Had a great conversation with an outstanding intern yesterday. He is bright, thoughtful and has a great bedside manner. He also is self aware and understands that he still has much to learn about being a great physician. He will get there because he cares, he reads and he learns from his attendings everyday. He is in a program that will expose him to enough patients that he can develop expertise.
I am personally tired of the competence movement. We have only one necessary competency – becoming great physicians. We spend too much time worrying about systems based practice, which can distract from learning how to make diagnoses and decide treatments.
Becoming an expert physician can not occur from a textbook. It can only happen when one follows learning with experience. Many physicians fear that we have forgotten that truism.
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What the payment system hasn’t killed off yet, the residency review commission is working to complete.