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Tuesday March 22, 2011
EVERY so often the issue of poorly trained house officers and medical officers crops up. The issue of poor training is not just seen with clinical medicine but research medicine as well.
Often, when a research publication gets retracted for being sub-standard, a junior researcher seems to be the culprit.
Of course some junior doctors have to shoulder their share of blame for their perceived lack of professionalism, but to put the blame solely on them would be an evasion of duty.
There is an explicit obligation on senior clinicians to be effective in their teaching, supervision and assessment of doctors-in-training. For most full-time senior clinicians the daily routine more or less encompasses a few important tasks.
Patient care, teaching and supervision of junior doctors, primary or secondary research and updating professional competency.
Unfortunately, added to this already busy schedule are tasks such as administration and serving on various committees.
In the past, full-time clinicians did some administrative work as these were rather uncomplicated.
Today, however, most medical units are complex organisations with large numbers of staff, dependent on sophisticated technology held together by a complex web of information technology.
Increasingly, hospital administration has been successfully handed over to professional administrators, many of them non-clinicians. It is not that administrative work is not important; indeed it is very important to the delivery of patient care.
It is just that it can now be done by administrators, leaving clinicians with more time to do the things that only a clinician is qualified to do.
Likewise, many senior clinicians may also find themselves sitting on too many time consuming committees.
An under-supervised medical officer left to his own devices while his specialists are busy with their committee work is certain to form unfortunate conclusions.
Senior clinicians must send a clear message to junior doctors that their priority, and most important work, is patient care related. Only then will junior doctors be inspired to be good clinicians themselves. In medicine leadership is definitely by example.
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