Sunday, January 16, 2011

Which form of Competition is Best?

Just came back from watching my daughter compete in ballroom dance competition. It struck me as a cross between a swim meet and an evening at the theater. I can’t decide if turning an art and a pleasure into a competitive activity is a good thing, or not. 

Which got me thinking about medicine, as most things do. Because what we offer is such a scarce resource, we inevitably select people who are, quietly or openly, highly competitive. Then we continue to rank them, in tiny increments, right through the end of training. At the other end, the money and perks that go with practice, or not, seem to play right into the same attitude. 

On the one hand, competitiveness has made my daughter a fine dancer, and my own competitive streak keeps me pushing myself to accomplish things I might otherwise not. But I do wonder if the drive, not only to excel, but to outshine, is a barrier to learning really important things—like the value of doing something for its own sake, or just being with our families, our patients, the people we work with. By the time my kids finished swimming competitively, they no longer could swim for fun. As a friend, I never learned to hang out; now I only seem able to be friends with people while I am doing something. And much as I try to be receptive with patients, I keep them and myself to a very tight schedule.

What bothers me most is that medical students are so conditioned to rely on their competitiveness for motivation, they can quickly become indifferent or hostile to anything that does not seem to have immediate value for giving them a leg up. The idea of studying anything because it is of intrinsic interest, or might someday be useful, seems to fall away quickly in the first semester of school, and may never return. Since it is especially hard to compete on the basis of creativity, which, by definition, confounds existing standards, this, too, seems to be systematically discouraged in our students. Creative problem solving is an essential element of practice, not just a frill. But to ask “how can we reward creativity?” immediately puts us back in the position of selecting, rating, and favoring, the same dynamic that fosters competition.

Resigning totally from a competitive environment—the ashram approach—never appealed to me. It always struck me as a paradox of people competing to show how anti-competitive they were. I just wish our education—the one we had and the one we offer—allowed us to allow ourselves to freewheel more, and enjoy it. As recent posts and discussions have highlighted, being present in our immediate lives—reading chicklit, not postponing everything in hopes of a future haven, or choosing family time over work--is an important counterweight competitiveness as the root of our motivation, and our rewards.


  1. What do you mean by the "ashram approach"? Are ashrams places where people are not competitive?

  2. I totally get what you mean about the "non-competitive" people just being in a competition about who is least competitive. Totally backwards to me, but I'm a Type A Highly Competitive Overachiever.

  3. I think being competitive is good-- I just think we need to think about what we want to be competitive about. I've always found competing with myself the key, particularly when anyone tells me I can't do something. I was brought up (or maybe that was what I chose to take from my upbringing) to value learning something and tackling the hardest challenges over grades and being at the "top." In the end, that made me successful. I see a lot of people who hate what they do and are always miserable-- except it is so important to be "the best," they would be more miserable if they weren't doing what they are doing. I have a job I love. I sometimes wish I could be more enthusiastic about doing the things that matter for moving up, but overall focusing on the things I personally think are important seems to be working pretty well.

  4. I lack the competitive streak, which sometimes means I miss out on opportunities or that those who are more competitive assume I must be stupid because I am not driven to make sure I answer the questions etc.
    Mostly I am glad I march to the beat of my own drum. Perhaps it is the reason I have avoided some specialties that I am interested in, but I am happy with the adventure I have planned for life.
    Interestingly, My university decided that competitiveness among colleagues who work in a team environment was less than helpful, they did not release our marks. We would just get a pass or fail, for 4 years, until the top 10% of students graduated with honours. (in Australia) This was only possible because the hospitals moved away from a "ranking" system for job selection, and towards interviews and CV'c, But they had to ammend the rules for our American students, who needed marks and ranking for applying for jobs back home.

    My favourite couple of quotes through med school were
    "What do they call the person who graduates with the lowest marks? Doctor"
    "P's make degrees" and
    51% is 1% wasted effort.

    That being said, I have my own standards that i strive to and really did want to better than 51%, but didn't mind where I came in relation to anyone else.

    I don't think I;ve ever competed to be the least competitive either... but would be interested to know if others thought I had?!

    Thought provoking post

  5. Just wanted to add, when playing sports (having never been the most athletic person) the most enjoyable teams I have ever been in were losing ones. I love celebrating each goal (netball/basketball). Also in my recent venture as a new triathlete, I have met some top people at the back of the pack, which is where I am destined to stay. Sometimes losing really is fun. Truly!

  6. swim mom here. ;-) That is why I like THAT sport so much. Just the swimmer competing against the clock and trying to improve their time.

  7. I do think that drive to succeed is good, but the key is not being controlled by it. By the data, women tend to do this better:working in groups,collaborating for a set goal. However, my downfall is my kids. I do want them to succeed and have to curb the urge to push and foster their talents. Any thoughts on Amy Chua the "Tiger Mother" all over the news for how much she pushes her kids?


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