Article Title

Just What do I have to do to Practice Medicine?

The three obvious major criteria are: 1) graduate from an accredited program; 2) do whatever it takes to become legal, such as passing some licensing and/or certifying exam; and, 3) convince someone to take you in or the alternative is to be able to invest in the opening of your own practice. Convincing someone to take you in generally relies more on your personality, assuming that you have accomplished the first two criteria.

But what about the pathway that brings one to be in a position to fulfill those criteria? Is the key to "simply study hard?” For most of us, probably not. While acknowledging that students have individual learning profiles, to have a truer picture of what it takes to succeed in those criteria, a candidate should be more realistically considering the following:

  1. Attending Classes: Although basic information is easily available via some electronic pathway, nowadays, sitting in the classroom still has some benefits. It may be that subtle nuances and/or personal mannerisms from professors may increase the absorption of information potential. Perhaps this is not very different from the situation in which a patient enters the practitioner’s office and the practitioner asks, "what seems to be the problem?”. The patient may then give two differing impressions when he exclaims that his head hurts with either a very placid affect as opposed to a very animated, emotional affect. Aren’t we teaching students to be attentive to the behavioral language of the patient? Might not there be something in the behavioral language in the professor that enhances the understanding of some medical information? In addition wouldn’t the immediate feedback to a question or comment add to the potential of learning something?
  2. Making use of professional resources: Most would agree that by professional resources we would include the library and any other technical / electronic capabilities the school has to offer. Most would also agree to the value of these resources. However, we frequently overlook the faculty as a "professional resource”. I always chuckle during the first day of a class when all of the students attempt to sit in the last three rows leaving the first three rows empty as if those first three rows were sources of pathogens.. There must be a feeling that learning is enhanced by being as obscure as possible! The point is that allowing for more interaction with a professor might be of substantial benefit for the student. Not only not trying to be obscure but perhaps going out of one’s way to visit with the professor in the office might give the professor more of an opportunity to get to know the student and most importantly, get to know how the student is thinking. This, then, becomes a two-way interaction because not only can the professor get to understand the student better, but the student creates a broader opportunity with which to benefit from the professor or in other words use the professor as a resource.
  3. Taking advantage of available colleagues: One of the pluses of any group dynamic is the gravitating of like to like or need to need…the pull of common interests. It is very often beneficial to be able to study with students who have different academic prowess. The stronger student reinforces him/herself when helping the weaker student and the weaker student learns from the stronger student. In addition to sheer academic help back and forth, student working with student gives them the opportunity to experience the interdependency that medicine is gradually leaning on. The concept of "team” care for the patient is not a far cry from "team” effort in the academic arena.
  4. Broadening one’s sensitivities and personality: The professional educational experience could be a platform for the student to improve or reinforce his/her skills at interacting. As a practitioner, one will better serve patient needs when one has a broader spectrum of communicating with a variety of patient backgrounds. It would be difficult to interact with the patient and practice the four major ethical principles of medical practice if the practitioner were so introverted that his/her personality impeded his/her ability to reach out to the patient. It would be important for the practitioner to be able to recognize the differences in the patient’s behavior. Differences such as ethnic, cultural, religious, familial, geographic, or differences in intellect or education, or differences due to life’s experiences. Two coughs may result from similar etiologies and require similar prescriptive medications, but the compliance of the two patients most probably depends upon the sensitivity shown by the practitioner.
  5. Understanding the differences between appearance and intent: An important element in the practice of medicine is doing what has to be done in order to get compliance out of the patient and earn respect and credibility. The professor is lecturing and at the same time the student has his head buried in a paper or a book or an electrical device. The professor makes a comment and the student replies that even though he is "checking out phone messages”, he has been listening to the professor. "I certainly am not intent on disrespecting you, sir”, says the student. The professor states, "I cannot see your intention nor can I see into your mind….but I certainly see that you are not looking at me and I can see that you are doing something that doesn’t appear to be related to my speaking to you”. Is this any different than the patient who comes into the practitioner’s office with a predetermined mind set because he/she is uncomfortable with something, such as a knife in the spleen, a disturbing cough, a severe headache, a nagging pain, an itchy skin, or discomfort from three days of constipation? Yet there stands (or sits) the practitioner trying to clear the phone messages, giving some instruction to an office mate, watching the screen while typing into the computer, or intensely burying his head while reading a chart. The intent is to serve the patient, although the appearance seems to suggest otherwise. In reality, when doing something else, isn’t that a message that what is more important than the patient’s need at that moment is the practitioner’s desire to solve his own need. We have to learn that the message that we give off is more apt to be interpreted by what someone else sees us doing as opposed to what we intend, in our minds.

The bottom line is that the medical educational experience should provide the potential practitioner with the opportunities to not only acquire the hard skills necessary to satisfy the first two criteria referred to earlier, but also the softer and less tangible skills that enable a practitioner to be able to favorably interact with either colleague or with patient.

Just what does one have to do in order to practice medicine? It certainly seems that it has to be more than just "study hard!”


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