Excellence

I met some medical students this week.

The week before it was GP trainees.

On each occasion I felt hopelessly out of my depth.

You see, nowadays, in order to study medicine, you have to be little short of an academic wunderkind.

It isn’t enough to score well in A-levels or Highers, not even enough to have a driving passion, you have to, from an early age focus on what you want to do and how you are going to do it.

Care and compassion are not enough.

‘Why do you want to study medicine?’

‘I want to help people.’

Inadequate…

You have to be single-minded, committed, driven.

As a starting-point you need lots of A’s, and ideally not just ‘A’ but A-star or star-star, you have to volunteer, participate in a multitude of extra-curricular activities – sports, art, outdoors, innovation, business; you have to pass an additional exam after you have passed your school exams – called a medical aptitude test – to determine whether you have what it takes to be a good doctor – whatever that is.

Presumably the test is flexible enough to determine what makes a good GP, psychiatrist, cardiac surgeon and histopathologist.

Certain universities – Oxford and Cambridge have opted-out of this in favour of their own special selection. (Let’s not go there…)

Once you have made-it into medical school, not only must you contend with learning and exams, there is the competition. From the first day your performance is measured, calibrated, analysed; to determine whether you are good.

These measurements determine both your final mark five or six years later as well as which job you well get – where and, doing what, when you finally graduate.

If and when you move-on there are more exams – professional, entrance, exit, aptitude, hurdle after hurdle of preparation.

(I will not even mention NHS interviews.)

To the best of my knowledge I have no more exams to sit, although that will likely change one day.

This preamble leads me to explain that the medical students, burdened with debt and pressure seem different from those in my day, when studies were predominantly seen as an inconvenience on the way to growing-up, where the real learning came after graduation and, yes, it was hard (very, at times), but not this constancy of assessment and determination.

Last week I ventured into this world when I attempted to teach some doctors training to become GPs.

I received some of my worst teaching feedback ever.*

This hurt initially, as does any form of assessment or criticism, I am over it now.

Yet, it did reveal to me that for a significant proportion of the doctors, what I was saying was either a waste of time or just plain, daft.

The criticism of too much philosophy made it on to my Twitter feed.

You see, my perception is, the seriousness of doctors these days is somehow different to my day. And, yes, I am not what you would call ancient, just, relative to these folk, digital and post-truth natives, I am behind the curve.

What do I have to teach them?

This led to my yesterday withdrawing from a conference where I was scheduled to run a session on safety.

Essentially, I reflected, ‘What do I know about safety?’

In some respects, I know much; however, in modern terms, in the criteria of diplomas, certificates and degrees I am all but naked.

You could even question the value of this blog. Which I won’t – I have done enough of that; yet, some of you must know what I mean.

It always has and probably always will be that it is not what you know, it is how confident you are in expressing it.

There are times when I struggle with this confidence, particularly when everything around me seems so very uncertain.

The inverse of this rule is adopting a guise of seeking and searching for the truth; acknowledging that whatever you know can only ever be half the answer, there always has to be more.

How do you forge a reality that is split between this confident approach and one in which we can never know enough?

On reflection, and, this is probably for me at least, the essence of this blog; I faced a situation of too-much tea.

You know the Zen tale relating to the student who is served tea by his master, only to find that the master, when the cup is full keeps on pouring until it overflows, runs hot onto the floor;

‘Master, why do you keep pouring?’

‘In order to learn you first must become empty, this is the value of any vessel.’

This, a graphic format of, ‘when the student is ready, the teacher will come,’ says that to learn you must first unlearn, unload your judgments, preconceptions and understanding of what is expected. Make yourself empty.

I felt my session with the GP trainees was one where only half the audience were happy to engage in an exploration of ‘the other’ to consider different ways of approaching a blood test or best interests’ decision beyond the limitations of an exam question.

Life is more than facts; it is subtleties, nuances and mistakes.

I know I should take heed and perhaps push-on through; it is difficult to be a seeker in an age of certainty.

Brexit.

Such a divisive word.

You are either for or against.

This week I accidentally ‘liked’ a Tweet that called for Laura Kuenssberg’s resignation. She said something about the parent who confronted BJ.

Ironically, looking at this Tweet led me for the first time in ages to examine some of the arguments from the other side (my preferences and biases are so locked-in to Googles algorithms that I am shown only one view of the world that is based on what I already think, know and ‘like’).

The relationship between Brexit and medical students or young doctors?

Well, probably the sticking-point of saying, ‘I don’t know,’ of, expressing uncertainty.

I don’t know whether to treat or investigate this condition; whether medicine A, B or C is best.

I don’t know what the EU does and is, I don’t know why anyone would take a BJ or NF stance.

Stop and Think is not a 21^st Century mantra.

It is more do.

And this perhaps is the point of my blog.

I do not know.

No one really knows.

Stop being so clever.

Only by listening can we hear.

Do not be too quick to judge.

Our lives are long and the compacting of experience into school and university and competition for primo inter pares is not ideal.

Stop and think.

Stop and admire the sunrise/set.

Watch the moment.

Calm/chill/relax.

*This cloud doesn’t look how it felt…