Wednesday, February 04, 2009

Good or Bad Medical Educators?

Wilson was inwardly thankful that his long day of assisting in the operating room was finally coming to an end. As a fourth-year medical student heading toward a residency in surgery, he had at first been ecstatic when he secured a rotation with Dr. Cartwright, a renowned surgeon and head of the trauma surgery service...

On the first day that Wilson was allowed to assist in the operating room on a fairly stable case, Dr. Cartwright had seemed to be in a nastier mood than usual. He raised his voice when he thought the nurses were too slow in complying with his orders or when supplies were not immediately available. He swore audibly on most of these occasions. Wilson had earned honors in the surgery clerkship during his third year of medical school and was fairly confident in his skills. On this occasion, he couldn't do anything right apparently. Dr. Cartwright upbraided him each step of the way, constantly criticizing how Wilson was holding the retractors. He sometimes simply shoved Wilson's hands out of the way or rapped him on the knuckles with the instrument he had in hand at the time. When it came time to close up, Dr. Cartwright's patience seemed to have reached an end, and he simply pushed Wilson out of the way, finishing up the sutures himself.

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Medical education or training of young doctors have always been an apprentice system. Though recently there have been moves to make it less person-dependent and more task-orientated. The reason is that the apprentice system depends on persons- senior doctors! And persons comes with attitudes and personalities.

An ideal medical educator will be a person with cutting edge medical knowledge and wisdom on his or her finger tips, pleasant personality and an helpful gentle encouraging attitude. Unfortunately these three positive combinations in one person is hard to find. Often a student have to bear with or struggle with one or two negatives or even, horrors, three negatives in their tutors.

Does that means students do not learn? No, it just means that they have to learn to deal with their tutors for that too is a fact of life and the earlier they discover that nothing is given to them free on a silver platter, the better. While I am not condoning abusing behaviour on the part of medical educators, I am against the move to make every medical educator, and every medical experience a pleasant one for the students. The students will soon discover when they graduate that the world outside is not a nice place and that not everyone they meet is kind. And that their medical career involve coming to terms with persons that are difficult. Personally I believe that dealing with their medical tutors, however weird they are, is part of their learning experience.

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