Swimming in "the Shallows"

I have had the opportunity to review medical school curricula lately and have some simple questions. After reading about the changing curricula, and ruminating on the Atlantic article "Is Google making us stupid" by Nicholas Carr (the basis for his new book "The Shallows: What the Internet is doing to our brains" which I have yet to read) several questions emerged.

I began to wonder just how different incoming students to medical school would be when compared to older generations. The first two years of medical school (the basic science years) had always been compared to "putting your mouth to a firehouse and swallowing all you could without drowning." One of the Deans of my medical school actually said that to us on our first day. In many ways, aside from the anatomy and physiology, this is probably one of the most important steps in the creation of a modern physician. As medical science has exploded over the last several decades, this proverbial firehouse has gushed even more.

Each physicians learned to deal with this information overload in their own way. Unfortunately, many practicing clinicians simply memorized what they were told, and never changed/updated knowledge from outside their clinical area as the years went by. An example from my own training (early 90s) was several older clinicians who would try to impress me with their knowledge regarding heart failure. These were specialists in other areas (opthalmology, ent,...) who would state "And what is the one class of drugs you do not want to use in heart failure patients." The answer they were seeking was beta-blockers, but by this time beta-blockers (certain classes) were recognized as one of the most important treatments for hear failure.

I think that young, new college graduate medical students may deal with this phenomenon better. They have lived much of their adolescent and adult life in a world of (relatively) instant knowledge through the internet. They may more easily adapt to rapidly changing information, discarding old concepts and accepting new ones as necessary. If so, then maybe the rapid growth of available medical information, shallow as it may be, has created its own solution. A clinician capable of dealing with the firehose on its own terms.