The Socratic method, or directed questioning aimed at assessing and evaluating a learner’s knowledge, is
a traditional teaching modality commonly
used in the clinical setting.
1, 2 “Pimping,”
on the other hand, is a line of questioning meant to affirm the hierarchical order
of a small group of learners by cultivating
feelings of humiliation, fear, and intimidation for those answering the questions.
Some learners and medical educators have
recently sought to determine why pimping is increasingly considered a form of the
Socratic teaching method.
This article looks at the use of pimping
as a common pedagogic technique throughout the history of formal medical education,
describes the pros and cons of pimping,
Time-honored educational tradition
or relic of the past?
by Jessica R. Burgess, MD; Elizabeth Bailey, MD, MsEd;
Kristin M. Busch, MD; Rebecca L. Hoffman, MD, MSCE; and Luke V. Selby, MD, MS
• Looks at the tradition of “pimping”
in surgical and medical education
• Describes the advantages and
disadvantages of the pimping process
• Explains how pimping can be
successfully applied in today’s
surgical training environment
explains how medical students respond to this method, and
offers suggestions to effectively engage in pimping.
Pimping may have preceded the 17th century practice of
medicine, but the technique’s earliest reference is attributed
to William Harvey, MD, a London-based physician who first
described the systemic circulation in 1628.3 German physician
Robert Koch, MD, in 1889 and Sir William Osler, MD, at Johns
Hopkins University, Baltimore, MD, in 1916 later referred to
pimping in the medical literature, but it wasn’t until the
Journal of the American Medical Association published an article by
Frederick Brancat in 1989 titled “The art of pimping” that this
method of teaching was popularized.
Surgeons in particular are known for their use of pimping as
an educational strategy. The art of pimping for the purpose of
demoralizing students has certainly contributed to the perception that surgeons are difficult and may have turned off medical
students who might otherwise have been interested in pursuing a career in the profession. However, the unique learning
environment that a surgeon practices in, more than any other
specialty, is conducive to the type of short, directed questioning
that is characteristic of both pimping and the Socratic method.
Over the past several generations, the definition of pimping has
been reclaimed, in some respects, to characterize the type of
teaching that is feasible during a busy surgical rotation and an
approach that is not necessarily malicious.
An appreciation of different learning styles, the incorporation of technology into everyday learning, and an explosion in
the amount of knowledge that must be mastered by the medical student has changed how learning occurs today. Educators