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This very moving and important piece set me thinking – and searching.
It’s not just postgraduate medical curricula which make no mention of
kindness: it doesn’t seem to figure in undergraduate curricula either, and
I can’t recall having come across it in connection with appraisal or
revalidation.
Is the General Medical Council (GMC) to blame? Kindness does not
feature in its description of “Good Doctors” in “Good Medical Practice”,
despite a clear statement in its review of its work from 1995 to 1999,
“Changing Times, Changing Cultures”, that patients want doctors who “will
treat them with kindness and consideration”. Nor does it feature in the
rest of “Good Medical Practice” or in “Tomorrow’s Doctors”, the GMC’s
recommendations on undergraduate medical education. Searching the GMC
website for the word “kindness” finds only four occurrences: the review
referred to above, a lay person describing her expectations of her doctor,
a comment about the subject of a Fitness to Practice Panel; and a comment
on a visit to a Deanery.
But it’s not just the GMC that rarely uses the word kindness. The
Royal College of General Practitioners’ curriculum statement “Being a
general practitioner” talks of person-centred care and a holistic
approach, but does not mention kindness. Searching the journal Medical
Education online for “kindness” finds nothing, which suggests it’s not a
subject of academic interest to medical educationalists. Searching the BMJ
online is productive: kindness has been mentioned in 193 articles since
1994. Interestingly, half of these are obituaries, and most of the rest
are personal views, book reviews, fillers and editorials.
Why is kindness a taboo subject in medical education and regulation,
even though we all want kindness in our own doctors as well as competence?
Are we embarrassed by it, perhaps because we are unsure how well we would
score as individuals if it could be measured? Or can formal medical
discourse simply not cope with attributes we don’t know how to measure?
On second thoughts, kindness must figure in undergraduate and
postgraduate curricula: not in the declared, written curriculum, but in
the hidden curriculum of informal learning. I hope students and trainees
see the value of kindness from observing doctors – both kind and unkind.
Maybe we should make its value more explicit through discussion. Can
kindness be taught, or should we be trying to find a way to select for it?
Perhaps the GMC should consider the importance of kindness in doctors
as part of its current review of “Tomorrow’s Doctors”. Meanwhile, an
article found in my searching seems worth trying as a discussion starter
in small group teaching1.
1. Chochinov HM. Dignity and the essence of medicine: the A, B, C and
D of dignity conserving care. BMJ 2007;335:184-187.
Competing interests:
None declared
Competing interests:
No competing interests
17 October 2008
John Temple
Part-time lecturer in primary care and GP appraiser
The Medical School, University of Nottingham, NG7 2UH
Medicine’s lost word?
This very moving and important piece set me thinking – and searching.
It’s not just postgraduate medical curricula which make no mention of
kindness: it doesn’t seem to figure in undergraduate curricula either, and
I can’t recall having come across it in connection with appraisal or
revalidation.
Is the General Medical Council (GMC) to blame? Kindness does not
feature in its description of “Good Doctors” in “Good Medical Practice”,
despite a clear statement in its review of its work from 1995 to 1999,
“Changing Times, Changing Cultures”, that patients want doctors who “will
treat them with kindness and consideration”. Nor does it feature in the
rest of “Good Medical Practice” or in “Tomorrow’s Doctors”, the GMC’s
recommendations on undergraduate medical education. Searching the GMC
website for the word “kindness” finds only four occurrences: the review
referred to above, a lay person describing her expectations of her doctor,
a comment about the subject of a Fitness to Practice Panel; and a comment
on a visit to a Deanery.
But it’s not just the GMC that rarely uses the word kindness. The
Royal College of General Practitioners’ curriculum statement “Being a
general practitioner” talks of person-centred care and a holistic
approach, but does not mention kindness. Searching the journal Medical
Education online for “kindness” finds nothing, which suggests it’s not a
subject of academic interest to medical educationalists. Searching the BMJ
online is productive: kindness has been mentioned in 193 articles since
1994. Interestingly, half of these are obituaries, and most of the rest
are personal views, book reviews, fillers and editorials.
Why is kindness a taboo subject in medical education and regulation,
even though we all want kindness in our own doctors as well as competence?
Are we embarrassed by it, perhaps because we are unsure how well we would
score as individuals if it could be measured? Or can formal medical
discourse simply not cope with attributes we don’t know how to measure?
On second thoughts, kindness must figure in undergraduate and
postgraduate curricula: not in the declared, written curriculum, but in
the hidden curriculum of informal learning. I hope students and trainees
see the value of kindness from observing doctors – both kind and unkind.
Maybe we should make its value more explicit through discussion. Can
kindness be taught, or should we be trying to find a way to select for it?
Perhaps the GMC should consider the importance of kindness in doctors
as part of its current review of “Tomorrow’s Doctors”. Meanwhile, an
article found in my searching seems worth trying as a discussion starter
in small group teaching1.
1. Chochinov HM. Dignity and the essence of medicine: the A, B, C and
D of dignity conserving care. BMJ 2007;335:184-187.
Competing interests:
None declared
Competing interests: No competing interests