I Didn’t Join the Circus, So Why Must I Jump Through These Hoops?

One of the things that troubles me most as a teacher is watching medical students’ enthusiasm and curiosity deteriorate during medical school. Within about three months, I see them going from thinking about what they are learning to trying to pare down the material to what is likely to be on the next test. The competitive habits that got them into school provide a deeply debased motivation for studying—without knowing why, they fret about being AOA or getting into a competitive specialty . Few of them live in the present—as preclinical students, too many want only to survive to move to the clinical years. As clerks, they worry about buffing up their records to get into residency. Once in residency, I wonder if they ever recover the vitality that comes from being fascinated and engaged in learning something, thinking a new thought, or enjoying the unfolding of a new relationship .

Given the deadening effect of our current way of educating— or to be precise, training—doctors, I understand why the competing challenges of mothering appeal so strongly. With children, we have to live in the present (though we do also eventually transmit to them worries about their future and risk turning high school into nothing but a springboard to college). We can’t stop to study them for the next exam. Their development and our relationship to them propels us forward, and it is only in looking back that we see how much we may have learned in the last few days, weeks, months or years.
A lot of paper and ink is currently wasted by people pontificating about “adult learners,” postulating that they learn differently from children—because they have to incorporate new information into older structures and because they need to learn by doing rather than by rote. I often find myself doubting whether any of these theorists (mostly men, I might add) have actually watched children explore the world, puzzle out new information to figure where it fits with what they already know, and joyfully practice new skills.

I wish that I could be creative and persuasive enough as a teacher who draws on experiences as a mother to enlist others to think differently about how to engage and encourage students . Rather than spice up our lectures with video clips to entertain them, we should think about creating relationships with patients, peers, and mentors that both stimulate their felt need to learn things and reward them, immediately, for doing so. I know that a medical student will never learn the complexity of our profession in the unselfconscious, apparently effortless way that our children learn in their early years, but I think they long for it to be so, and I long to able to make it that way for them. But even if that is not possible, we need to think more about motivating them by stimulating curiosity rather than fear of failure, rewarding learning immediately rather than in the distant future, and engaging with them as teachers so that they in turn will engage with patients and be the doctors we would want to see when we get sick.