The failure of Medical Education?

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Are medical schools and specialty training programs adequately preparing doctors for the complexity of modern medical practice? The Health LEADS Framework is shown here. This is a framework for professional development in healthcare that has been widely adopted in both Canada and Australia. A template for the types of professional skills we need in healthcare. Domains include Leads self, Engages others, Achieves outcomes, Drives innovation, Shapes systems.

When we map assessment criteria for medical graduates at intern, RMO and registrar training level, approximately 60% of these relate to the ‘Leads self’ and ‘Engages others’ domains. Almost 50% do in senior doctor performance reviews.

If we value professionals who have skills such as self-awareness, articulate communication, and graded assertiveness, who are strong collaborators, adaptable and empathic - how are we actually training for these qualities? Are medical schools doing a good job? Do the curricula of structured specialty training programs reflect this? On the job training? Or do we largely stick to medical knowledge and procedural skills?

From my own experience as a clinical leader looking to appoint a new specialist, I don’t care if you’ve done 100 or 1000 hysterectomies. Of course, your Fellowship and safe practice are expected. But I want to know that you’ll get on well with your colleagues, support the doctors in training, be self-aware, engage harmoniously with the wider clinical team and be compassionate with your patients. The rest you can learn - these core skills are critical to a successful department and safe clinical care.

I just sense there’s a gap between what medicine trains for, and what it expects from its doctors.