Hi Everyone,
Humiliating memories sear themselves into our brains. My brain for sure. Yours too. During my second month of internship, my resident berated me on rounds for not knowing a patient’s drip rates. I stood there, shaking, sweating, and plotting my revenge as she tried to disgrace me into competence. The episode taught me a lesson, not about medicine, but about teaching.
My friends and I adored teachers who challenged us with hard questions. We welcomed prodding and probing as we unpacked acid-base disorders, x-rays, and EKGs. Our favorite attendings and seniors devoted hours to educating and encouraging us, so we could take chances and grow.
But we also endured hazing, which seemed so normal that many considered humiliation a rite of passage. If you messed up, you were flogged. If your ignorance was exposed, you were publicly disgraced. As a result, mistakes and misunderstandings were often buried. Trainees hid errors and bluffed their way through rounds, pretending to know things they didn’t understand. It was a recipe for cynicism and emotional exhaustion.
These days, most teachers are kinder. I’ve heard claims that today’s trainees dislike tough questions, as if kindness and high expectations were incompatible. But that’s false: our trainees love challenges like I did, and our best educators, the winners of teaching awards, are pillars of rigor. They are beloved because they suffuse learning with joy.
These days, it’s rare to hear about attendings humiliating residents or residents mistreating interns. Our program is famous for its supportive learning climate, which is why our trainees thrive. Supportive learning climates allow residents to admit what they don’t know, so we can teach them. It lets them disclose errors, so trainees learn from mistakes. The most important lesson they learn is that when we teach with kindness, even in stressful settings, our residents become healers.
In the decades since my nightmare rotation, I’ve witnessed the worst and best in medical education, and I’ve devoted my career to nurturing the latter. We’re not perfect (yet), but we’re getting closer, one lesson at a time.
Enjoy your Sunday, everyone. Stay warm and safe as the Nor’easter barrels into New Haven. I’ll be in the Stepdown Unit today and the rest of the week.
Mark
P.S. Happy Lunar New Year and Ramadan Mubarak to those who celebrate!
P.P.S. What I’m reading:
- How The Pitt’s AI Drama is Playing Out in Real Hospitals By Andrew R. Chow (featuring our own Sud Perera)
- Even the Hospitals Aren’t Safe in Iran By Cora Engelbrecht
- Take It From a Doctor: It’s OK if Your Medical Advice Comes From A.I. By Adam Rodman