What Makes A Good Medical Student?
Dr Maithri Goonetilleke is an Australian medical doctor and associate professor in global health, with extensive teaching experience in public health across undergraduate and postgraduate medical programs.
Dr Goonetilleke shares his advice for aspiring medical practitioners with some reflections from his time as both a student and a teacher of medicine.
How would you describe a good medical student?
It's a lovely, evocative question. I tend to think that every doctor is a medical student, so we're all lifelong learners. The traits that matter to me in a medical student are the same as the ones which matter to me in doctors. Broadly, those are a deep sense of humility and deep kindness, because without these, you create all sorts of barriers between yourself and your patient.
That’s very interesting, because these are very intangible qualities, and not something we can work towards with strict targets in mind. If you were to go back to your medical student days, what would you do differently?
I think I would counsel myself to run my own race. I'm sure you've encountered, being a medical student yourself, especially when you're starting out in medicine, but also all the way along your journey, that there is this sort of myriad of voices that are offering you advice telling you what you should do, the kind of doctor that you should become. I would say that a lot of those voices are very well intentioned. I'd also say that a fair few of those voices are fearful of projecting their own fear or their own vanity onto you.
The task, therefore, of the medical student or the person that would become a doctor, that makes a difference in the world, is to discern which voices you'll actually listen to and to be able to cut through that noise, and really be able to cultivate your own inner compass as you are navigating that terrain.
Everything that we do in preclinical medicine has a great focus on 'preparing' students for the clinical world. But which aspect of being a doctor and teacher did medical school not prepare you for?
Well, what a great question. There's a lot of things that medical school doesn't prepare you for. For me, it didn't teach me about the interconnectedness of health. It didn't demonstrate to me the really powerful ways in which social and environmental disorder can generate and amplify biological disorder.
It also fundamentally didn't teach me how to look after myself. It didn't teach me how to make a chicken curry. It didn't teach me why it was important to keep singing, to keep writing, to keep fortifying the parts of me that stood outside of medicine and why it's so important to fortify that aspect of yourself, because that is what will support you when things get rough and the road becomes a little less clear.
As a teacher, what is the only quality or message you try to instill in all of your students?
Definitely a passion for justice. I think if you've sat in one of my classes, you'll probably agree! That to me, is so important because the world is so unequal. Those of us who believe that health is a human pride need to be confronted and affronted by that inequity many times a day and then engender this passion to create health justice. As we were talking about before, there's a lot of intangibles, which we consider really important to becoming a good medical student, to becoming a good doctor. But I think if you start with the end in mind - that justice is your goal, then these sorts of dormant forces within you start to actually work to create that objective. Because you need innovation and ingenuity and compassion, and the ability to think in systems, all of those can be developed but if you have the goal in mind of justice of health, it will help you to create that toolkit.
As a med student, justice feels like a distant concept. What is the value in medical students getting involved in advocacy issues beyond the classroom and how can we go about building that passion for justice?
Look, I think it's crucial. I think it's absolutely crucial because as we talked about before, health is not confined to a clinic space. Health is broad and intersectorial, it is not this kind of monogenetic linear thing that we think about, where you have this kind of frail arithmetic of illness plus some medication leading to health. A good clinician anywhere in the world will tell you that it is impacted by so many different things. One of the things which everyone, whether they are a clinician or not, can do, is to recognise the impact that all of these larger social and environmental factors have on health, and then become active participants in conversations, which lead to better health. I think that's something really, really practical and powerful that medical students can do.
Is there a particular incident or conversation you have had with a student that has stood out to you or surprised you?
I've had many beautiful interactions with students over the years. I remember one of the very first years that I was teaching many years ago, I was asking a group of students, why medicine, why do you want to be a doctor? You know, you had a lot of the sort of usual first year responses which were quite well-crafted. Then there was one which surprised me and has stayed with me. I remember he said, ‘human beings come to a doctor when they're at their most vulnerable, and so when I think of why I want to be a doctor, I just want to be someone who meets vulnerability with gentleness’. I felt that that really was a profound insight into what we do, adding to the responsibility that we have and into what our objectives should be in clinical practice.
Lastly, what advice would you give to medical students?
I would say that the thing, which I perhaps had an intuitive understanding of, but didn't really articulate to myself when I was a student was that the better, the deeper that you connect with your own humanity, the better doctor you will be. So much of the effectiveness of a doctor is measured by their ability to understand, by their ability to not judge, by their ability to stand with a patient in a multitude of diverse circumstances. If you can expose yourself to that array of humanity from your medical student days, I think that is really equipping you to engage in a richer practice and to serve your patients at a higher level.
So I would say, do all the things which make you, you, and do them well and dive into them, engage in them! And I personally also would suggest reading, beyond medical textbooks; reading Dickens and Arundathi Roy and reading broadly from those who can give you insights into a diversity of communities which sort of constitute the global community. For me, I find every time I spend a little bit of time exploring another person's perspective, it adds something to my ability to be a good doctor in the world.
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