I shared my assessment and plan with the preceptor as she walked into the room. She cut me off, “You think this patient needs surgery?” she smirked. “He has no idea what he is talking about, don’t mind him,” she whispered loudly to the patient. I kept quiet until the patient left, and my preceptor began writing her note. I pulled up a recent research article I had found prior to interviewing the patient and explained why I had suggested surgery. “OK, but I don’t do it that way, bye!” she replied without turning her head from the computer screen. I left the room, not entirely sure why we had decided on the course of management we did.
The clinical practice of medicine is fascinating in that teaching and mentoring is an integral part of the profession, yet there is very little medical training on how to be an effective educator for both students and physicians in our current training model.
One may make the argument that they did not sign up to teach their colleagues when they signed up to practice medicine. But few physicians would say they did not sign up to take care of patients. Having knowledgeable future physicians who are inspired, passionate, and excited to strive for improvement is in the best interests of everyone in the field and will ultimately benefit the most important people in the field: the patients.
But who are the best educators for medical students in medicine? From my own experiences, I have found they have three key qualities. They serve as a role model, they are able to mentor, and they have learned to teach. I define a role model as someone students aspire to be like, a mentor as someone who is able to guide students in their career, and a teacher as someone who is able to effectively explain clinical and medical information in a way others can understand and apply themselves.
Even embracing one of these qualities is important. Many physicians may have too much of a workload to mentor or may not have a knack for teaching but can serve as a role model by engaging in professional behavior with their colleagues and patients. The vast majority of medical practitioners fulfill this role, and with deference to the busy workload of a physician, it is enough for students.
Teaching and mentoring require a further level of personal investment, and require formalized feedback and experience to master. Medical schools often offer tutoring, teaching assistants positions, and peer mentorship groups. However, oftentimes, there are selection processes that exclude interested students, or these opportunities are not readily available at all medical schools. Some residency programs offer residency teaching courses, which can be an invaluable resource in creating physician-educators. During most medical schools primary pre-clinical curriculum, interested physician faculty who generally have an interest in teaching and mentoring have the opportunity to run didactics sessions or problem based learning with students. Institutions with residency programs often have training for faculty to help them teach and mentor residents.
However, in many of these instances, there is an optional component, and medical students or physicians have to actively seek out those institutional programs that provide these opportunities. Perhaps the selection criteria for medicine should aim to seek out those with individuals with comfort with teaching and mentoring.
When selecting interested applicants into medical school and residency, rather than creating a numerical arms race with GPA and MCAT, it is worth formulating selection criteria for holistic qualities including experiences with teaching and mentoring. It is worth building an educational curriculum where mandatory training on teaching and mentoring is built early on in medical school and continued throughout residency training. In this way, a physician also becomes a master educator and can give back to the medical field while practicing.
I remember a particularly good learning experience. I shared my assessment and plan with another preceptor when she walked into the room. “That was a good presentation, but another area we want to ask is about school performance. Chronic ear infections can often cause problems with hearing and speech, and we need to make sure we address that element when we see patients with ear infections,” she explained to the patient and myself. This was a simple point and took five seconds, but an invaluable and relevant medical consideration. This is one example, but there are many phenomenal educators in medicine who are able to make an impact on student’s lives and even help a student cultivate a passion for their field that they may have not discovered without their guidance.
Although those who did medicine may not have wanted to be an educator, by taking part in the practice of medicine, you are by definition an educator, both to your colleagues and patients.
Kunal Shetty is a medical student.
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