Domhnall MacAuley: Recognising good medical teachers

Domhnall MacauleyWhat is a good clinical teacher? Asked to host an awards ceremony, I have been thinking about it. At the BMJ we focus on “Helping doctors make better decisions” and in the education section we produce great content. That’s the easy part. Teaching is much more than reproducing this content. Its about passing on knowledge and its also about encouraging, stimulating, and inspiring future generations.

Medical schools are doctor factories. Chatting to an academic colleague, he put it like this: if a medical student spent three hours researching, thinking about, and writing a single essay each week, how long should a tutor spend reading it? But, if there are 250 in a medical class and if a tutor spent just 10 minutes reading each one—you can work it out. Traditional models of teaching are unsustainable. A medical school might be able to pick up the poorer students and the high flyers will probably identify themselves. But, what about the majority—the medical students in the middle? (I didn’t use the word average—medical students are not average.)

More than ever, medical school teaching is about facilitating students to learn for themselves, pointing them in the right direction, helping them make the most of their time in medical school (which, for graduate entry, is not that long) being role models for professional development, and creating an environment where learning is fun, exciting and stimulating.

Are there teachers like this? Even those long retired can recall medical teachers who helped mould their careers, gave them values that they retained throughout their professional careers and who they remember for their teaching decades previously. I am sure we came across research wizards but we weren’t interested in how many papers they published, keynotes they gave, citations or awards. We knew who had the greatest influence on our student days and later careers—those who cared for their patients, who supported student medical societies, who were interested in student sport, helped our struggling classmates, came in early to take tutorials, stayed late to coach us for exams, and fired our enthusiasm for medicine and learning. And, they probably didn’t know how influential they were.

And, we knew the bad ones too—those who didn’t bother to prepare, whose slides hadn’t changed in decades and whose lectures were ill thought out or sloppy. University teaching is under increasing scrutiny now and not before time. Students expect value for money, there is formal feedback, students chat freely on social media, and there are websites to rate your teacher.

In recent years, universities focused on research assessment. I cringe when I hear academics bemoan the time they have to devote to teaching, implying that it takes them away from much more important business. But it really matters—medicine is a profession not a points race. When the pendulum swings back, as it will inevitably we will, I look forward to renewed emphasis on teaching, recognising its lifelong influence on careers, and how we can inspire future generations. Let’s recognise the great teachers.

Domhnall MacAuley is due to host the BMA Cymru Wales AND BMJ Learning Clinical Teacher of the Year Award 2013 on 24 April.

Domhnall MacAuley is primary care editor, BMJ.