Would Most Doctors Pass The Stanford Marshmallow Test?

The premise of the marshmallow test is simple.

Put a young child in a room with a marshmallow. Promise them two marshmallows if they can wait 15 minutes without eating the marshmallow. Those who waited demonstrated the delayed gratification skills that were correlated with future success in school and life.

These experiments were replicated numerous times since the original experiments in the 1960s, and an entire literature on the marshmallow experiment and its implications on self-control was born. While famous in psychology circles, it gained mainstream attention when conservative columnist David Brooks of the New York Times cited it in an op-ed column.

The lead author of the original marshmallow study, Walter Mischel of Columbia University, wrote The Marshmallow Test: Mastering Self-Control by Walter Mischel in 2015, which describes the marshmallow test and its related studies and self-control and described its implications for parents, savers, and public policymakers.

One of the reasons why the marshmallow test has captured the public’s imagination is because it instills a competitiveness in ourselves as parents. Would my children pass the marshmallow test? If so, what does that mean for his or her future success? And if they fail, is he or she doomed to a career of mediocrity and impulsiveness? Most importantly, can success on the marshmallow test (or any other test of self-control) be taught or improved or is it innate?

As Walter Mischel readily admits, the results of the marshmallow test are merely correlations, and that while as a population children who pass the marshmallow test do better later in life, that does not that mean individuals who fail the test are doomed. In fact, much of the book is devoted to the strategies that can help children, as well as adults, improve self-control so that they are more likely to pass the marshmallow test, as well as more important tests, such as controlling weight or quitting smoking.

Would most physicians have passed the marshmallow test?

My guess is that most physicians would have passed the marshmallow test.

Every physician passed the marshmallow test as college students, when they chose to study for a few extra hours to do better on their tests rather than relax with friends or play video games. They were rewarded with an acceptance to medical school, enabling them to enjoy (hopefully) lucrative, fulfilling careers as physicians.

And since passing the marshmallow test was correlated with future success, as measured by higher income or higher SAT scores, than being a physician should also be correlated with passing the marshmallow test.

Falling Off The Wagon: Saving For Retirement After Residency

Unfortunately, many physicians rapidly inflate their lifestyle once they finish residency and fellowship. After more than a decade of deprivation, they could not stand to live the medical student / resident lifestyle any longer and quickly inflate their spending to match their new income. They do not save as much as they could during the most critical early years following residency, and they end up having to catch up later or fall short of their retirement goals.

There is an unlimited number of toys that high-income professionals can spend on. Exercising the self-control to not spend all of their money and continue to save is similar to a marshmallow test for adults. Save a little more now and hold off on buying the mansion or the sports car, so that you can enjoy a better (or earlier) retirement later.

I think the major reason why physicians struggle to keep their spending in check after residency is the long length of medical training. Once you go past the first few years of medical school, it becomes very difficult to get off the treadmill of medical training. The delay of 7-12 years after college in earning significant income isn’t a demonstration of physicians’ abilities to exercise self-control. Rather, it is “forced” upon them. As their college classmates build their dream homes and drive fancy cars while working in jobs on Wall Street, Silicon Valley, or engineering, medical students and resident physicians have little choice but to live like a resident because of their student loan burdens. As a result, there is a strong urge to finally rapidly inflate their spending once they finally complete residency and start making a big salary.

Tips to Help You Improve Your Self-Control

Fortunately, the core of Dr. Mischel’s decades of research demonstrates that willpower can be taught, and that self-control is not just a personality trait. Here are some of the tips that he offers in his book:

Look at your future self

Dr. Mischel quit smoking after walking past a patient being rolled towards the radiation oncology department for lung cancer treatment. Whenever the urge to smoke another cigarette hit him, he looked at his future self, ailing with lung cancer, and this thought was enough to resist the cigarette.

Studies have shown that if you spend time thinking about your future self, rather than your present self, you are more likely to make decisions that exercise better self-control. Before electing your 401(k) contributions or buying that fancy sports car right after residency graduation, spend a few moments thinking about your 65-year-old self. Those who do tend to save more than those who don’t.

If/Then statements

Another tip is to pre-program if/then statements in your mind to help combat the most common situations where you need to demonstrate self-control. For example, when losing weight, one if/then statement might be “If I see the dessert spread in the hospital cafeteria, then I will look away and say to myself ‘I can’t eat that. I’m on a diet.'”

One powerful motivator is to promise to donate money to an organization you dislike (e.g. the rival college) when you fall off the wagon. In the previous example, your if/then statement might become, “If I see the dessert in the hospital cafeteria, then I will look away and say to myself ‘I can’t eat that. If I do, I’d have to donate to the Ohio State (or Michigan, if you are an Ohio State fan) football program.”

Hot Versus Cool Focus

Dr. Mischel observed that children were able to resist the marshmallow longer if they considered the non-appealing parts of the marshmallow. You can divide characteristics of a marshmallow into hot and cool foci: hot foci of a marshmallow might be its chewiness or the sweetness you experience when you eat it. Thinking about these aspects of a marshmallow makes it harder to resist. Alternatively, cool foci of a marshmallow might be that it’s round, white, and small. Thinking about these aspects of a marshmallow made it easier for children to not eat it.

One way to apply this to big spending decisions is to think about the cool foci rather than the hot foci. When purchasing a car, think about it as a mode of transportation to get you from home to work, rather than its leather interior, flashy colors, or going from 0-60 in 3.2 seconds.

Conclusion

I’m confident that most physicians would have passed the marshmallow test as children. The sustained willpower to focus on studying during college rather than playing video games shows that they understood the future rewards of working hard in college. However, some physicians do fall off the bandwagon when they rapidly inflate their lifestyle following residency. Fortunately, there is extensive social science research which demonstrates multiple techniques to help improve self-control in our many financial, health, and life decisions.

What do you think? Would you have passed the marshmallow test as a child? Do you think most physicians would have passed the marshmallow test as children? Do you think self-control is innate, learned, or a combination of both?