Everything bad is good for you

BMJ 2006; 333 doi: (Published 14 September 2006) Cite this as: BMJ 2006;333:600
  1. Kieran Walsh, clinical editor (bmjlearning{at}
  1. BMJ Learning

    There is no shortage of complaints from doctors these days about dumbing down. Consultants complain that they can't trust their registrars any more, and registrars say that foundation year doctors don't get enough experience and don't know what they're doing. And grumpy old men everywhere complain that exam results don't mean what they used to. But what objective evidence do we have that medicine is being dumbed down? The truth is that there is little such evidence that doctors are better or worse than they were a generation ago. Mowa and Alcolado have shown a large increase in the number of final year medical students being awarded honours, but this could reflect either smarter students or lower standards.1

    The reason that we have such little evidence is that the context in which doctors practise medicine has changed. Early medical curriculums concentrated on doctors' retention of knowledge, but more recent ones emphasise the importance of skills, attitudes, and behaviours. But if we look beyond the world of medicine then we see strong evidence that IQ scores of the population at large are rising, a phenomenon dubbed the Flynn effect. Because of the Flynn effect, IQ tests are periodically readjusted, making them harder.2 Why is this happening? Steven Johnson, author of Everything Bad Is Good for You, attributes it to the rise of the popular media and computer games. Could it be that the hours we spend on the internet and playing games are teaching us vital skills such as understanding complex systems and spatial awareness? Are more sophisticated games enabling us to learn strategic thinking?

    The interactive case histories presented by BMJ Learning are designed to help you learn knowledge and skills in a safe environment—without anyone looking over your shoulder. One of the latest is on acne: it starts by explaining the basics of diagnosis and treatment and goes on to deal with more complex clinical problems such as how drug induced acne differs from acne vulgaris. It also looks at other issues such as how to advise a patient with mild acne but who is very distressed by it. To have a look, go to


    1. 1.
    2. 2.
    View Abstract

    Log in

    Log in through your institution


    * For online subscription