During orientation I gazed out at our new class of students, almost uniformly clad in shorts and flip-flops. I must admit wondering how they would evolve from this undergraduate casual style to professionals at the bedside of an elderly woman facing the greatest challenge of her life. I related this concern at home that night. My daughter, wise beyond her years, said “Dad, you’re just jealous. What difference does it make if they wear flip flops if they are in the classroom all day.” Of course, she was right on both counts. I was a bit jealous and professionalism is much more than appearances. I have fond memories of my medical school days. And, no, I did not wear a coat and tie to class in those days! Later during the orientation week at Founders’ Day, the students recited the Declaration of Geneva, the modern day version of the Hippocratic Oath. They also donned white coats in a ceremony that symbolizes entrance into the field of medicine. Our new University President, Morton Schapiro, welcomed the students in his first official function at Northwestern and lightened the moment by noting that he felt like an imposter, first because he was among a large group of physicians, and second because he was clad in the long purple robe he had borrowed from former President Henry Bienen. We probably all feel this way at times – but he had the courage to say it. These oaths and ceremonies are important symbols of our profession. They serve as reminders of our social contract that always places the patient’s interests first. We hold ourselves to high standards of medical professionalism in all of its manifestations. I was also pleased to see the “Competency Compass” we launched last year introduced from day one of orientation. It includes eight different areas that comprise the essential competencies for an effective physician. In a poignant moment during Sandy Sanguino’s comments to the students in her role as Associate Dean for Student Programs and Career Development, she showed a film clip from “The Doctor”, a movie about a talented but arrogant cardiac surgeon played by William Hurt. He is trailed by eager students and residents who hang on his every word and imprint on his cues, spoken and unspoken. When asked for comments, several of our new students acknowledge that he is exactly their image of a physician - a role model for them. He is confident, bold, “god-like”. After all, will he not have a patient’s heart in his hands as he performs a life-saving transplant? Because this is an older movie (1991), they don’t know the rest of the story... The heart surgeon is diagnosed with a terminal illness and is forced to face his own mortality and reflect on his cold bedside manner. No doubt, a cardiac or neurosurgeon must develop psychological buffers as well as technical skills to allow them to carry out procedures that otherwise cross boundaries laid down by society. Generating these buffers is not easy. There is no formula as one might look up in the chemistry lab. This vignette from “The Doctor” underscores the importance of role modeling in our training environment. In this regard we are blessed with many physicians and educators who embody the characteristics of professionalism. The competency compass is yet another means of facilitating this process by adding definition and structure to our learning environment. Knowledge and evidence will change over time but the art of medicine will remain more constant. As I reflect on the passion of our entering students, I can’t help but note that 40% will seek training experiences outside of the U.S. Robert Havey and his colleagues at Chicago Lakeshore Medical Associates sponsored a fund-raising event last week to support international rotations by our students. Dr. Havey believes, and I agree, that student participation in international rotations, particularly in underserved areas, can be life-changing. The students who attended the event reinforced this notion with their testimonials. Each year we see a video of these rotations, narrated by Bill Kurtis (you will know him from his AT&T 3G commercials). This year, after driving for miles through the jungle, and pushing the SUV through rocky creek beds, the student group arrived at a remote clinic where people had lined up for care. There were no coats and ties, and even a few flip flops. The students provided compassionate care, in Spanish, to some of the most grateful patients one can imagine. There are many dimensions to cultural competency. I could not be more proud of the students and faculty we attract to Feinberg. In a future message, I will address our plans to further revise the medical school curriculum. It has been nearly 15 years since the curriculum underwent a major redesign. Best regards, 
J. Larry Jameson, MD, PhD
Vice President for Medical Affairs
and Lewis Landsberg Dean,
Feinberg School of Medicine
Northwestern University |
October 5, 2009