How important are role models in making good doctors?

[jackiedavis351]

The use of teaching staff as role models for professional behaviour has long been an informal part of medical training. The authors consider whether role models can still be an effective means of imparting professional values, attitudes, and behaviours in a health service that is increasingly sensitive to society's expectations

Role models—people we can identify with, who have qualities we would like to have, and are in positions we would like to reach—have been shown as a way to inculcate professional values, attitudes, and behaviours in students and young doctors.1,2 Because good role models are seen as important in the making of a good doctor, we need to know more about them. What are the attributes young people look for in role models? Are these the attributes they really emulate? How do they react when they find that seniors lack these attributes? We consider these questions and whether we should rely on role models as a mechanism for developing doctors who are more patient centred and ethically sensitive.


The attributes of medical role models have been the subject of several interesting studies. Wright and colleagues looked at physicians who had been identified as excellent role models by students and residents.3–5 They found that the most important qualities in role models were a positive attitude to junior colleagues, compassion for patients, and integrity. Clinical competence, enthusiasm for their subject, and teaching ability were also important, but research achievement and academic status were much less so. Compared with colleagues, physicians who were identified as Doctor near meexcellent role models spent more time teaching and conducting rounds and were more likely to stress the importance of the doctor-patient relationship and psychosocial aspects of medicine. They also socialised more with house staff, sharing professional experiences and talking about their personal lives.

A survey of general practitioners and their students identified a positive attitude to teaching and excellent doctor-patient relationships as important in role models.6 Using a different approach, other researchers asked medical students to name one or two role models among their teachers and list five characteristics that described the role models.7 The commonly recurring characteristics were grouped under the headings “physician,” “teacher,” and “person.” The role models themselves were then asked which of these characteristics they had. The most commonly identified characteristics were, as physicians, enthusiasm for the their specialty, clinical reasoning skills, doctor-patient relationships, and viewing the patient as a whole; as teachers, enthusiasm for teaching, involving students, and communicating effectively with students; and as people, enthusiasm, compassion, and competence. Attributes that did not feature highly on any list were excellence of research, publications, success in raising grants, senior management roles, service development, and professional leadership. Nor did power, status, and high earnings feature highly.

Are these the qualities that students and junior doctors really emulate?

The work of Simon Sinclair, a psychiatrist and anthropologist who spent a year observing a group of medical students, gives contrasting findings to these studies.8 He saw that the students were drawn to and emulated senior doctors who had responsibility and status. The students were not impressed by doctors who seemed to share their power and responsibility with other professionals. He also observed the students learning an aversion to investigating patients' social and psychological problems. Their personal idealism waned as they became distanced from their family and non-medical friends and adopted the idealism of the profession. They had little awareness of the internal conflicts that must have been associated with these changes. These observations suggest a divergence between the qualities that students and young doctors say they seek in their role models and the qualities that they actually emulate. The most sought after careers are not necessarily those most associated with a holistic, patient centred approach.9

Go to:
Are these the qualities they find in their teachers?

By no means all doctors with teaching responsibilities have the attributes that students and young doctors say they seek in role models. Over half the students in a Canadian medical school considered their teachers to be insensitive to the anxieties of students and patients and their needs for communication.10 A study of clinical teachers found that the teachers' negative attitudes towards the doctor-patient relationship were obstacles to their teaching about the relationship. The teachers were hard pressed to think of occasions when they modelled the doctor-patient relationship for their students, and they expected more of the students than of themselves in this regard.11 When graduates from a US medical school were invited to write a brief essay on their time in internal medicine, they showed such a high level of dissatisfaction with the teaching staff that the researchers were taken aback.

Business Name: The House Call Doctor in Tulum
Phone Number: [phone]