HealthJuly 23, 2020

A guide to pimping in medical education

By: Ogie M. Ezeoke, MD

You’re sure to encounter pimping in medical education during medical school and residency training. Here are some tips on how to navigate this practice.

From medical school through residency and even fellowship training, "pimping" is a staple. Over the centuries - yes, centuries - it's attracted its share of critics, who argue that it unnecessarily humiliates trainees and can even undermine patient safety.

Yet others defend it as an important tool for learning, and since it's an entrenched tradition, you'll inevitably come face to face with it. Here's what you need to know.

What is pimping?

Simply put, pimping is a process through which the most senior medical person - usually the attending physician - asks the team questions about relevant medical information, typically during morning rounds.

The term "pimping" was popularized by Frederick L. Brancati, MD, in a 1989 article titled "The Art of Pimping," published by the Journal of the American Medical Association. Dr. Brancati traces the term to the 17th century and the formal practice of posing questions to trainees during rounds to the early 19th century.

More recently, pimping in medical education often takes the form of Socratic instruction. Through a series of questions and answers, trainees connect preclinical and clinical theory with a specific case, reinforcing and expanding their clinical knowledge.

Why Is pimping part of medical education?

If you're a medical student returning to the hospital, especially after being kept from the floors in the early months of the COVID-19 pandemic, you may be wondering why pimping in medical education has persisted for so long. If you have the normal trainee anxieties that come with transitioning from preclinical studies to direct patient care, pimping may seem like an unnecessary and even nerve-wracking prospect.

While pimping certainly isn't the favorite learning tool of most trainees, remember that it supports the continued importance of a strong preclinical foundation. When done properly, pimping by a senior faculty member ties together theoretical knowledge with clinical practice, reinforcing the theory's relevance to patient care and our responsibility as physicians to maintain a culture of continued study.

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How can pimping help you?

The goal of pimping in medical education should always be learning; it should never be used as an opportunity to embarrass a junior member of the team. Yet even the most well-meaning of senior faculty may place a trainee in the spotlight during a pimping session. Depending on the trainee, this may be a much-wished-for opportunity to shine while on rounds or an uncomfortable experience as you publicly think through a question.

So how do you turn this inevitable aspect of medical education to your advantage? Think of every question as a learning opportunity for your growth. A pimping session can be a review of what information is most relevant in a given field and help you prepare for future patients or even your board certification examinations. Sometimes, pimp questions can guide your reading outside the floors and reinforce material that you may have previously seen only in a textbook.

Think of yourself as a lifelong learner and remember that you're not expected to be an expert on any given topic. When you're called on or observing a colleague being asked questions, absorb information as though it's part of an ongoing lecture series taking place outside of your classroom.

What are strategies for navigating pimping?

While changing your mindset about pimping in medical education may improve your feelings about the process, having the tools to navigate a pimp session will take you one step further. Keep these five tips in mind:

  1. Answer questions to the best of your knowledge. When you do, be sure to cite any medically sound sources that support your contribution. This can lead to a conversation about the sources as well as what else could help with the clinical puzzle your team is reviewing.
  2. Acknowledge that you may not know the entire answer. Also mention how the information will be helpful to you and emphasize that you plan to review the topic outside rounds.
  3. Listen to your colleagues before jumping in. Not only is this a common courtesy, but it also helps you broaden your way of thinking about a topic. Sometimes if you pay attention, you're able to jog your memory about previously reviewed material.
  4. Offer to bring some additional material to teach the team. This is particularly valuable when you're a medical student. It shows your desire to continue learning and your commitment to supporting the learning of the team.
  5. Ask clarifying questions. If an initial pimp question is confusing to you, it may simply be that the terminology being used is making it more difficult.

Above all, always remember that pimping - and the Socratic method of teaching more broadly - can be an invaluable tool to support your growth in medicine. It doesn't need to be a source of fear.

Ogie M. Ezeoke, MD
Lippincott® Medicine
Lippincott is a leading international medical publisher of professional health information for practitioners, faculty, residents, students, and healthcare institutions with a full suite of essential medical products, from books and journals to digital solutions.
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