Competency: Professionalism
Professionalism. For me, this word has had evolving meaning over the course of the last few years while a medical student. Many experiences have shaped my perspective of its meaning in the context of medicine. To me it seems word “professionalism” is often invoked in the context of discussions regarding honesty, accountability and integrity, indeed the “Core Educational Objectives of the Medical Curriculum” identifies these qualities among those that should ideally be aspirational of every medical student that graduates from The Ohio State University College of Medicine. Such qualities form essential framework in the pursuit of becoming a functioning member of any health care team. However, I have also come to see, through the example of others, how professionalism extends beyond these qualities to that of compassion, altruism, and commitment to excellence. I have also seen how the way in which each physician demonstrates these qualities is often markedly different from their peers, but no less valuable.
Some of my earliest lessons in professionalism came from my Longitudinal Practice preceptor as a first-year student, Dr. Andritsos. Dr. Andritsos masterfully demonstrated compassion balanced against integrity and accountability. This was best shown by the juxtaposition of two experiences: the first speed-walking to an appointment to keep a tight schedule for future patients, and second the contrasting calmness inside that appointment with her current patient as she would compassionately ask about both symptoms and the daily struggles of life. She knew each patient well enough to ask about pet pigs, beekeeping, church events and much more. The appointment never felt rushed despite her firm integrity to her schedule. This balance fostered a trust she shared with her patients that helped her to deliver truly excellent care. As I focused on emulating these aspects of Dr. Andritsos professionalism throughout the next few years, with time I saw evidence of success in this pursuit via my evaluations. The following comment demonstrates my effort to approach patient care in the wholistic manner I learned from Dr. Andritsos.
Another important aspect of professionalism I witnessed as a student has been the altruistic commitment to excellence seen in education. I have been taught by numerous phenomenal educators during my time as a student here at OSU COM, but the manner in which each individual taught was often markedly different from that of their colleges.
This was especially apparent during my time on my emergency medicine rotation. Due to the nature of the rotation, I had a different attending every day I was on the service. On my first day, I was grateful to have an attending that focused his methods of teaching on providing experiential education. I was provided numerous opportunities to both observe his skills interviewing and treating patients and then apply what I learned by having my own experiences. He would often both teach me a skill or a behavior and then model it through a live encounter with a patient before asking me to do the same. This served as an excellent introduction to the rotation and really made me feel I was getting a world class, personalized education by seeing a pro in action.
The next day, however, I worked with an attending that had a very different approach. In contrast do the previous day, I never actually saw him perform any patient care at all. However, whenever questions or new topics would come up throughout the course of the shift, he would take the time to give a personalized, high yield lecture complete with marker and white board that was immensely effective at simplifying otherwise complex issues and subject material. This style of teaching provided a way to tackle complicated topics in a way that just wouldn’t be feasible in the experiential-based method of teaching from the previous day.
My third day I again experienced a very different approach to medical education. This attending focused on self-directed learning. He asked me to set mini-goals I wanted to achieve by the end of the rotation and then did everything he could, and even recruited residents to help me achieve them. He provided pertinent patient problems, medical settings, and even procedures to help me achieve my goals to a degree I wouldn’t have thought possible in just one emergency room shift.
If I was asked after those first three days of that rotation which style of teaching was the most superior, I would not have a good answer. Each was immensely valuable in its own way. Furthermore, this experience with multiple physicians in the ED is but one example of the massive variety of teaching styles exhibited by my varied attendings throughout the last few years. So while the role of becoming a good educator might be a fairly universal way that physicians can develop an altruistic commitment to excellence, this can be achieved in many different ways.
So what does this mean for me? Like all medical students, I have often been discouraged at my progress as a budding clinician when compared to both my peers and my supervising interns, residents, and attending physicians. Sometimes it feels as if a physician is stretched in all directions with regard to professionalism. We have to wear many “hats” in order to truly develop the honesty, integrity, commitment to excellence, altruism, accountability, prudence, respect, and commitment to social justice that professionalism in medicine calls for. We also need to wear all of these hats all while staying calm and composed in situations that cause many outside of medicine to panic or break down in tears. It’s hard. But despite the difficulty, what I’ve learned from my Dr. Andritsos and my ED attending physicians and so many other great mentors is that while we all have to, at some point, wear these hats, that doesn’t mean they all have to look the same. I can teach in a way, counsel in a way, research in a way, and even crack jokes in a way that will cater to my strengths and ultimately achieve my own unique potential as a future medical professional.
While it is but one “hat”, ultrasound is one area I have identified as a way for me to demonstrate altruism and a commitment to excellence as a future educator. While I have already begun to teach my peers as an ultrasound proctor, I am currently building an ultrasound portfolio, catered to my own strengths and interest, that will help me to make my own unique contribution as a future educator.
For example, the following image is a scan of the my own brachial plexus. Any resident training in anesthesiology will need to be able to readily identify this structure with a high degree of certainty in order to perform the ultrasound guided nerve blocks in a safe manner. My commitment this next year is to volunteer my time and ultrasound expertise through dedicated extra-curricular time in the skills lab as well as in free time on critical care rotations. I believe that this in addition to helping students and residents individually when opportunities arise will be just one example of how I can uniquely exhibit professionalism in an altruistic commitment to excellence throughout my residency and beyond.
