Thursday, 2 July 2009

Metaphors of Medicine... and implications for medical education

Just a short post. Last week I saw Annemarie Mol speak at COMET09 about the 'messiness' of clinical practice. Today I received an email from a colleague where we were discussiing the fact that many aspects of medicine do not "offer a script". And then through Rakesh Biswas I came across this blog of Shashikiran Umakanth, a physician and associate professor in India. His former student comments that "no patient comes in a neatly packed diagnostic disease".

So these metaphors of medicine are about its complexity and unpredictability. But do we acknowlege this in our medical courses?

What are your metaphors for medicine and how do they inform the way we prepare students to become doctors?

7 comments:

  1. Where lowland is, that's where water goes. All medicine wants is pain to cure - Rumi.

    http://tinyurl.com/m8os6m

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  2. he best way to learn medicine is through clerk ship of residency, don't know how it's called in different places in the world. So teaching by doing is the most important but based on theoretical knowledge. When they start their clinical rounds their heads are full with facts but clinical practice is indeed very different from all the theory how well educated as it might be.
    Kind regards Dr Shock

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  3. It's going back to the two keystones of education for health professionals: individual assessment and communication.

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  4. Hi
    I just wondered about your thoughts, Chris is facilitator and clinical leader for the GPEP 2 program here in NZ for the College of GP's. The GPEP 2 program is a program GP registra's and overseas GP follow to gain their fellowship of the College here in New Zealand. As a facilitator Chris goes into a practice where someone is trying to attain their fellowship and he supports them to give them feedback prior to their assessment visit. He has been taking comments as clinical leader from other facilitators about how many Dr's are actually taking blood pressures listening through clothing and also examining patients through their clothing. They have all been amazed at this cutting of corners which has meant that Chris has had to issue a directive to ensure they return to good practice.
    I know it is nothing to do with your post and Metaphors of medicine but just was interested to hear your thoughts.

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  5. Thank you to all for your comments.

    Pam,
    To answer your question. I have never tried to listen to a patient's heart or lungs through an item of clothing... just wouldn't work. But at same time I don't always get them to fully strip.

    Next, BP is more controversial that you might think. I use an electronic sphygmo... checked on myself an through light item of clothing made no difference. I would rather take BP through a shirt sleeve that pull it up too tight around upper arm. Most of the time I use bare skin. But had a quick search and found this:
    http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2244658

    What do you think?
    Anne Marie

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