The case for Lacan in medical education

In this article, we explore the potential role of Lacanian psychoanalytic ideas in contemporary medical education research and practice. We discuss the background to current medical education, the identity of the doctor as “subject supposed to know,” and the role of discourse and transference. We finish by examining existing medical education pedagogy, specifically simulation, and offer a novel Lacan-inspired idea, the “simtom.” The “simtom” encapsulates the idea that reliance on simulation-based education is a symptom of the inability of a system to deliver effective workplace learning. Consideration is given to the symptom’s origin, how it is enjoyed in contemporary medical education, and what harm it may produce. Due to its increasing popularity, we regard the rise of simulation-based education as functioning analogously to a sinthome: a fourth ring in the Borromean knot of healthcare that is sustaining the current practice of medical education. We suggest the term “simtom” for this concept which is Lacanian in origin and indicative of analytic potential in simulation-based education.