions under circumstances of intense
pressure and time constraint. The result of giving a wrong answer is not just being the
'goat,' but adversely affecting someone's life. Medical students need to get used to
the fact that they are in positions of responsibility, of making life-death decisions, and of
working under intense pressure. So get ready to pimp and be pimped.