Good and Bad teachers.

Right so here's the kind of shocking thing you read this blog to learn- Doctors aren't teachers.

A bombshell, I know. Yet they're expected to teach us, every day. Hospitals and GP practises get paid large amounts of money to have us as students there (I heard a hospital gets £40,000 per student but that's completely unconfirmed).

However the standard of teaching we receive is very different. At best, we are fully involved, receive lectures and loads of practical experience. At worst, we are reduced to silently following a doctor around on a ward round, or chasing round a ward trying to find a patient to clerk, and a doctor to present to.


You can tell the kind of teaching you're going to get from a doctor almost straight away, by gauging how they react to your presence.
When you go up to them, one of two situations will arise- they will be expecting you, or they won't. (Most of the time they won't, because King's have a cute habit of making us sign up to timetables that aren't actually communicated to the hospital itself in any way). And funnily enough, whether they were or not isn't the important thing. It's whether they are happy to take you on at that moment. If they start questioning you on whether you're supposed to be here, now, bad sign. If they tell you they're really busy today, that's a very bad sign. The best ones are like "okay, you're here, fine, let's deal with that".

Then they have to decide what to do with you. Some of them are essentially lazy, and simply decide to let you sit in the corner of their clinic, or follow them around on the ward round. You'll be lucky if you get anything explained to you about the patient's conditions, or any questions you ask answered.
The absolute opposite of this is a confident doctor who wants to get you involved. You turn up and they say "oh there's a patient in bed 4 with really good signs, go examine them and report back to me what you found", or "great I have a few patients to clerk, please talk to one and present back". Or they let you take over and do something they would have done, but under their supervision, say some simple procedure. (Sometimes they're so keen that they tell you to do something before you explain that you left your bag here, and have they seen it?)

Then you get the ones who are well-meaning but can't think what to do with you. And that's when they utter the words, those disappointing, heart-sinking words:
"What do you want to learn?"

Um, the entirety of medicine maybe? You're an F1/F2/Reg/Consultant, you've got 3/4/5/10+ years of study on me, why don't you fill me in on those. Or how about the whole of the rotation I'm currently placed on, why don't you just go over that quickly?*

Okay, to be fair, sometimes I have a particular topic I'm confused on, or logbook sign-up I need to cover, and that question is good. But I can lead a keen doctor into a particularly topic if I need to as well, and I'd *much* rather have a keen teacher.
By now I've learnt that if the doctor is asking me what to teach me, they actually don't have a clue what I need to know at my level, or can't think of a topic themselves to suggest, or even worse, just want to vaguely explain one concept to me then send me away.


As well as lazy-teaching doctors, the other terrible type of teacher are the "why aren't you psychic" doctors. These are the ones who teach by questions. The questions start simple, then get harder and harder as you get them right, ultimately terminating in some complex nuance of biomedical theory that no-one understands (or needs to know) other than the PhD student who discovered it. When you eventually tap out due to your brain having dribbled out of your ears/using all the acronyms you can possibly think of and running out, they look away in disgust and stop talking to you.
Not only this, but often the questions don't make sense, and they expect you to guess the one answer that they are thinking of. They will even give you clues to help you guess exactly what they want to hear, ignoring various other relevant answers along the way.
(An example here could be the question "What makes you worried that a person is having a severe asthma attack?" You suggest several things, such as low oxygen, silent chest, cyanosis, but they will ignore these and say really specific, helpful statements like "and what other things about their breathing will you worry about" until you give up and they explain one other aspect of the blood gases you should have thought about. Then decide you are stupid and either ignore you or start explaining what asthma is.)**



*Rude answers I have to suppress when I get asked that question.

**A doctor once asked me what the normal HBA1C was for a non-diabetic, and when I couldn't remember the figure, decided to spend the next half-hour explaining to me that diabetes was a problem regulating a patient's GLUCOSE, which is controlled by INSULIN.