Mississippi medicine’s “Johnny Appleseed” is the brilliant Dr. John R. Mitchell, our current MSMA president, who as director of the Office of Mississippi Physician Workforce (OMPW) spreads seeds for medical training sites everywhere he goes. Seeding more than 15 training sites and 21 accredited residency programs during more than a decade of work, OMPW has transformed the Mississippi medical landscape. Once confined to Jackson, medical education and residency training are now integrated into almost every medical facility in the state. The average Mississippi physician today is not only rubbing shoulders with physicians-in-training (learners) but also teaching them in clinical and didactic settings. Many practicing physicians seem to fear and attempt to avoid this role, often due to their concerns of it distracting from their work or their lack of pedagogic training. However, teaching is what doctors do, and this is a role all of us should embrace. So, how does one teach a medical learner?
One of the best of Mississippi’s physician teachers was Dr. Thomas M. “Peter” Blake (1920-2002) who taught generations of students and residents. His reflection on the role of a clinical teacher asserted a few basic duties: “Learning is undoubtedly a more important process than teaching, but the teacher participates by providing information, stimulation, support, criticism, and guidance. The opportunity to influence the development of thought processes and sense of values in young people who oftentimes have a greater potential for effectiveness than the teacher himself must be one of the most stimulating, frustrating, and rewarding experiences there is.”1 The teacher’s focus, says Blake, should be to encourage “how to think” about a problem as well as a sense of right and wrong in practicing the medical art. Guiding and stimulating students to do the right thing, as he so often encouraged, may be the best any clinical teacher can do.
Another master clinical teacher was Sir William Osler (1849-1919), who despite his many groundbreaking accomplishments, once remarked that he desired no other epitaph than the statement “I taught medical students in the wards.” His advice for clinical teachers on how to approach learners was simple: become a “senior student anxious to help [one’s] juniors.” Stressing humility and a teacher’s own status as a continuous learner, he encouraged clinical teachers to follow the “natural method of teaching” in which the “student begins with the patient, continues with the patient, and ends his study with the patient, using books and lectures as tools.” Teaching students how to focus on the patient may be the most critical lesson. Osler emphasized, “We can only instill principles, put the student in the right path, give him methods, teach him how to study, and early to discern between essentials and non-essentials.”2 By becoming a senior student who guides and stimulates the junior student, the clinical teacher succeeds simply by caring for a patient and sharing any insight he or she can.
Contact me at drluciuslampton@gmail.com. — Lucius M. Lampton, MD, Editor