Wednesday, April 15, 2009


A common thread running through both medical courses is a focus on reflective practice. Indeed, there is a strong similarity between Australia and the UK regarding the emphasis being placed on this aspect of the training. I can appreciate the importance of ensuring that doctors in training have an understanding of the importance of self-awareness, but I suspect I am in the minority among my student peers on that.

One difference, however, is the almost absolute lack of formal "professionalism" lectures and assignments here in Australia. "Professional behaviour" was almost fetishistically followed in the UK. Whether Australia considers professionalism to be a no-brainer, or whether the previously discussed lack of a Shipman means that the importance of teaching this formally is not appreciated, is hard to say. Perhaps later in the course we will get lectures on this but I can't see anything in he course outline so far.

Unlike reflective practice, the case of drumming professionalism into young medics is, I think, rather less clear cut. By formalising the process of ensuring professional behaviours, by providing all and sundry with the "unprofessional" stick with which to beat 18 yr olds, the importance of such behaviours is eroded. Further, certain parties, including peers, have a tendency to conflate "professional behaviour" with "doing as I say and shutting up". Here are a few examples of "unprofessional behaviour" as defined in UK:
  • Not putting hand up prior to speaking in a public forum having been requested to ask a question.
  • Not wearing a tie for a social work client encounter having been told previously that wearing a tie would intimidate their clients.
  • Ditto another student being reported for wearing trainers which turned out to be smart casual leather shoes.
  • Not using Vancouver referencing system correctly (that is, missing out on a comma or two).
  • Forgetting to hand in a marking guide cover sheet on an assignment.
And on it went in all its nit-picking glory.

Cheerfully, currently the Australian course seems rather more relaxed as to whether the cover sheet on your assignment is 12 or 14 point font. Perhaps this is not setting the right standard up front and perhaps this course will turn out terribly slapdash students who will be unable to recite the 12 or so Duties of a Doctor (the number is hard to pin down because the list isn't MECE and is very hard to fit into a mnemonic). Or perhaps it means that sanctions can be saved for less trivial errors and oversights.

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