Archive for January 2010

The magic number: 10,000

Have you ever wondered if it is really necessary for doctors to go through a minimum of 11 years of training to be able to practice their field of medicine?  I’m not going to lie- I have.  After reading Malcolm Gladwell’s, Outliers, I realize again the value in the length of our training.

He states, “The idea that excellence at performing a complex task requires a critical minimum level of practice surfaces again and again in studies of expertise.  In fact, researchers have settled on what they believe is the magic number for true expertise: ten thousand hours. ‘ The emerging picture from such studies is that ten thousand hours of practice is required to achieve the level of mastery associated with being a world-class expert- in anything’ writes the neurologist Daniel Levitin.”

Becoming an expert in medicine appears to be the same.  A doctor training in primary care has already spent 4 years in undergraduate school then 4 years in medical school learning the basic sciences required to practice clinical medicine.  Except for the last 2 years of medical school, these 8 years are not spent actually practicing medicine though.  That begins in residency.  A family medicine or internal medicine physician will spend 3 years in residency working on average 60 hours a week (seldom <40 hours and by law not more than 80 hours).  Working about 49 weeks out of the year at 60 hours a week adds up to 8, 820 hours practicing medicine.  Add in 1000 hours from the clinical years in medical school and what do you know- about 10,000 hours.  No matter how intelligent someone is upon graduating from medical school they still need the 10,000 hours “practicing” medicine to become an expert.

Interestingly, for specialists the numbers work out too- for example a cardiothoracic surgeon spends the same 8 years in school prior to residency then spends 5 years in a general surgery residency then 2-3 years in cardiothoracic surgery residency.  The 8 years of school plus 5 years of general surgery are prerequisites in preparation for the more specialized skill. Then spending 70-80 hours a week (more typical in surgery residencies) over 3 years is just over 10,000 hours.

So, if you’re seeing a young physician or an older, more experienced one, at least you can be assured they have all met their 10,000 hours in their field required to be an expert.