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Clinician-educator or a clinician who educates?


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By Warren R. Heymann, MD
July 11, 2016


Ever since my first exposure to dermatology as medical student at the Albert Einstein College of Medicine, I was mesmerized by the enthusiasm of the dermatology faculty, lead by Dr. Michael Fisher. He was a teacher par excellence; I cannot overestimate the influence he had on my future path.

I have always been comfortable with considering myself a “clinician-educator” until I read the essay by Stoddard and Brownfield considering the current status of clinician-educators as dual professionals.

The authors raise intriguing points, noting the pressures on clinician-educators to provide exemplary, altruistic patient care, while being accountable for the competency of their trainees, against a background of eroding public trust (for all professions) and the “democratization” of medical knowledge on the internet.

They opine: “Specifically, rather than attempting to practice both professions, clinician–educators should rely on the professional educators’ judgment and specialized knowledge — and vice versa — to construct a shared, transdisciplinary framework for medical education.” Their abstract concludes by stating that: “Relying on collaboration with education professionals constitutes a substantial change to how clinician–educators define themselves, but it holds the best promise for medical training in the current social milieu” (1).

After reading that quote, I quickly realized that I have never been a clinician-educator in the formal sense — I am a clinician that educates. (All physicians are educators — “doctor” is derived from the Latin “docère,” meaning, “to teach”). I have never had formal education classes (other than an occasional workshop and lecture about teaching in the clinic), and my patients have always been my first priority. While teaching dermatology has always been integral to my career, it has always been secondary to the primary intent of making me a better dermatologist. It remains the proverbial “win-win-win” situation: Teaching forces me think and probe (a professor should strive to know more than the students), making me more knowledgeable, which helps my patients. I never viewed my role as being “dual” — it has always been integrated into one package. (An extra dividend is that working with residents is tremendously entertaining!)

When questions arise about our practice finances, I consult with our financial advisors; for legal issues, our attorneys; for hospital issues our administration; and for academic affairs our educational staff. Although I have become savvier about a range of issues, I have no interest in becoming an accountant, lawyer, administrator, or teacher. All I want to do is dermatology and share my knowledge.

The reality is that my approach to dermatologic education is no longer adequate for those currently seeking a traditional clinical-educator track. The complexities and dictates of academic medicine demand that future clinician-educators receive formal training in clinical teaching, curriculum development, administration, scholarship, and leadership, as provided in programs such as the O’Connor Stanford Leaders in Education Residency (OSLER) track (2). Despite the laments of Stoddard and Brownstein’s about the current status of the clinician-educator, for the right person, I couldn’t think of a better career in dermatology.

1. Stoddard HA, Brownfield ED. Clinician-educators as dual professionals: A contemporary reappraisal. Acad Med 2016; 91: 921-4.
2. Lin S. Training future clinician-educators: A track for family medicine residents. Fam Med 2016; 48: 212-6.
Addendum:


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