First impressions: (Student Perspective) Medical student education focuses on factual learning and problem-solving skills. Upon entering third year clerkships, medical students apply these skills to patients that are not as clear cut as the clinical vignettes they have become so good at deciphering.
Doctors as Makers is a commentary on the role of creativity, storytelling, and acceptance of the unknown in the life of a physician. Dr. Baruch states in the article “I rely on my story making skills more often than any other clinical skill in my practice” and “I am first and foremost a professional story listener”. He goes on to say that physicians feel the need to “create a recognizable story”. After pondering these statements as well as my minimal experience in the clinical world, I realized that the key to an ideal medical student on clerkships is the ability to communicate, or as Dr. Baruch would say, to tell stories. Medical students tend to have less patients than attendings/residents and thus more time to spend on each, therefore some may believe that the medical student is the supreme listener. However, coming fresh out of the textbook descriptions of first and second year gives the medical student the challenge of deciphering through the immense amounts of information that patients love to tell, putting us further into the trap of editing symptoms/stories to match our potential diagnosis. This often leads us to misconstrue information and allows the attending to obtain a completely different story upon leaving the room.
Dr. Baruch advocates the importance of normalizing uncertainty in the medical field therefore opening the medical student mind to induce creative learning. The type A medical student in me disagrees because there is always a right answer to test questions, and I believe the desire to know and understand is what drives physicians and researchers to push science farther and achieve better care for patients. However, everything in medicine is constantly changing, therefore accepting that you do not fully know the answer to all problems makes you more adaptable to change. Maybe he has a point.
The faculty at MCG is very adaptable to change, and as the years progress they continue to bring about changes that are in line with the vision of this article. The “problem based learning” class is probably the main example of creativity in which students are intentionally given cases with missing information, in an effort to inspire creativity and critical reasoning. This forces them to deviate from the robotic memorization of lists and textbooks and transition into the reality of their looming clerkship years. Other changes include first and second year students writing multiple choice questions for their classmates, and physical diagnosis classes where students enter patient rooms with no prior history/knowledge given. Potential future changes could include instituting art areas/projects for mental health and healing, revamping or eliminating the monotonous “OLDCARTS” pneumonic to challenge students, creating art instead of a presentation about a patient, and changing the style of each module in the first year to teach adaptability.
Further research in the benefits in art/creativity in medical education needs to be studied to prove its efficacy. However, I do agree that we need to think about how we can apply the teaching point of this article: how to train our students to think creatively and feel comfort in the unknown.
Kiley Fagan, BS
MD Candidate, 2019
Medical College of Georgia
Abstract: Traditional skills and expertise are not enough to prepare future physicians for the complexity, instability, and uncertainty of clinical practice. Responding and making meaning from ill-defined or unusual problems calls for, even demands, creativity. In this article, the author suggests expanding the traditional role of doctor as science-using, evidence-based practitioner to include that of doctor as a “maker” (creator) and artist. Such a reimagining requires a shift in how we view medical knowledge and patients’ stories, as well as a new appreciation for “not-knowing” as a generative, creative space in medicine. Creative thinking deserves a central place in the training of doctors, driven by a reconceptualization of the traditional educational model to include medical disciplines, humanities scholars, artists, and designers.