P*mping in Medicine (learning or hazing)

By: Samiha Saifudeen Improve Life PLLC Research Intern

“Toxic quizzing,” often referred to as “p*mping,” (stands for "put in my place) remains a longstanding practice in medical education. While some educators defend it as a way to challenge students and encourage quick thinking, its real impact raises important concerns. Increasingly, evidence and student experiences suggest that, rather than enhancing learning, this approach may undermine both education and well-being.

At its core, p*mping is intended to assess knowledge and stimulate critical thinking. However, in practice, it often emphasizes the rapid recall of obscure or highly specific facts rather than meaningful understanding. For example, instead of guiding students through the reasoning behind a patient’s diagnosis or treatment plan, instructors may focus on rare eponyms or trivial details. This approach prioritizes memorization over clinical reasoning—the very skill that is essential for effective patient care. Knowing isolated facts may appear impressive in the moment, but it does not necessarily translate into the ability to think critically or make sound medical decisions.

Beyond its academic limitations, the emotional impact of toxic quizzing is significant. Many students report feelings of anxiety, embarrassment, and even humiliation during these interactions. Such an environment can be counterproductive to learning. When individuals are preoccupied with avoiding mistakes or public embarrassment, their ability to engage deeply with the material diminishes. Research in education consistently shows that learners perform better in environments where they feel psychologically safe, supported, and encouraged to take intellectual risks.

Proponents of p*mping often argue that it prepares students for the high-pressure nature of clinical practice or point out that the method “worked for them.” However, this reasoning is flawed. The persistence of a tradition does not guarantee its effectiveness. Moreover, the relationship between stress and performance is complex. While moderate levels of challenge can enhance focus, excessive stress impairs cognitive function, reduces retention, and discourages curiosity key components of meaningful learning.

Importantly, questioning itself is not inherently problematic. In fact, when used appropriately, it is one of the most powerful tools in education. Thoughtful, open-ended questions can promote critical thinking, deepen understanding, and encourage active participation. The difference lies in the approach. When educators create space for students to admit uncertainty, explore ideas, and learn without fear of judgment, questioning becomes a constructive and empowering process rather than a punitive one.

Ultimately, toxic quizzing represents a low-value educational practice. It lacks strong evidence of effectiveness and carries clear risks for learner well-being. Medical education should prioritize not only the acquisition of knowledge but also the development of confident, thoughtful, and compassionate clinicians. Creating a respectful and supportive learning environment is not simply beneficial for students it is essential for the future of patient care.