Patient as teacher-learnings about becoming a good physician from senior medical students

Abstract

For 15 years, in fourth-year clerkships in Family Medicine / Underserved Health Care, the author, a core clerkship faculty member, meets with 8-12 students at the beginning and end of their monthly rotation. Students reflect on and write goals in four areas, including Primary Care, Teaching, and Working with Underserved Communities. A key goal is the fourth. Students reflect on their training, especially third year, as a ‘socialization’ process where they may have learned some good habits, but also some behaviors that may have felt like survival, that are not congruent with the physician they aspired to become. In a safe and supportive learning environment, at the Student-Run Free Clinic, where time and reimbursement are not the drivers, the students grow in self-awareness as physicians, healers, and teachers. In the final session, each student also shares a meaningful story about a patient who will sit on their shoulder throughout their career and gently remind them about the physician they are becoming. Each student then identifies the essence of the patient’s teaching. Another student takes notes. The students co-create, in a facilitated and supportive environment, a set of teachings. One student reads them aloud and sends them to the group. The specific teachings, in the students’ own words, are about listening, to being present, to thoroughness, to asking open-ended questions, to exploring the social determinants of health, to learning from our errors, to taking the extra minute, and many others. More than 1200 students have participated in this activity, with consistent positive feedback.