Summary: Life-long learning is a valuable and necessary habit of physicians, but not a useful objective for medical school, because it can not be evaluated. Description: I am regularly asked to contribute to MedEdWorld, a wonderful resource to stimulate the thinking about medical education. Reflections like this give space to be a bit provocative, so this title is meant that way.

I can hardly think of ‘modern’ medical education programs that do not state they educate for life-long learning. It has become a fad to add that to the objectives. It is really not very surprising, and many educators start recognizing that what they teach may be outdated or deficient at the time students graduate and certainly as soon as they start practicing. Doctors need to keep up with knowledge and skills, meaning that they both maintain what they know and can, but also add what they not yet know or can. They must possess flexibility and adaptive expertise. These qualities are not easy objectives for an undergraduate medical course, both for teaching and for assessment. I have yet to see which assessment approaches can validly measure such objectives. How would we ever know at graduation that LLL will happen?

To pretend that we graduate students who will be ‘life-long-learners’ is like a promise we can’t be hold accountable to. It sounds like the objective that our graduates will be happy doctors. I have never seen a study that examines whether people have learned their life long or not, and then looked back what the medical school did to make this happen (or not). In fact, I advise a PhD candidate studying CPD in older nurses who (rightfully) states that it is difficult NOT to learn while being a practitioner, and the diversity of learning activities and approaches at work is big. And in fact, I did see studies that examine whether doctors remain happy, not whether they remain life-long learners.

Of course, some practitioners are clearly excellent learners and some should do more, but I would like to boldly state that other factors determine whether they do this or not are far more important then the education received in medical school. Willingness to do so and stimuli arising from the context are probably dominant predictors of LLL behavior. A busy clinician, with little time to dig in the literature may or may not try to learn about an unexpected finding, a new protocol, may read the New England Journal of Medicine, the JAMA, the BMJ, and three or four highly relevant specialty-specific medical journals. Or not. Why? Because of their inquisitive nature or not, because their department values discussing novelties in journal clubs or other meetings or not, or because re-registration requires them to do so. Or not. Or in the rare case, when they need to know because of research and own publications. But because of their long time ago medical school’s education? I believe that if we really want to stimulate life-long learning (and we should want this), the structure of health care and the natural expectations at work should stimulate this and should include learning, next to doing. Re-registration requirements should be far more focused on life-long learning that they do now.

I have no problem with hoping our own graduates will learn their life long, but let’s limit the objectives for medical school to things we can truly evaluate. Learning skills would be terrific if we can measure these, but “life-long-learning” is a silly objective.