Re: Unprofessional professionals

I would like to add somewhat to Dr Brian Day’s excellent editorial “Unprofessional professionals” [BCMJ 2011;53:6-7].
I agree 100% with what Dr Day had to say in his editorial. I firmly believe that the main reason that we are in this predicament today is because some years ago we started selecting medical students based primarily on their grades, rather than on the type of human being they are.

At one time, the selection process included extensive interviews where applicants were assessed on their potential for professionalism, empathy, courtesy, respect for patients and colleagues, and also grades, not the other way around as it is today. Applicants could apply with high Bs and some As, and still be eligible for those interviews, where all those qualities could be seen and assessed, and they were often accepted to medical school, even ahead of the straight-A applicants.

A second reason for our present predicament is that no one accepted into medical school is ever rejected halfway through, despite obvious flaws in their professionalism that may come to light during their training. Schools seem to be afraid of losing their investment.

As a consequence, we have future doctors who are quite possibly geniuses but have serious impairments of empathy, humility, and dedication to patients. We have bypassed excellent candidates because their grades are not 98% or above, selecting individuals who often graduate with extensive knowledge but deplorable human skills and over-inflated egos. 

Worse yet, they are more interested in their quality of life than in their patients, and while dedicating every waking moment to medicine is unhealthy, if one wants the equivalent of a 9-to-5 job, one should not go into medicine.

Worst of all, those individuals have never heard of (or feel inclined to practise) professional courtesy. In my time, if a patient was a fellow physician, or a relative of a colleague, we went the extra mile. That goes well under the premise, “Physician, heal thyself.” If we don’t look after our colleagues, who will?

The problems Dr Day alluded to will only get worse as those new physicians join the ranks of teachers themselves. What a dismal prospect for all of us in the medical profession. Quite frankly, as more of my generation of physicians retire, I dread the thought that I may have to be hospitalized for more than 2 days, or need any intervention that has long waiting lists. As Dr Day so aptly asked, “What kind of team leader do you want when you become ill?”
—Ana Porzecanski, MD