The Wisdom of Youth: Docs on what they've learned from those they've trained

Dr. Clover Hemans, primary care physician and past-president of the Federation of Medical Women of Canada in Burlington, Ont. Never underestimate the power of lived experience. Trainees and students bring a new lens/perspective that might be missed in those with multiple exposures (in itself a type of bias—though I’m not disrespecting or dismissing this type of conventional, experiential wisdom!). Students and trainees offer you multiple opportunities to learn from their challenges if you listen and reflect. They are often able to bring more details from patients that can change/add opportunities for care, rehab, reintegration back into their own community. Read: OMA tackles relativity with new report examining income linked to education Years ago, I was facilitating a session with students, patients and some faculty on maternal-child health and the multiple challenges and opportunities associated with teenage pregnancy, birth and child rearing. A young mom noted that in the delivery room, everyone was giving her the disapproving eye.… They seemed only focused on the pitfalls of having a baby as a teenager to the point that when the baby was born, not one person congratulated her on successfully delivering a healthy child! What a wake-up moment! It was a profoundly uncomfortable (for me almost heartbreaking) moment. Before I could comment, a student stood up in class to apologize for our arrogance and bias. The bias we carry as healthcare personnel who believe we know more/ know better was exposed in that moment. The student clearly saw this and authentically sent a long overdue apology in the moment. I have never forgotten it. Age might bring wisdom, BUT lived experiences—particularly the difficult, anguish-filled ones (and yes, occasionally the true, pure-joy infused ones) impart an existential bridge to learning about what really matters in life. Wisdom is not restricted by age, status or educational ranking. That’s another thing I learned from my mentees, students and trainees. In life, we are all in it together. How you live it is influenced by how you see it. Dr. Erica Lasher Coates, FP in Meteghan Centre, N.S., and preceptor for learners from the Dalhousie family medicine residency program, South West Nova Teaching site. I still remember the first time I was asked by our department if I would be willing to take on a family medicine resident for a two-year preceptorship. My instinct was to say, “Who, me?” I wondered what I had to offer as a preceptor, as a mentor . . . I assumed I would gain something valuable in teaching medical students and residents but I don’t think I realized it would become such a passion. Agreeing to be a preceptor was career-changing for me. It reinforced the true passion I had (and have) for family medicine and my patients. Being a mentor allowed me to be a better and more conscious physician and reminded me why I chose this career for myself. Read: Driving culture change in medical education I can think of countless ways in which students and residents taught me humility, kindness, patience and so many other qualities that make me a better physician. I remember the times when they’ve challenged me and also the times when they made me dig deep for answers I didn’t have. I hope that each of them can one day know the joy of teaching/mentoring but also the impact that they have on their preceptors in return. We probably don’t tell them enough. Dr. Rod Lim, associate professor and site chief, pediatric emergency department at the Children’s Hospital at London Health Sciences Centre, London, Ont. Sometimes, when I am coaching and mentoring students, I see a better version of ourselves. We have a lot to offer the students on navigating the challenges of a medical career, mentoring them on how to keep their head above water, and sharing what decisions in our life we wish we had made differently. They in turn remind us of our love of the profession, the mission to help and care for others, and lately, a better, more professional view of how we treat each other and those in the community. I love that through our learners, we are seeing demands on protecting vulnerable people, non-tolerance of the way a certain doctor behaves, and the hope of a balanced professional and personal life. Read: Medical education needs reform to reduce physician burnout: FMF panel Dr. Daniel Ezekiel, FP in Vancouver, UBC professor. Many years ago, shortly after starting my family practice, an old teacher of mine asked me if I had ever considered teaching medical students. I distinctly remember suffering from “Impostor Syndrome” in those early days of my career, and my immediate response was no, I could never do that. Fortunately for me, that old teacher did not take no for an answer and gently pushed me in the desired direction. Now, 24 years later, I am keenly aware that the experience of teaching medical students has given me so much. I teach two quite different groups of medical students. The first group hails from my local medical school at the University of British Columbia. These students are in their first and second years and are still very green. They ask questions that are often so basic that it forces me to dig deep into the pathophysiology of diseases and think about things I have not thought about for many years. At this relatively late stage in my career, there are many things in clinical practice that I simply take for granted, but when a student asks me “Why is that so?” I take pause and really have to reflect on why I think that. Could there be an alternative I had not considered? Then, I have to explain my rationale to the students. As they say, you don’t really understand something until you have to teach it to someone else! Read: Educational materials aid hospitals in mandatory reporting of drug, device incidents The second group of students I teach are Canadians who are studying medicine abroad and are desperate to find a way home. These students are usually in their last year of medical school and spend some of their elective time with me in order to see the Canadian medical system at work and, hopefully, garner a positive letter of reference from me in support of their applications to Canadian residency programs. Some of them have never been exposed to family practice. These international students often come long distances for the experience and spend every day with me for a month. Initially, I was uncertain and apprehensive about the quality of their training, but I was dead wrong. They, too, are a joy for me to teach as they are ultra-keen to help in my office and ask many, many nonclinical questions, like how to build a practice, how we are paid, how we order supplies, how we negotiate a lease, and so on. It gives me great pleasure to spend time with them after the work day is done, just mentoring them on their journeys. So go teach some medical students! Sure they might put you a little behind schedule, but you won’t regret it! Dr. Matthew McInnes, professor, department of radiology, University of Ottawa. One thing I have learned from the many great trainees that I have worked with is that there are many paths to success. The path I followed is not necessarily the correct one for a trainee who is in a different situation. For example, sometimes I work with people from different countries who have already done many years of training in a different specialty. So understanding people’s backgrounds, various skill sets and personal/professional situations is critical when developing a teaching and/ or mentoring plan for them. Read: Educational toolkit about cannabis intended for health professionals Dr. Mike Wadden, FP in Kentville, N.S., and preceptor for the Dalhousie family medicine residency program, Annapolis Valley teaching site. There is an old saying that you really do not know something until you must teach it, and that is certainly true in medicine. Being challenged constantly by learners has spurred me on to do more reading and critical appraisal of evidence—and not just use treatments because of dogma. They have improved my practice. The different perspectives and novel ways of thinking of each learner add different perspectives to the care of patients. Even the most challenging learners teach you things about yourself both professionally and personally. Dr. Melissa Yuan-Innes, emergency physician in Alexandria, Ont. I was a bit nervous about teaching at a tertiary hospital after being away from academia, but an FRCP(C) resident told me I was her best teacher because I asked her for her learning objectives, and then ensured that she got to attend a conscious sedation, even though it wasn’t my case. I was touched. Read: Educational efforts reduce docusate use in hospitalized patients A medical student taught me that we still have a long way to go. There was no dedicated pumping space at her school. New moms were expected to take a 20-minute shuttle ride elsewhere on campus. This is ridiculous. Another resident opened my eyes to discrimination. Part of the bias against her, I’d say now, was the fact that she was an international medical graduate. So sad how physicians eat our own.

The Wisdom of Youth: Docs on what they've learned from those they've trained

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