Professionalism is a word I am well acquainted with in medicine. But what does it mean to be a scholar? Going as a medical student to the ‘Medical Professionalism Matters: The Doctor as a Scholar’ event I was unsure what to expect. I was intrigued from the offset by the title.
Is a scholar not a student of the humanities? A student pondering over some anthropology, or philosophy, in a grand armchair surrounded by stacks of books, sipping a large cup of tea. I quite like the sound of that, but I expect that may be a nuance to me! Before the event I started to think about the title, wondering if there is something, or anything in these primary thoughts.
The doctor as a scientist, stands in stark contrast as a concept no one questions, or misunderstands the importance of, or is confused about. It is one we are often keen to pursue and further. The study begins early in school, with STEM (science, technology, engineering and mathematics) subjects being highly valued, many undergraduates arrive with all three sciences and maths.
Perhaps we do not need to read philosophy or anthropology, but we do need to ‘read’ the patient, understand the patient, holistically. Science does not give us a full understanding of patients and medical teams. The person enjoys culture and art. It is often said that medicine is an art. Is that art scholarship? The art of practicing medicine.
I’m currently learning to spot the classical presentations of disease, but as Dr Aidan Bannon helpfully pointed out on the panel it is often not so classical. If the art of identifying atypical presentations are not learned, diagnoses will be missed, and if the art of communication is not developed then effective and proper partnerships between patients and doctors will not be formed, and patients may not share their real concern, or their embarrassing symptom.
So, what does it mean to be scholarly? I have concluded that to be a scholar is to have a type of attitude. An attitude of intentional thinking, evaluating, and learning from experiences and knowledge, it is being ready to take time to solve the problem, or to ask how practice could be improved. It includes the study of science, and research but it is not exclusive to it. It will reach further to improve the holistic care of patients and the whole medical team. It will be aided by innovation and ideas from within and from outside the medical field.
How then can one be scholarly? It is unlikely I will be involved in research at this stage, but I can have a scholarly attitude. I can ask questions.
Questions like these:
- Why did I do that? Could this be done any other way?
- How can that problem be overcome or diminished?
- Should that be like that? What should I do about it?
- What do I know? What do I not know? What should I know?
Reflecting on the conference I’d like to share how I have tried to broaden this into practice.
As a medical student taking histories and completing examinations is common. Do we judge their success on what was included or forgotten in the history or examination, and on whether the conclusions reached were correct? All this is good to do, it is crucial to learn and reflect from, but what weight do we place on understanding the patient, on taking time to get to know them a little, allowing the patient to feel at ease, seen and cared for? Let’s remember to treat patients as patients and not ‘props’ to learning, to reflect on what factors affect communication with patients and learn to practice the best way we can.
It is easy as a medical student to arrive into the clinical setting with a fear of being exposed for not knowing this or that. A game of hiding then begins. This can of course backfire, when it is spotted! But perhaps, a better and more scholarly attitude, would be to admit openly and honestly, ‘I will try with what I know’ or ‘I do not know that’, and be ready to learn from another the answer or skill. Practicing medicine is a team activity, one we should start when we are learning. Each of us have limits to our knowledge, and blind spots, how great it is that we can gain advice from one another. Small groups are great to study and practice skills in, you can ask questions together, share knowledge and receive feedback. I’d really encourage any students out there to form a little group!
Christy Reid is a fourth year medical student at Queen’s University Belfast.