[9/2005 journal entry] The workshop Dr. McRay and I conducted recently in Chicago as part of the program for a meeting of the Society for Teachers of Family Medicine was very well received. The title/focus of the workshop – “Look where caring got me!” We presented a number of the teaching tools/techniques we have developed over many years of working with medical students, with residents, and with young physicians in their first years of practice after residency. We sought a critical review of these tools/techniques from the workshop participants (all fulltime medical school educators). Here are a few highlights from the session.
The workshop participants seemed intrigued by our use of the ‘personal statement’ with residents near the end of their grueling training experience. A ‘personal statement’ is part of the application fourth-year medical students submit to the residency programs where they hope to interview. These ‘personal statements’ are routinely replete with expressions of caring, passion, anticipation, confidence. Here are some examples we lifted last fall from the personal statements of some senior family medicine residents with whom we spent three hours in an afternoon didactic session --
The workshop participants seemed intrigued by our use of the ‘personal statement’ with residents near the end of their grueling training experience. A ‘personal statement’ is part of the application fourth-year medical students submit to the residency programs where they hope to interview. These ‘personal statements’ are routinely replete with expressions of caring, passion, anticipation, confidence. Here are some examples we lifted last fall from the personal statements of some senior family medicine residents with whom we spent three hours in an afternoon didactic session --
Medicine is the most humanistic of the scholarly professions.
I yearn for an approach to health care that heals all aspects of a human
being.
What I love about medicine is serving the great variety of needs for all of my patients. The breadth of practice can be so exhilarating!
A family physician has the responsibility to stay on top of the latest developments in many fields.
Family practice is the backbone of medicine. It takes a special breed to be a family
physician.
I am well rounded, love to develop relationships with people, can be flexible from moment to moment.
I am confident about my career choice and my ability to perform. I feel just as committed to my choice of specialties now as at the time of my application.
I am always willing to teach or lead where needed.
My education from medical school is incomplete. I received little or no foundational philosophy on which to base my understanding of health. Is health merely a disease-free state? Why is community health education for the most part disease prevention?
It is important to be able to communicate with people in their own language. . . . [These experiences] have helped me learn to appreciate a variety of cultures and adapt to different situations quickly. This aspect of personal interaction is the aspect of medicine I enjoy the most.
I love medicine. . . . In the practice of medicine, I can become the type of person I desire to be.
I have immensely enjoyed participating in the care of ill individuals.
During the residency portion of my training, my goal is to seek out experiences that will further my development into a compassionate, flexible, and competent practitioner of primary medicine.
One of our teaching methods is to put such expressions one by one before graduating residents. They do not know we have had access (anonymously) to their ‘personal statements’. Interestingly, they rarely recognize their words/thoughts. The selections from their ‘personal statements’ suggest very clear, trusting, expectant, energetic interpretations of “Look where caring got me!” Their reactions three years later to the selections from their ‘personal statements’ suggest very frustrated, betrayed, wounded, trapped, despondent, fatigued interpretations of “Look where caring got me!” One resident in the group last fall wrote the following in her very thoughtful and carefully crafted ‘personal statement’ –
The workshop participants also mirrored the responses of residents when we ask them to identify the word we were defining with – “relieved from a deception” . . . “relieved from a misapprehension of the true state of affairs” . . . “relieved from a faulty perception of an external object” . . . “relieved from a figment of the imagination”. The guesses are always the same – “education” . . . “illumination” . . . “informed” . . . . The word being defined – disillusioned. No one has yet guessed correctly. We begin by constructing the value/progress inherent in being disillusioned. Then we turn to the crucial task of regrouping on the other side of being disillusioned, since one’s vision and motivation are so often tied to that which has been shown/experienced to be illusion.
The conference program committee chair has encouraged us to submit a workshop proposal for next year’s meeting. The title/focus will be – “I have learned how mean and selfish I can be” (a painful admission made by a dismayed and burdened intern near the end of his first year of residency during a didactic afternoon Dr. McRay and I spent last Spring with a group of first-year family medicine residents).
I am passionate about socio-economic issues that contribute to suffering. . . . Inspired by Albert Schweitzer and organizations such as Doctors Without Borders, I chose to study medicine. . . . My path as a physician will lead me to work with the underserved in this country and abroad. My goal is to establish sister clinics here and in the developing world and to provide longitudinal careWhen she saw these statements on the screen three years later, she became emotional as she confessed –
in an integrative fashion.
I think I said something like that in my personal statement. . . . Now where am I? I dream of taking care of rich patients, educated patients, compliant patients, healthy patients. What has happened?The ensuing discussion we have with such residents probes the exposed distance between where they were at the end of medical school and where they find themselves at the end of residency, with particular attention to phrases such as “What I yearn for is . . .” or “What I love about medicine is . . .” or “ . . . can be so exhilarating” or “I am confident about . . .” or “ . . . is the aspect of medicine I enjoy the most” or “I am passionate about . . .”.
The workshop participants also mirrored the responses of residents when we ask them to identify the word we were defining with – “relieved from a deception” . . . “relieved from a misapprehension of the true state of affairs” . . . “relieved from a faulty perception of an external object” . . . “relieved from a figment of the imagination”. The guesses are always the same – “education” . . . “illumination” . . . “informed” . . . . The word being defined – disillusioned. No one has yet guessed correctly. We begin by constructing the value/progress inherent in being disillusioned. Then we turn to the crucial task of regrouping on the other side of being disillusioned, since one’s vision and motivation are so often tied to that which has been shown/experienced to be illusion.
The conference program committee chair has encouraged us to submit a workshop proposal for next year’s meeting. The title/focus will be – “I have learned how mean and selfish I can be” (a painful admission made by a dismayed and burdened intern near the end of his first year of residency during a didactic afternoon Dr. McRay and I spent last Spring with a group of first-year family medicine residents).