One of the most appealing aspects of a medical career is that you are always learning. In my field of Psychiatry this has been especially true, although perhaps I say this in ignorance since I am not nearly as familiar with the developments and discoveries in specialties other than my own.
Ongoing self-education is so important to a medical career that all educational colleges require their members to be current in their chosen field. In the Royal College of Physicians and Surgeons of Canada, of which I am a Fellow, there is a five-year cycle of learning in which I must participate. I must also prove that I have completed the elements of the cycle on an annual basis. Over the 30 years that I have been a Fellow, this system of establishing that I continue to participate in Continuing Medical Education has developed and modernized. The Royal College strives to promote that Fellows must be current and knowledgeable.
This is not even a new concept in medicine. Sir William Osler told medical students: The greater the ignorance, the greater the dogmatism.” Osler’s love of learning was reflected in the vast library he accumulated. His original library of 8,000 volumes of medical and other books was donated by Osler to McGill University, in gratitude for his medical education. That collection formed the original collection of the Osler Library of the History of Medicine at McGill University. (http://www.mcgill.ca/library/branches/osler) The collection has grown to over 100,000 volumes. When I was a medical student, I spent a great deal of time in the Osler Library. When anatomy and physiology seemed incomprehensible to my English-honours trained brain, Osler’s library was a wonderful reminder that I had years, a whole lifetime, to learn my craft. Osler loved teaching medical students and residents ( albeit only male medical students and residents) and he certainly instilled the idea that medicine was a career of life-long learning.
I am committed to the principle that a doctor must continue to study, observe and learn. Because of this, I am very much troubled by the current fashion to call medical students and residents “learners”. It seems to exclude the rest of us from the category when, in fact, we likely all want doctors to continue to be “learners” throughout their career. I have looked through the websites of the educational colleges to have an idea of when this practice began. It seems to be one of those trends that just snuck up on us, but it does seem to be sticking. In general, I hate to mention my dislike of this usage for fear of insulting both residents and students since this is the term that all student and resident leaders use to describe the collective of medical students and residents. I never use “learner” when I mean a resident or a medical student, for the reason I have set out. I do not want to be excluded from those who must continue to study.
I would also never want to give the impression that learning in medicine (or any worthwhile career, for that matter) stops. My life-long effort to learn medicine is ongoing. This was proven to me very definitively about three years ago when I found myself describing exactly where the hypothalamus is located in the brain – something I could never have done as a medical student. There is still hope that I will learn the physiology of the Loop of Henle.