The developing physician – becoming a professional

nejm1.gif   The following article and accompanying editorial were published in the October 26 issue of the New England Journal of Medicine:

Stern DT, Papadakis M. The developing physician – becoming a professional. N Engl J Med 2006; 355(17):1794-1799. [by subscription only]

Excerpt: We all reflect on our formal training in medicine and know that somehow we made the transition from being a student in a classroom to being a seasoned clinician caring for patients. We spent years acquiring the knowledge and skills necessary to function as a physician, and part of that learning was accomplished by following examples and by trial and error. Most of us are still learning how to be better “professionals,” but we are building on a foundation that was developed in medical school and early postgraduate training. These educational and training environments have changed substantially in recent years  . .Section headings:  Setting Expectations;  Providing Experiences;  Evaluating Outcomes;  Teaching Professionalism 

Hafferty FW. Professionalism: The next wave [editorial]. N Engl J Med October 25 2006 [free full text]
Excerpt: In the october 26 issue of the Journal, Stern and Papadakis make a number of observations about professionalism and the learning environments in which medical training occurs. Like a growing number of medical educators, they recognize that considerable learning (some think most) takes place outside the domain of the formal curriculum and that such learning involves indoctrination in the unwritten rules of studenthood and medical practice. Some medical schools and residency programs have acknowledged the existence of alternative, or shadow, domains of learning, whose lessons are sometimes collectively called the “hidden curriculum,” and have accepted responsibility for both understanding and modulating the effects of these domains on students’ knowledge, skills, and values. Included in this broadened curriculum are the lessons students learn as they witness conflicts between the expectations and ideals articulated in professional codes and the behavior of individual physicians (particularly faculty members) and organizations as both go about the daily and concurrent work of medicine and education. 

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