In the 1930′s, the United States suffered through a horrible depression. Many Americans were jobless, food was scarce, and the nation needed someone to lift them out of this decade of misery. President Roosevelt came up with The New Deal to rejuvenate the economy. His plan involved giving jobs to people just for the sake of having employment. For example, a person might dig a hole on Monday, and then fill the hole back up on Tuesday. These employment systems were put into place to take up time so that people would have something to do during the day. In a similar fashion, my school created a course entitled Physicianship Training for no other purpose than to keep us busy during the week.
The class runs the entirety of the first two years of medical school. We undergo everything: clinical skills training, diversity training, ethics, professionalism, geriatrics, and evidence-based medicine every Tuesday and Thursday afternoon during M1 and M2. Physicianship is the bane of my existence. I’ve already mentioned my experiences with complementary and alternative medicine. The two biggest evils of this course come in the forms of geriatrics and evidence-based medicine.
As part of geriatrics training, we have to adopt an elder member of the community and then interview that person throughout the year. My first elder buddy got cancer after our first interview and had to drop out of the program. My second partner also got cancer and had to leave the state. My dean was so worried that I might kill someone that he told me to make up the results of my third interview. To make matters worse, I didn’t get the cuddly Wal-Mart greeter type of geriatric friend. Instead, I managed to adopt the senile, hates young people type of elder person who spent the whole time criticizing doctors.
Another component of Physicianship Training involves the cult of science known as evidenced-based medicine (EBM). Every month I have to do a directed search on PubMed, the government’s storage house of medical literature. Keep in mind that PubMed is a boolean search engine and works the same way as Google; but for some reason, my university has librarians descend upon us monthly so that we get to learn new ways of using AND/OR/NOT to find journal articles. What really surprises me is that whole books have been written about evidenced-based medicine. Never mind that using the principles of EBM will not lead to better clinical answers. The school just needs to keep the students busy so that we don’t go off and try to study for class or the boards.
While the stated goal of Physicianship Training is to prepare us to become doctors—to teach us the soft skills needed to practice medicine—I don’t know how coddling dinosaurs and sitting through presentations on using the Internet is supposed to make us better prepared to diagnose and treat diseases. Probably the biggest farce to come out of the Physicianship class is professionalism. According to this principle, our interactions with patients and colleagues should be strictly professional. The down side is that one of the instructors routinely hits on female medical students, telling one that she “has nice breasts and skin.”
In the spirit of soft skills, I leave you with this haiku on professionalism:
Do as I say, not I do—
The bane of med school.