PANACEA 2020

I don’t know about your medical school, but
mine often raises this concept of ‘student
wellbeing.’ We receive regular reminders that
we need to be ‘looking after ourselves’ and
should contact faculty if we need help. Over
the years however, I have been increasingly
frustrated by the fact that, despite us
learning in our course that prevention is the
best cure, this hasn’t extended to med school’s
approach to student wellbeing. Sure, they
offer counsellor access when you’ve fallen
apart, but they seem to pay less attention to
preventing the falling apart process from
happening in the first place. Medicine has
never been known as the easiest course to get
through, but I’ve found myself wondering so
many times over the past years how a course
designed by some of the brightest minds in the
world is struggling to educate the next
generation of doctors without damaging
them with stress and anxiety, and
encouraging in them a fear of exposing any
imperfection or vulnerability.
I feel very lucky to get to be taught by some of
the most talented and knowledgeable
physicians and medical professionals in the
country. My admiration for these teachers is
slightly dimmed however, every time I have to
hear the phrase, in response to student
inability to answer a question that has been
posed, ‘You should know this.’ In my more
tempestuous moods, I can’t help but wonder
about the inherent ridiculousness of the
statement. Do our teachers think we enjoy
not knowing the answer? Do they think a
bunch of neurotic perfectionists (guilty as
charged!) need more shame heaped on them?
Do they think they need to have their
impossibly high standards for themselves
raised even more impossibly high? Now of
course the majority of educators are
wonderful humans who, if asked, would no
doubt answer negative to all the above. But I
also think the majority have been educated in
med schools in times when shame and
perfectionism was rampant and encouraged,
and public humiliation used as a weapon to
force med students to study harder. I guess
some habits and ways of thinking die hard.
Another thing that seems to occur regularly
in the lectures and tutorials I attend in
hospital and at university is teacher-led
laughing at wrong answers. I cringe
internally and feel so bad every time I see a
student give an answer, and watch the
lecturer imply that the answer is so wrong, it
is funny, thereby implying the student is a joke
for suggesting it. Ridicule doesn’t have to be
performed by the malicious; sometimes it comes
from a simple inability to remember back to a
time when questions that seem obvious to you
now were anything but. The same lecturers I
see laughing at ‘silly’ answers that have been
offered by well-meaning students are also
ones that complain that students in their
classes don’t seem to want to speak up and
answer questions they pose to the class. Hmm,
I wonder why that could be…
But do we want students to be trained to see
not knowing the answer as a weakness that
must be hidden at all costs? Is it not possible
that such an attitude may lead to issues down
the line in a clinical setting with doctors
feeling unable to admit to their colleagues
that they feel unsure about how to manage a
patient? Medical schools emphasise that
patient safety and wellbeing should be the
priority; maybe for this to be ensured, doctors
need to be comfortable from the time they are
still med students with not knowing the
answer, and be able to be out and proud about
this. Right now, as we think about how to fix
things so that we exit the COVID-19 era better
than we entered it, let’s spare a thought for
how we can help medical schools to recover
from the culture of shame that has gripped
them for far too long.
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