Medicine Needs a Dose of Creative Thinking

Admissions panels have unforgiving standards for new medical students. That scares Jacob Scott.

Scott, a radiation oncologist and cancer theoretician, told an audience of doctors, scientists, government officials, and others at TEDMED 2012 this morning that these standards threaten to kill creativity in biology and medicine.

Scott said the tremendous growth of biological knowledge in the last 15 years or so has separated biological experts into disconnected pigeonholes. While it’s necessary for true experts to focus on their particular area, it’s also scary: “There’s a disconnectedness we’ve never seen before.”

He believes curious and creative medical students are the best candidates to be the “dot connectors”—for example, that will apply information theory to improve personalized medicine or champion the use of computer-simulated experiments. Unfortunately, those likely to see (or at least attempt to see) connections between disparate subject areas are likely to be weeded out in the medical school application process, he said. Most medical school admissions boards require near-perfect grades and MCAT scores. Students hoping for that MD are scared from straying from the beaten path and dabbling in math or computer science.

This limited view of what makes for a good medical school candidate prevents the community from meeting its need for “specialist generalists,” he said—people who can connect the dots between the different silos of biological expertise that have sprung up because of technological advances.  Such generalists need creativity, an open mind, and an explorer’s approach to education. He said that the potential benefit of the technological advances in biology, such as genome sequencing and cultured cell lines, won’t be realized without people who can make connections between all the disparate branches of medical science.

With his diverse academic background, Scott himself would a good candidate. The 35-year-old clinical resident studied astrophysics in college, then worked on a nuclear submarine as a reactor controls assistant, then decided to take on medical school. Now, he is studying biological mathematics while practicing cancer medicine.

It isn’t that Scott doesn’t see the growth and expansion of molecular biology and genomics as positive. His concern is whether anyone will be able to harness all this data for human health benefit. “It’s a good thing that we aren’t taking advantage of,” he said. “If we continue to summarily rip the creativity from our MD students, we will never have a new player come forward.”