How a good doctor becomes a good teacher (and still ‘pimps’)
Dr. Christopher Brandt
Today’s medical student is as bright, mentally agile and ready to evolve at about the same speed as medicine is changing.
The professors are catching up, too.
“Too much has changed. There’s more and more specialization,” said Dr. Christopher Brandt, a general surgeon at MetroHealth Medical Center and a professor at Case Western Reserve University. “You have to have the tools to learn and evolve over time. I think that’s very clear to the students — and clearer and clearer and clearer to the educators.”
Brandt won this year’s Kaiser-Permanente Excellence in Teaching Award, which is given annually by CWRU’s Medical School. He’s worked with students since arriving at Metro in 1989, regularly oversees two or three students there, and is the surgery department’s clerkship director who manages the surgical rotation.
Brandt’s reputation preceded him, according to the student who nominated him for the award. He’s known as a “demanding attending” who expects students to know everything about the patients and their operations.
But “he never gave up on the med students,” wrote the student. “No doubt he challenged us and it wasn’t easy. But he did it in a way that encouraged self-motivation, encouraged us to learn for learning sake and for the patient’s.”
Below, Brandt discusses the modern medical student and his approach to making a good doctor.
Q. What’s learning for learning’s sake?
A. There are more and more demands on people’s time to do clinical work. It’s always easy to let the educational part slack off a bit. And these are very bright kids. I’m trying to demonstrate an approach to a patient and seeking out knowledge independently because there’s no way someone can know everything.
I want them discovering information and not spoon feed them bits of information. Things change so much in medical knowledge — the specifics of what you learn today will not be applicable in five years. They have to know how to approach a problem and how to determine a solution. If you can instill that you are instilling something they can use.
Q.The student who recommended you wrote that you would ask “questions tirelessly and from every angle possible” until you “uncovered that one page” in their textbooks they had not read. It sounds like you pimp your students.
A. Sometimes. I think there is a role for pimping. Students do have to put some effort into their own preparation and pimping does get that across. It can give you a sense of what a student’s baseline knowledge is. But to make it the only way you deal with things is not very productive.
When you’re pimping you’re just looking for a fact. You just keep pushing and pushing and they can sit there and it’s not coming to their heads. It’s a high-pressure situation that is not enjoyable for anybody.
You can make them work through a clinical problem and realize they may need that fact — rather than coming out and just asking, “What’s the innervation of the deltoid muscle?”
Q. What’s something you try and avoid?
A. Some of what we do as surgeons is we have students in the operating room. Sometimes they can be ignored. We should be explaining things, asking them what the options are. It gets them engaged in the procedure rather than for five hours holding a retractor with their backs to the rest of the team. I try to be cognizant of that.
I also watch their scut work — things like drawing blood. They need to be part of that to realize they’re part of the team of physicians taking care of people. But if you leave it up to residents to monitor students, sometimes the students will do a lot of scut work.
Q. What’s the difference between medical students in 1989 and the one’s today?
A. Today they are less and less exposed to rote, lecture-based learning and respond more to interactive styles of teaching. It’s more team-based and problem solving. They are certainly more savvy about using the Internet and electronic-based resources. And many of them are more independent as learners. If you give them the research and the direction and resources they are willing to go out and do it on their own.
Q. Some think electronic records and other technologies make it harder to make a good doctor.
A. There are lots of advantages. But it always comes down to the physician and students interacting on a personal level. You have to be careful that the electronic environment doesn’t distract from the interpersonal communication that has to be established.
It’s in some ways easier now to access medical knowledge and information. But you have to know how to interpret it and filter it. It’s nice to get the answer right away. But you have to know how to use it wisely and use the information that’s out there on case-by-case basis.
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Case Daily…
The Case Western Reserve University School of Medicine has received a combined commitment of $1.75 million to create the Jack H. Medalie Chair in Home-Centered Health Care. Initiated with a challenge grant from an anonymous donor, this professorship ha…
by CASE DAILY on May 22, 2009 at 3:15 pm
Chris Brandt is a role model for his peers. We are so lucky to have him here at Metro and CWRU.
by Al Connors on May 22, 2009 at 5:30 pm
youre going to see those mentally agile medical students bailing from the field once they realize how little we actually do for patients.
by Chris Hall on Jan 31, 2011 at 4:25 pm