An anonymous medical student has this post on KevinMD — A star medical student feels like he made a terrible decision:

And so, medical students learn quickly how to play this game. We enter noble. We leave jaded. We leave seeing that the smart move is to get out of it. And so the smartest of the smartest, the ones lucky enough to have a choice, go into fields where they limit their involvement with patients: dermatology, radiology, ophthalmology, anesthesiology. It begs the question: why are these the happiest, the most high-salaried, and patient-limited specialties? They all must have a connection.

He goes on to lament how hard many clinicians work and how the other physicians make more money.  He laments has loss of empathy.  He clearly has burnout and possibly depression.

As I wrote in the comments, we (the clinician educators) have to take some of the blame, and our academic leaders have to share that blame.

As clinician educators, we are role models.  We should be showing students and residents the best of medicine.  We should show how to discuss the science and at the same time discuss the patient.  We should go to the bedside and show the patient great respect.  We should show the same respect for our students and residents.

The problem here is that too often clinician educators are not rewarded in medical schools.  From an outside perspective, one would think that teaching should be the number one priority of a medical school.  Unfortunately, medical schools have transformed into academic medical enterprises.  These institutions, like most enterprises, focus on money.  Therefore, the institutions value research dollars or clinical skills that attract patients.  Teaching does not enhance the enterprise.

We need two revolutions in academic medicine.  First we need to understand that clinician educators need development.  We spend money developing researchers and clinicians, but we assume that any successful physician makes an excellent clinician educators.  We do little to evaluate them or educate them.

We need to make teaching students and residents the number one focus.  We call the institutions medical schools.  Being a clinician educator is a great responsibility and a great opportunity.  Great clinician educators can help our students and residents navigate their training more easily.  When we respect our learners, treat then like adults and demonstrate the right way to treat patients, they are more likely to develop into the physicians that we need,

Until we change that perspective, we will not produce the physicians that we should.  Medical training is difficult.  We must recognize that and help our learners through that process.

So I believe the medical students role models failed him.   Perhaps it is inevitable for some students, but I believe that we can do better for our students.

Robert Centor is an internal medicine physician who blogs at DB’s Medical Rants.

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