This thoughtful article in the New England Journal of Medicine, by our very own Dr. Richard Wenzel, argues for the critical importance of teaching, inquiry, observation and reflection in medical education, particularly in an era of alternative facts where sound bites and reverence for patient throughput reign. Clinician-educators work under the pressures of increased revenue generation, frequently at the detriment of important intellectual and educational pursuits. Thought and reflection are undervalued.
I fully agree.
As a Division Chair much of my job is to function as a steward of educational and academic opportunities so as to protect faculty time (typically 20%) for non-clinical work. Setting reasonable RVU generation benchmarks is also important.This is not easy yet achievable.These structural mechanisms, along with mentorship, are necessary yet not sufficient for academic success.
Intrinsic motivation is key.
There is little that can be done to motivate someone. As explored in the book Drive, by Daniel Pink, highly functional people are driven by autonomy, mastery and purpose. Extrinsic motivators, such as more pay, prestige and enhanced benefits work less effectively.
Spanish Nobel Prize winning physician, Santiago Ramon y Cajal published Reglas y Consejos Sobre Investigación Científica (1898), wherein he summarizes his observations and perspectives on medicine and scientific investigation. Many of the observations still ring true. Discovery is not necessarily a function of special talent, but a function of hard work, which creates talent, and, low achievement is less commonly from a lack of time and resources, it is more from a lack of willpower.
Intrinsically motivated faculty should be recruited,
selected and celebrated. This will be fruitless without the appropriate environment to flourish.
