On treating medical students with respect


Category : Medical Rants

I spend much time talking with medical students.  It is part of my job, but more than that I like medical students. 

What should be the goal of medical schools?  I believe we have an obligation to help our students grow into great physicians.  What philosophical principles should we use?

Perhaps the answer to success is Servant Leadership.  As I learn more about this concept, I hope that have become a servant leader.  My guess is that often I am, but perhaps I must strive to do this even better.

Here are the basics of servant leadership:

"The servant-leader is servant first… It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. That person is sharply different from one who is leader first, perhaps because of the need to assuage an unusual power drive or to acquire material possessions…The leader-first and the servant-first are two extreme types. Between them there are shadings and blends that are part of the infinite variety of human nature."

"The difference manifests itself in the care taken by the servant-first to make sure that other people’s highest priority needs are being served. The best test, and difficult to administer, is: Do those served grow as persons? Do they, while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants? And, what is the effect on the least privileged in society? Will they benefit or at least not be further deprived?"

For many years I have asked myself every day on rounds and often ask my students – did you get your money's worth today?  I try to remember that students are paying unreasonably large amounts of money to go to medical school.  Therefore I have a responsibility to the students to give them what they are paying to receive – education.  I must be their servant.  That does not mean that I do not challenge them, because through those challenges I should be able to help them grow.  And that is the point.  I have an obligation to the students.

Is this a common philosophy?  I submit that through servant leadership I get better rewards than through arrogant leadership. 

The best analogy is parenthood.  Being a parent should prepare one for this style of leadership.

All attending physicians should treat students in this way.  Many do, unfortunately those who do not have too important a negative impact on students who do not deserve negativity.

We who teach have a great responsibility.  When we take the Hippocratic Oath we say these words:

To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.

True teaching occurs best when respect starts as an underlying principle.  Respect is not difficult. It does not hurt.

Comments (4)

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I feel like all I remember from my medical training is being abused:


The above link to doccartoon is telling. Not only medical students, but interns and residents need to be treated with more respect.
When I was an intern many years ago I admitted a young woman who was found to be blind and deaf by a friend of hers, who dropped her off at the ER. To obtain a history, I traced out letters on this patient's thigh, creating words and sentences. A simple question like "Do you have any allergies?" was incredibly difficult to ask, and frequently we would get turned around in mid-sentence and have to start over. At about 3 am, after several hours of this, in possession of a head CT scan revealing a large tumor, with the patient and myself exhausted and frustrated, I called it quits. The next morning a prominent academic neurology consultant lambasted me in the chart with a scathing note (totally inappropriate) about the inadequacy of the history. He, however, was not able to get a better history or come up with a better method of trying to obtain one. I think all of us have had similar experiences. "Dr Houses" are unfortunately walking around in real life. I also had the good fortune to have several very wise, kind teachers who were good role models for the type of doctor I wanted to become. I had hoped that things were better now, but reading the link above indicates they are not.
A colleague of mine once commented that academic medicine is the one of the few fields where you can be a jerk to everyone and still succeed. I'm glad you posted this and feel that your medical students are very lucky.

I agree with Mt Doc – your students are very lucky, You sound like the kind of teacher whostudents would aspire to be like when they, in turn, need to teach.

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