Education and the changing face of medical professionalism: from priest to mountain guide?

Abstract

It is an honour to present the 40th William Pickles lecture of the Royal College of General Practitioners (RCGP). Past lecturers have included people I revere, people who have been my career heroes, and people who I count among my closest friends, and so I feel privileged to join the list. This lecture is expected to take an educational theme, although a few have focused on research in general practice. In reviewing the manuscripts of previous lectures, which has been a journey of great value to me, numerous themes and topics have appeared, some more frequently than others. They have ranged across the spectrum of medical education, invoked the practice of Pickles' time, or looked at the content of general practice. Is it possible to say anything genuinely new or original about general practice education after 40 years? As I made my way through the years from 1968 onwards, a time corresponding exactly to my own career from aspiring medical student to the present, I was initially disappointed that all of what I thought might be original reflections and insights about education and general practice had been said by others before me (often several times). Gradually this disappointment was replaced by a reassurance about the ideals and values that this College stands for, that of enhancing patient care and maintaining the highest possible standards, and also of our commitment to education as the most important means to attain these. So the content of this lecture is not so much new, as enduring. I will aim to place it in today's context, and to look to the future, but I would like briefly to review the past in order to set the context. Pickles lecture titles have shown greater variation than their messages and themes — from the cryptic and snappy …