Pimping as a Practice in Medical Education--Reply.

Abstract

EnglishPimping in medical education, as both a term and an activity, has long been a subject of controversy.1,2 Pimping often polarizes physicians and medical educators into 2 opposing camps; those who think that pimping is a time-honored tool in clinical training and those who think it is a harmful vestige of the past that should be retired to the medical education museum.2 Ms Crosby provides an outsider’s view of pimping, finding the practice both “startling and demeaning” and comparing it to “hazing.” She suggests that “students learn best when they have the emotional support of their teachers and peers.” We agree. Our Viewpoint was motivated not as a defense of pimping, but rather as a call to action to develop more evidence either for or against it. Specifically, although Crosby argues that pimping hinders students from reaching their full potential, the opposite may also be true. The pressurized environment cultivated by pimping may prepare medical students for the stress of making life and death decisions; therefore, the benefit of this educational modality may be unique to the medical profession.3 EnglishBoth Ms Crosby and Dr Ravi take issue with the use of the term pimping in medical education. Whereas Ravi objects on the basis of the linguistic association of the word with exploitive and violent sex practices, Crosby focuses on the damage inflicted when future physicians are routinely humiliated. Writing as a teacher who is outside the medical profession, Crosby reacts to McCarthy and McEvoy’s1 definition of pimping, which was drawn from the 1989 article by Brancati, “The Art of Pimping.”2 But when Brancati extolled unanswerable questions and “ridding the intern of needless self-esteem,” his tongue was planted firmly in his cheek. Brancati used irony to critique, not endorse, this practice. More recent descriptions of such behavior might use the expression “malignant” pimping, which has become indefensible if not yet extinct. Medical education must show compassion and promote well-being in students, and educators must continue to improve in this regard.