Great Health Care Requires Great Medical Educators

This lack of respect for education can contribute to another problem, a dearth of resources. To educate future physicians, we need time, money, equipment, and personnel. If medical school faculty members become too busy caring for patients or doing research, they may not have time to teach. Because tuition revenues tend to be fixed, leaders may shift funding away from education to purposes that can generate additional revenue. Eventually, the size of teaching faculties may decline, at least relative to the number of students. Faced with such challenges, we need to remember that medical schools exist to educate physicians. All other responsibilities should flow from this.

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On the up side, there are several steps we can take to enhance the performance of medical educators. One is to make sure that educators remain engaged and challenged by their work. There has been a trend toward increasing centralization in US medical education, with a central authority determining what gets taught, how, when, where, why, and to whom. Here is the problem with that. Once educators become mere implementers of others' ideas, their level of engagement and growth diminishes. Education at its best more closely resembles a relationship (e.g. friendship) than assembly-line mass production. The personal commitment of educators is a vital

The moment medical educators stagnate, they begin to begin becoming disengaged and ineffective. Students can tell when an educator is just going through the motions, and it takes a huge toll on their enthusiasm. We need to keep educators engaged with students and excited about teaching by encouraging them to innovate and grow in their work. Great teaching is not a matter of knowledge transfer. Instead it involves a pursuit of knowledge shared by educators and students. Great educators don't merely tell students what to memorize; they engage their imaginations. They encourage learners to begin asking good questions, which is exactly what good doctors do.

Perhaps the greatest lure to excellence in medical education is the opportunity to see students flourish as medical professionals and human beings. It is deeply fulfilling to know that some bit of knowledge or skill an educator has promoted has enabled a student to make a positive difference in the life of a patient. It is even more so to see a former student thriving in the practice of medicine, making a real difference in the lives of patients every day fully and developing fully as a human being. Each medical educator is like a candle that has been set alight by the prior generation and has the opportunity to pass on the flame to the next, ideally burning a bit more brightly.

I had one particularly great medical educator who happened to be a Nobel laureate. But what made him great as a teacher was not captured by any of his accolades. It was to be found in the gleam that appeared in his eye and the quickening of his pace that occurred every time he or one of his students formulated a good question. In the words of one of his former students, no one came under his influence "without discovering in themselves unrecognized abilities and powers." In short, he didn't just teach facts, he taught learners to discover. He taught us to plumb the depths of our capabilities. A great educator, he helped to train many fine physicians who carry on his passion today.

When many of my colleagues and I look back on our own medical education, we are struck by how often the biggest difference was made not by curriculum or technique, but by the character and passion of a few great medical educators. These giants taught us not just facts and skills but how to interact with patients and colleagues, how to handle errors, how to balance the personal and professional dimensions of life in medicine, and how exhilarating it can be to feel that we contributed something important to a patient's life. The giants of medical education, like all great teachers, are benefactors of their students and communities, but they are also benefactors of mankind.

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Richard Gunderman, MD, PhD, is a contributing writer for The Atlantic. He is a professor of radiology, pediatrics, medical education, philosophy, liberal arts, and philanthropy, and vice-chair of the Radiology Department, at Indiana University. Gunderman's most recent book is X-Ray Vision.

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