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Over the past two years I have attended quite a number of medical educational seminars and ‘workshops’ and have been a bit shocked at how out of kilter with reality the world of education seems to be now. It seems that there is a proliferation of various educational qualifications and more and more people are undertaking an MSc in order to teach medical students things that in the past you would have just taught them in your own style in a senior doctor-junior doctor apprenticeship.

Instead of useful practical information born out of the crucible of clinical practice there has to be a proper ‘structure’ to every educational encounter, every learning experience must be grouped, and feedback on just about everything is absolutely sacrosanct. Where would we be without the ubiquitous feedback form? In a form of medical educational Purgatory with no hope of salvation. There must by now be courses I am sure on how to evaluate feedback. How to act on it. How to measure it. And shortly there must be courses on how to teach other people how to analyse feedback. It is a continuous circle of doom that has no end.

Medicine, and in particular the teaching of medicine, is part science and part art. I think most can agree that much of ophthalmology is not really really a science. It just isn’t. A patient with a retinal vein occlusion has 1001 different priorities and concerns and the OCT thickness is for them not as important as you might like to think. The world of ocular surface disorders is much worse, with doctors having to sell the patient the idea of some form of treatment for a chronic condition with no cure, in which personality and stoicism is vitally important in separating those patients who are happy to be sent away with a poorly photocopied departmental eyelid hygiene leaflet, from those who will refuse to leave without 12 different prescribed ointments and a follow-up slip for an appointment in two weeks in their hand.

 

 

In my opinion, at least, you can’t teach the science of medicine beyond a certain level because how patients are affected by their condition is to do with so many more things that the condition itself, and anyone who pretends to have an algorithm for understanding all or even most of these factors is either lying or is undertaking a medical education qualification. Recently, for example, I attended an event whereby answering questions about yourself would tell you what kind of a personality ‘animal’ you were; an owl, a lion, a beaver and so on. Everyone cooed in delight at finding out what their animal was but other than the university equivalent of those Facebook ‘what Game of Thrones character are you?’ type quizzes, what is the point of this?

Having realised that there is a big river of pseudoscientific nonsense constantly being generated in the name of promoting scientific learning I thought I would contribute with my equally entirely made up on the spot guide to the different animal personality types that are represented by trainees that I have come across over the years, and therefore, by extension, every trainee that has ever existed anywhere in the world at any time.

Trainee animal personality types:

The Horse

Horses will glide gracefully into clinic and theatre alike and display remarkable speed at every task and be well respected by patients on account of their noble bearing. Horses are particularly good at presenting to a crowd, though are not so good at fine motor skills on account of their hooves. Tend to be vegan, or vegetarian at the most, and can come across as condescending if you, as their supervising consultant, are also not a horse.

The Wolf

Wolves tend to be rough and ready and will tough out difficult situations with canine cunning. These trainees will sometimes appear difficult to control, though they can be very clever indeed when dealing with tough surgical situations or when hunted to near extinction in central and eastern Europe. Not so good at research, although night vision can be excellent.

The Kung Fu Panda

These genial, sometimes overweight trainees will amble into clinic an hour late, with their shirt not properly tucked into their trousers and yesterday’s curry staining their jacket. Very easy going and generally well liked and, although eager to learn, can appear lazy. Kung Fu Pandas take an inordinate amount of sick leave although make up for this through being able to defeat improbable enemies who occasionally appear threatening the integrity of the world as we know it. May need support with exams.

The Pufferfish

These difficult trainees can change quite quickly from what appear to be easy going but hard working trainees into big nightmares that can kill several people after a simple but poorly prepared meal. Expect trouble if you don’t consistently rank pufferfish as anything other than ‘very good’ on the Case-based Discussions (CbDs) that they send you. Everything is the fault of others when dealing with pufferfish trainees. They have very little insight and are best cut up by an expert supervisor who knows how to properly prepare rare dishes.

The Koala Bear

Koala bears look cute and friendly and as if they couldn’t hurt a fly. You want to protect them and support them and just pinch their cheek and say ‘awww don’t you look cute!’ but one false move and they will chew your hand off. Beware their cuteness; koala bears are as frustrated by their cuteness as you are attracted to it. Tend to be very good at research, oculoplastic surgery and at creating perfectly consistent circular rhexes, as well as being big fans of Eucalyptus trees.

The Elephant

Dependable. Reliable. Strong. Not graceful surgeons but they make up for it by having tusks. Don’t tend to work well with unreliable colleagues and / or ivory hunters.

The Earthworm

These trainees are not very visible but actually their hard work is vital to the smooth running of the department. By constantly working under the surface, they ensure the richness of the soil and the fruitfulness of those plants that grow from their hard churned sod. Tend to score very highly in the ‘communication’ sections of the e-portfolio and pass exams first time. Don’t tend to apply for the early bird discount when booking Congress.

There we go. All I need now is to construct an utterly pointless scoring system to determine how trainees discover what animal personality they are and to validate it by getting many people to undertake the survey all over the country and to publicise the results in a non-peer reviewed journal or magazine. Perhaps someday this will be taught as part of a medical education MSc somewhere. The next stage is constructing a useful guide for consultants supervising difficult trainees that results in them being aware of what type of mineral or rock they represent in an exhaustive system of geological pseudo-educational pop-culture psychological mumbo jumbo. Or we should abandon all these new and ‘innovative’ advanced teaching methods for the tried and tested apprenticeship. And I should know, being a Horse.

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CONTRIBUTOR
Gwyn Samuel Williams

Singleton Hospital, Swansea, UK.

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