Why “High Yield” Thinking is Harmful in Medicine

 You may hear medical students talk about “high yield” and “low yield” topics, the idea that some things are worth learning because they’ll score marks, while others can safely be ignored. I, like many others, find this discussion at best irritating and at worst exasperating or even offensive. Why?

This mindset is short-sighted and demeaning to patients and their experiences. Labelling parts of the curriculum as “low yield” suggests they are less valuable, when in reality, every condition, system, and clinical story matters to the people living it. The “rare” syndrome, the “niche” complication, or the “uncommon” presentation may be the defining moment in one patient’s life - and the patient in front of you deserves your full attention, not a calculation of yield.

There is also a degree of arrogance in the “high yield” mindset. As students, you do not yet have the experience to judge what will or won’t be important in your future practice. What feels irrelevant today may be critical tomorrow. Senior medical educators have designed the curriculum with decades of accumulated wisdom. To dismiss parts of it as “low yield” is to assume you know better than those who have seen the consequences when knowledge gaps harm patients.

Focusing only on what might appear in exams encourages skipping over knowledge simply because it’s uncommon, uninteresting to you, or because you don't yet have the experience to understand its value. That erodes your future readiness as a doctor and risks patient safety. Medicine is built on breadth as well as depth - on curiosity, humility, and a willingness to take every presentation seriously. You don’t get to choose which patient walks through your door. When it’s their story, it will always be high yield.

Instead of chasing the most marks for the least effort, or trying to be “strategic,” aim higher: focus on becoming the best doctor you can be. That means:

• Building strong foundational concepts that you can apply across conditions.
• Seeking integration: understanding how systems connect, not just isolated facts.
• Practising clinical reasoning: applying knowledge in scenarios, not memorising lists.
• Reflecting on the kind of doctor you want to be - one who values marks, or one who values patients.

Exams will come and go, but your patients will live with the consequences of how seriously you approached your learning. Choose to respect the curriculum, respect your educators, and above all respect your patients - because in real medicine, everything is high yield.