In awe of doctor–teachers

MY years as a medical student have given me cause to reflect on interprofessional relationships and power dynamics within the health care system.

The medical profession is not without its problems. Sexism, bullying and harassment, mental health and wellbeing of staff, clinical errors, waste and hospital sustainability are all areas where there is a need for ongoing dialogue and change.

However, teaching is an age-old pillar of the medical profession; an upside to the hierarchy. There is much in medicine that cannot be learnt from books, but rather at the bedside and through dialogue, supervision and constructive criticism. At every stage of their careers, doctors will benefit from the knowledge and guidance of their seniors, and many are equally eager to impart it.

That this culture exists in medicine is inspiring and worth preserving. While I believe we are entitled to expect it, I am still suffused with gratitude every time I encounter a doctor who doubles as a teacher.

Conversely, I have little respect for those doctors who are indifferent to students. Their failure to respond to students’ initiative demonstrates a lack of leadership and common decency, and their only impact is to strengthen my resolve to be different in my practice.

If the measure of a person is how they treat their inferiors, then the measure of a good doctor is how they treat their junior team members.

Medical students are highly motivated; we love to learn and participate. Given a nurturing and inclusive environment, we will flourish. You will see our confidence grow, our knowledge advancing in leaps and bounds, our intuitive understanding of clinical decision-making mature.

What makes a good teacher?

In my experience, undermining the power imbalance is vital. At some hospitals, using the correct title to address doctors is insisted upon and here the weight of the hierarchy is keenly felt. I was pleasantly surprised to find that on my present rotation, the first names of staff are used regardless of rank. It is a subtle difference, but it discernibly breaks down barriers and implies equal worth.

The teachers I have admired are patient, encourage participation and forgive procedural inelegance with a sense of humour. They take an interest in their students’ lives, express concern for their wellbeing and praise a job well done.

A good teacher of medicine will articulate their thought process, invite questions and ask questions in a way that is kind and not belittling. I have listened to students recount their experiences of being verbally abused for giving incorrect answers. Such bullying is inexcusable.

Lack of time can make teaching difficult, but not impossible. I have been in busy emergency departments with a swarm of paramedics in triage and insufficient beds for patients, where a consultant will still spare a minute to quiz me about sepsis.

I have been a student with gynaecology teams where coffee breaks are hard to come by, and yet, as we power down the hallway, we’ll chat about prolapse. These moments mean that despite the fact that I’ve been on my feet all day, I’ll ride home grinning, elated and with a feeling of extraordinary gratitude and love for what it means to be a doctor.

And to the doctors with a passion for teaching: I suspect our undivided attention, furrowed brows, scrawling in notebooks and shining eyes remind you of what it was to be wide-eyed and inspired by medicine, and that is a reward in itself.

Nishani Nithianandan is a final-year medical student at Monash University, a board Member of the not-for-profit organisation Possible Dreams International, and has completed a Bachelor of Medical Sciences (Hons) in health services research. She is interested in infectious diseases, children’s and public health

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