When I first considered medicine as a career and learned about the history of medicine in America, I was drawn to the idea of the physician achieving excellence simultaneously through three paths: being a great clinician, a great researcher, and a great educator. After slowly losing interest in research just to have it rekindled and propelled forward by a fast-growing passion for Neurology, my focus has turned toward developing my skills as a clinician and as a teacher. Many academic physicians claim that it is currently impossible to excel at all three simultaneously due to the increasing complexity and subspecialization of medical knowledge. I believe this is wrong. In reflecting on the great academic and private clinicians I know, I realize that the best clinicians are those who are also excellent teachers.
My perspective is understandably biased: I am a student, and so I will naturally be drawn to clinicians who do not ignore me or discount my educational needs. On the other hand, the fundamental characteristics of great educators align well with those required for the development of clinical acumen as well as the “art” of medicine, the healer’s art. First, they both must be great communicators: they need to clearly express ideas and understand the perspectives of others. The way a clinician develops rapport with a patient is not different from the way a good teacher connects with students: there is always an initial, immediate affirmation of purpose and an expression of caring (e.g. the clinician cares for how the patient fares, the educator cares for how the students perform). Second, they both deliver a performance-measured product and service that is desired and fosters a good reputation and good will within the community. Great clinicians, like educators, function best as part of a medical community rather than as isolated practitioners. Poor performers in clinical practice or education fail to garner that good will or reputation. Third, they both require very advanced, organized thought: great clinicians need methods and approaches to diagnostic and treatment questions, while great educators need to provide their students with systems of thought around which they can build their knowledge through reading and experience. Lastly, they both empower others and function as ideal leaders. A great clinician empowers his patients and his residents and students; a great educator empowers his learners to perform better.
Being a great educator may not be the means to becoming a great clinician, but I believe that becoming a great educator is a requirement for becoming a great clinician.