Educating Doctors

At a time when medical care for the people of the United States is undergoing wrenching change due mainly to vast and costly technological progress, doctors have had to cede much of their initiative and responsibility to third parties. Medicine has become a commercial enterprise. Patients must affiliate themselves with a managed health care organization in order to have access to their doctors. In the hurly-burly of today's techno-medicine, many physicians are too busy to spend time in dialogue with their patients. As a consequence, social and emotional circumstances that have been thoroughly documented to affect physiology and susceptibility to disease are overlooked. Stewart Wolf here critiques the medical establishment and the way those concerned with its various responsibilities discharge them. He puts medicine's responsibilities to society into historical perspective, relating it to social changes. He begins with the ways medical candidates are selected. He continues with commentary on currently designed teaching and learning, the qualities required in a physician and in a medical scientist, and the nature and challenges of disease and what can be done about them. Finally, Wolf provides a useful way of thinking about human biology, to better understand why people become sick or well and what people have to contend with to stay well. Throughout he emphasizes the role of the brain in controlling behavior of all sorts, general and visceral. Wolf emphasizes the regulatory power of the nervous system as it perceives and evaluates life experiences and influences learning, behavior, and susceptibility to disease. Wolf'sgoal is not to supply a recipe for the achievement of better health, but to encourage a better understanding of ourselves and the paths toward health. Educating Doctors reexamines the responsibilities, goals, and activities of the medical establishment. As such it is a must read for policymakers, sociologists, and professionals working in the medical field.

This book is designed to aid the faculty of medical and other health related schools in developing the pedagogical skills to transform their teaching in multiple settings including the classroom, the conference room, the ambulatory office, and the hospital from a passive learning experience to an active learning experience. In this transformation, the teacher morphs from the ‘all knowing expert’ to the ‘learning facilitator and coach’. After a brief review of adult learning theory the remainder of the book will focus on a broad variety of teaching techniques and classroom activities that ‘flip’ the classroom from a passive to an active learning environment. In addition to condensed explanations of each of the techniques, examples of each process will be presented with suggestions for flexing the techniques to better accommodate a variety of learning settings and a diversity of learners.

Recent surveys of medical students reveal stark conditions: more than a quarter have experienced episodes of depression during their medical school and residency careers, a figure much higher than that of the general population. Compounded by long hours of intellectually challenging, physically taxing, and emotionally exhausting work, medical school has been called one of the most harrowing experiences a student can encounter. Plumbing the diaries, memoirs, and blogs of physicians-in-training, Suzanne Poirier's Doctors in the Making illuminates not just the process by which students become doctors but also the physical, emotional, and spiritual consequences of the process. Through close readings of these accounts, Poirier draws attention to the complex nature of power in medicine, the rewards and hazards of professional and interpersonal relationships in all aspects of physicians' lives, and the benefits to and threats from the vulnerability that medical students and residents experience. Although most students emerge from medical education as well-trained, well-prepared professionals, few of them will claim that they survived the process unscathed. The authors of these accounts document--for better or for worse--the ways in which they have been changed. Based on their stories, Poirier recommends that medical education should make room for the central importance of personal relationships, the profound sense of isolation and powerlessness that can threaten the wellbeing of patients and physicians alike, and the physical and moral vulnerability that are part of every physician's life.

How Do I Look? Educating Doctors’ Senses Through the Medical Humanities uses the medical diagnostic method to identify a chronic symptom in medical culture: the unintentional production of insensibility through compulsory mis-education. This book identifies the symptom and its origins and offers an intervention: deliberate and planned education of sensibility through the introduction of medical humanities to the core undergraduate medicine and surgery curriculum. To change medical culture is an enormous challenge, and this book sets out how to do this by answering the following questions: How has a compulsory mis-education for insensibility developed in medical culture and medical education? How is sensibility capital generated, who ‘owns’ it, and how is it distributed, mal-distributed and re-distributed? What is the place of resistance (or ‘dissensus’) in this process? How can the symptom of a ‘developed’ insensibility be addressed pedagogically through introduction of the medical humanities as core and integrated curriculum provision? How can both the identity constructions of doctors and doctor-patient relationships be tied up with education for sensibility? How can artists work with clinicians, through the medical humanities in medical education, to better educate sensibility? The book will be of interest to all medical educators and clinicians, including those health and social care professionals outside of medicine who work with doctors.

