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Apprenticeship reshapes medical training for confident clinicians

Claude E. Lett III, PA-C
Conditions
September 1, 2025
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I’ve worn many hats in my medical career—lab technician, Physician Assistant, Army Captain, and teacher. But no matter where I’ve served, one truth has followed me like a shadow: The most effective medical learning doesn’t happen in a classroom. It happens beside a patient, with blood pressure cuff in hand, chart under arm, and a mentor who knows when to step back and let you try.

The most powerful educational model I ever encountered wasn’t found in a textbook. It was the simple, unforgettable rhythm of: “See one. Do one. Teach one.”

As a young lab tech in the Army, I learned not from lectures but from repetition. I watched, I tried, I taught. Years later, as a practicing PA, I used the same rhythm to train medical students and residents. One day, while supervising a bone marrow procedure, a patient asked, “Are you a doctor?” I said, “No, but I’ve done this many times.” The patient said they’d prefer a doctor. So I offered to let the physician resident—who had never performed one—take over. The patient quickly said, “Actually, you go ahead.”

That story isn’t about ego. It’s about competence—and where it really comes from.

Our current medical education model is heavy on didactics, credentials, and abstraction. We frontload students with years of classroom theory before they’re allowed to touch a patient. We emphasize board scores over bedside instincts. But in the process, we delay the very thing patients need most: confident, hands-on healers.

We don’t need to dismantle the system—we need to rebalance it. Let’s bring back vocational-style learning. Let’s honor the apprenticeship model, where observation leads to action, and action leads to mentorship. Let’s remember that humility and repetition are better teachers than any slide deck.

I never wore a long white coat. I didn’t need one. Competence wore my name.

As educators and leaders, we must ask: Are we producing scholars, or practitioners? Are we preparing our students to answer test questions, or to stand calmly at a crashing bedside?

Let’s not forget that Hippocrates never graduated from medical school.

The next great leap in medical education won’t come from a new algorithm. It will come from an old truth, rediscovered: that seeing, doing, and teaching—on repeat—builds clinicians who are not only skilled, but confident, humble, and ready.

Let’s teach less about medicine—and more about how to practice it.

Claude E. Lett III is a physician assistant.

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