In the BHMA’s survey of medical students and foundation doctors (still under way), just over half of the responders so far feel the curriculum is adequate, yet very few say that medical schools look after them or take their views into account. This disparity between content and process suggests it isn’t simply knowledge that’s missing. Technical fact-based aspects, even if overloaded, may be good enough, but feeling listened to or supported are emotion-laden issues. The perceived lack might have to do with the swelling medical school intakes, or students’ increasing workloads and the heavy systemic demands on their educators. Yet we suspect there’s more to it than this: the hidden curriculum and the traditional doctor persona – emotionally detached and stoical – encourages a macho non-engagement with the challenges, especially the emotional labour of our work. Even where extensive student support is available, our students and doctors have tended to hold back from asking for help.
The 2022 BHMA’s annual Kilsby Essay Prize asked healthcare students to tell us what’s missing. In this issue we present the winners and some runners up in the form of essays and artistic responses. Relatedness seems to us to be an emerging theme: students and medical teachers have contributed articles on ways to escape the limitations of the lecture room and the encroachment of online teaching and virtual consultations that can put an unhealthy distance between student and teacher. Several articles raise concerns about these power dynamics whether in the clinic or by the hospital bed, and particularly if online consultations were to depersonalise the patient and submerge the humanity of the doctor.
Our profession should take these concerns seriously at a time when many doctors fail to flourish, and when they burn out their unhappiness impacts on patients and on the leadership and morale of the workforce. Can medical schools become altogether less anxious and competitive places, teach a more future-proof curriculum, where educators expand their imagination and students learn more effectively? If ever they are to flourish together in a long and satisfying patient- facing daily life they will need time for personal development, and to be psychologically and socially, as well as technically, well-informed. We are told in this issue of JHH that space
will have to be made beyond the confines of the teaching hospital space for creative engagement in the community,
for authentic reflection, and healthful recreation.
Cribb A & Bignold S (1999) Towards the reflexive medical school: The hidden curriculum and medical education research. Studies in Higher Education, 24(2) 195–209, doi 10.1080/03075079912331379888
Gale T, Brennan N, Langdon N, Read J, Keates N, Burns L, Khalil H, Mattick K (2022) Preparedness of recent medical graduates to meet anticipated healthcare needs. GMC. Available at: www.gmc-uk.org/-/media/documents/p4p- research-final-report-feb22_pdf-89855094.pdf (accessed 2 December 2022).