EDUCATING PHYSICIANS The current blueprint for medical education in North America was drawn up in 1910 by Abraham Flexner in his report Medical Education in the United States and Canada. The basic features outlined by Flexner remain in place today. Yet with the past century's enormous societal changes, the practice of medicine and its scientific, pharmacological, and technological foundations have been transformed. Now medical education in the United States is at a crossroads: those who teach medical students and residents must choose whether to continue in the direction established over a hundred years ago or to take a fundamentally different course, guided by contemporary innovation and new understandings about how people learn. Emerging from an extensive study of physician education by The Carnegie Foundation for the Advancement of Teaching, Educating Physicians calls for a major overhaul of the present approach to preparing doctors for their careers. The text addresses major issues for the future of the field and takes a comprehensive look at the most pressing concerns in physician education today. The key findings of the study recommend four goals for medical education: standardization of learning outcomes and individualization of the learning process; integration of formal knowledge and clinical experience; development of habits of inquiry and innovation; and focus on professional identity formation. Like The Carnegie Foundation's revolutionizing Flexner Report of 1910, Educating Physicians is destined to change the way administrators and faculty in medical schools and programs prepare their physicians for the future.

The field of the medical humanities is developing rapidly, however, there has also been parallel concern from sceptics that the value of medical humanities educational interventions should be open to scrutiny and evidence. Just what is the impact of medical humanities provision upon the education of medical students? In an era of limited resources, is such provision worth the investment? This innovative text addresses these pressing questions, describes the contemporary territory comprising the medical humanities in medical education, and explains how this field may be developed as a key medical education component for the future. Bleakley, a driving force of the international movement to establish the medical humanities as a core and integrated provision in the medical curriculum, proposes a model that requires collaboration between patients, artists, humanities scholars, doctors and other health professionals, in developing medical students’ sensibility (clinical acumen based on close noticing) and sensitivity (ethical, professional and humane practice). In particular, this text focuses upon how medical humanities input into the curriculum can help to shape the identities of medical students as future doctors who are humane, caring, expressive and creative – whose work will be technically sound but considerably enhanced by their abilities to communicate well with patients and colleagues, to empathise, to be adaptive and innovative, and to act as ‘medical citizens’ in shaping a future medical culture as a model democracy where social justice is a key aspect of medicine. Making sense of the new wave of medical humanities in medical education scholarship that calls for a ‘critical medical humanities’, Medical Humanities and Medical Education incorporates a range of case studies and illustrative and practical examples to aid integrating medical humanities into the medical curriculum. It will be important reading for medical educators and others working with the medical education community, and all those interested in the medical humanities.

Sir Donald Irvine asks what further changes have to be made to the culture and regulation of medicine to make it as trustworthy as the public today expects. As President of the General Medical Council between 1995 and 2002, Sir Donald helped shape the changes that followed disasters like the deaths of babies at Bristol and the murders of Dr Harold Shipman. In this frenetic period a new ethos of professionalism emerged, embodying the concept of the autonomous patient and more robust, transparent professional regulation founded on a partnership between the public and doctors. Sir Donald discusses candidly the struggles in the profession and with successive Governments over the key issues. He provides perspectives that are both startling and enlightening. He criticises the British Medical Association for its past resistance to accept the need for change, and explains why its role in the future must be radically different. He calls for specific fundamental changes to the National Health Service, and for Government to be separated from managing the provision of healthcare. And he outlines the qualities that the bodies regulating doctors in the future must have to succeed. In part a personal testimony, in part a clarion call for doctors to secure the new culture and re-establish public confidence, The Doctors' Tale is gripping and essential reading for everyone who cares about health.

This concise, easy to read title is designed for clinical teachers looking to refine their approach to teaching professional attitudes and basic skills to medical students. Doctors differ in values, training and practice setting, and eventually they adopt diverse approaches to patient interviewing, data collection and problem-solving. As a result, medical students may encounter significant differences in the clinical methods of their tutors. For example, some doctors encourage patients’ narratives by using open-ended questions while others favor closed-questions; and hospital- and community-based doctors may disagree on the value of the physical examination. Medical students may be puzzled by these differences and by controversies about issues, such as doctor-patient relations and the approaches to clinical reasoning. This handy title is intended to help tutors address many of these issues, and to provide an approach not only to teaching patient interviewing and the physical examination but to teaching some clinically relevant topics of the behavioral and social sciences that are so vital to developing an effective, well-rounded physician.