When I was a young ‘un - The changing professional life of the geriatrician
A conference report from the BGS Spring Meeting in Belfast, by Liz Gill.
The changing professional life of the doctor was also the subject of a session on medical education which looked at how modern methods have replaced those of a generation ago. As Dr Rick Plumb, clinical senior lecturer at Queens University in Belfast, put it “The main difference between now and my student days in the early 90s is that there is no point rote learning ten facts when you can access the best information instantly. In the old days learning about morphine, say, would typically involve looking at not very inspiring didactic slides. Now learning is active with built in bookmarks and links.”
Concerns about patient safety had led to a more simulated environment with students being video-ed and given feedback later. The fact that students now had to pay so much, had meant their expectations had gone sky high. The nationalisation of the curriculum had led to competence but also to uniformity. “Exposure to patients is not as varied now. There is less of the weird and wonderful,” he added. “Was change needed? Yes. Was it for the better? Probably. Have some good practices been lost? Probably. We may be in danger of losing some of the art of medicine through the need for uniformity of learning.”
Dr Ken Fullerton, consultant in geriatric medicine at Belfast City Hospital, believed the old system gave young doctors confidence in making decisions by placing them in a real environment with real patients. There were also strong links between scientists and practitioners. “Lab people didn’t live in a separate world.”
Prof Pascal McKeown, centre director at Queen’s, pointed out that there was more emphasis nowadays on communication skills and a doctor’s pastoral role. The selection process for medical students also looked at non cognitive skills such as empathy and problem solving ability. “Taking a patient’s history is black and white, listening to their story adds colour. We may even use poems and literature to understand a patient’s perspective.” His full presentation can be viewed here.
The session ended with Dr Oliver Corrado, consultant physician and dementia champion for Leeds Teaching Hospitals talking about the ‘significantly stressful’ transition from student to FY1. “Thirty five per cent do it away from their local foundation so it’s all very unfamiliar. They’re concerned about making errors, about having the right abilities, about meeting the expectations of their new colleagues.” Shadowing was found to help reduce self reported adverse effects as were tips from outgoing FY1s.