Divergent Thinking Among Medical Residents: A Comparison Between Pediatrics and Internal Medicine

Creativity is increasingly recognized as an essential component of adaptive expertise in contemporary medical practice, supporting clinicians’ ability to navigate diagnostic uncertainty, communicate effectively with diverse patient populations, and respond flexibly to complex clinical situations. Divergent thinking (DT)—the ability to generate multiple, flexible, and original ideas—is considered a key cognitive indicator of creative potential. Although creativity is highly relevant to medicine, particularly in patient-centered fields, empirical research on how medical specialties may foster or constrain DT remains limited. Pediatric medicine, which frequently involves multimodal communication, imaginative engagement, and management of ambiguous behaviors or non-verbal cues, may provide richer opportunities for developing creative cognitive processes than the more structured, protocol-driven environment typical of internal medicine. In addition, life-context factors such as gender and parenthood may also influence creative cognition, yet their contribution within medical training has rarely been assessed. This study examined whether residents in pediatrics differ from those in internal medicine in verbal and figural DT, and whether gender or parenthood explains additional variability. Fifty-eight residents (30 pediatrics; 28 internal medicine) from a major academic medical center completed validated verbal and figural DT tasks from the Runco Creative Assessment Battery. Fluency, flexibility, and originality were scored for each domain. Group differences were analyzed using MANOVAs, univariate ANOVAs, and two-way ANOVAs, and effect sizes were calculated. Pediatric residents demonstrated higher DT scores across most indices, with statistically significant differences in verbal flexibility and in all figural DT measures. Effect sizes were medium in magnitude, indicating meaningful cognitive differences between specialties even when some comparisons did not reach statistical significance. A significant interaction emerged for figural originality, wherein male pediatric residents scored higher than male internal medicine residents, while no such differences were observed among female residents. Parenthood showed a specialty-specific pattern: among internal medicine residents, those with children scored higher on figural DT, whereas no substantial differences were found among pediatric residents. These findings suggest that specialty environments, communication demands, and clinical interaction patterns may shape creative cognitive tendencies during residency. The results highlight creativity as an important yet underdeveloped competency in medical education and support integrating creativity-enhancing training and more flexible, supportive learning environments into residency programs.