There is no appeal to evidence that does not rely on an accepted paradigm. The relationship between evidence and theory may hinge more on psychology than on logic or the pursuit of objective truth.

Prognostication means informing patients what the outcome of their illnesses and treatments are expected to be, based on the best available evidence. Prognosticating in a way that helps patients in decision making about treatment is difficult for physicians to do.

That is how William Osler portrayed the medicine he practiced at the turn of the last century, but he might as well have been describing the current era of “evidence-based” medicine.

Our system of medical education and postgraduate medical training rewards the accumulation of publications (abstracts, posters, presentations, and papers) rather than the pursuit of truths. The consequences of all this bad science are not felt by researchers, whose careers may be propelled by these erroneous results, but by the patients who are subject to medical practices the validity of which is uncertain.

Reprint of Stephen Jay Gould's essay “The Median Isn't the Message.”

While medical training admissions processes have often focused on the qualities residing in the individual, the applicant's ability to build relationships is equally, if not more, important.

For the dean's letter to be valuable, it should be an objective and unabridged summary of the student's performance without obscuring or eliminating the very information that might predict difficulty in residency.

Admission committees are attempting to assess candidates holistically, looking for qualitative aspects of character such as empathy, emotional intelligence, and values.

The different social messages conveyed to male and female medical students may contribute to unequal representation in certain specialties.

Uncritical reliance on individual physicians' tacit knowledge about professional competence could lead to evaluating applicants and students according to idiosyncratic or outmoded standards.