As doctors, we can all remember the attending doctors who struck fear in our hearts or the senior residents who turned us into their personal scut slaves. Some people consider this a rite of passage: to tolerate abusive behavior by those who outrank us. Doctors train for years, deprive themselves of sleep and personal time. Is this truly an educational experience? Is this truly the way we should be passing on the education?
During my training, I learned under many great doctors and educators. But, I have also experienced the nasty grilling that strikes fear in the hearts of medical students the world over. In my experience, these power plays caused more anxiety than any true learning. And I served my tour of duty as a scut monkey under senior residents who liked to put students and interns to servitude, and often ridicule. I doubt any doctor cannot recall any incidents of humiliation during their training and education.
Now, as an attending doctor looking back, I see how unnecessary all this hazing really was. I teach many medical students and residents in my practice, some of them doing their core family medicine rotations and some just shadowing. I ask my students questions, but I never grill them or make them feel humiliated. And many of them keep in touch for years and let me know where their careers have traveled.
“This leads to a dangerous outcome: doctors who don’t know how to say they don’t know.”
I know that as an attending with over 15 years of clinical experience, I do not know everything. No one does no matter how many years they practiced. So, how can we expect those just starting out to do so? I witnessed many acts of ridicule on students simply because they didn’t know the answer to a question. This leads to a dangerous outcome: doctors who don’t know how to say they don’t know.
As doctors, we need to be able to say when we don’t know something. If I don’t have an answer for a patient, I will tell them so and I will find them the answer. If I don’t have an answer for a student, I will ask that we both look it up and later come back and discuss it.
How should we pass on our knowledge and experience to students?
- We need to understand that they are just learning and will not know many things. We need to gauge what they know and they do not.
- We need to make them comfortable to ask questions: any questions.
- Questions should be answered to the best of our ability. If we do not know, we should be able to tell our students where to find the answers.
- We need to give our students trust based on their abilities. No one can become a doctor without hands-on experience.
- We need to give knowledge based on our experience. Book learning needs to be married to real world medical experience.
- We need to be honest. If our student is doing something wrong, they need to know. This is the time for them to make mistakes, and learn from them. This can be done without ridicule and humiliation.
- We need to be a team. As the teachers, we may be captain of the ship, but everyone on the boat has a role to play.
There is a dire need for more doctors in the US. We want well-trained doctors to step up and fill the need. But, turning those trying to fill this void into our minions just breeds resentment: not education. Healthcare is rapidly changing in our country, and we need to get the humiliation and ridicule out of our training programs. The road ahead is tough for all of us. Perhaps the time is here to change this long-standing rite of passage?
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Dr. Linda Girgis MD, FAAFP, is a family physician in South River, New Jersey. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter’s University Hospital and Raritan Bay Hospital. Dr. Girgis earned her medical degree from St. George’s University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University and she was recognized as intern of the year. Over the course of her practice, Dr. Girgis has continued to earn awards and recognition from her peers and a variety of industry bodies, including: Patients’ Choice Award, 2011-2012, Compassionate Doctor Recognition, 2011-2012. Dr. Girgis’ primary goal as a physician remains ensuring that each of her patients receives the highest available standard of medical care.