John Launer is a GP educator and writer. He is on Bluesky: @johnlauner.bsky.social
If anyone asks these days what kind of doctor I am, I reply: “I’m a medical educator.” Thus, I avoid the annoying question you often get as a GP about whether you specialise in anything, but the conversations that ensue are just as telling. Almost everybody, including some fellow doctors, imagines that being an educator means spending your life standing in a lecture theatre full of medical students, imparting facts about bones, drugs and so forth. It comes as a surprise when I explain that nearly all my teaching takes place in interactive workshops with doctors who have already been qualified a few years or are in mid or late career as trainers themselves. Many people also find it hard to believe that much serious education for doctors concerns a universe of medicine beyond facts: this includes uncertainty, complexity, communication, emotion, ethics, organisational systems, how to teach and to learn, how to avoid burnout or breakdown and, most of all, how to remain a doctor and a human being at the same time.
Many people also find it hard to believe that much serious education for doctors concerns a universe of medicine beyond facts…
The co-authors of a new volume on becoming and being a physician are medical educators in this serious sense of the term. Between them, Shmuel Reis, Adina Kalet and W Wayne Weston have clocked up over 120 years as clinical teachers in three different countries (Israel, the United States and Canada.) They have read, assimilated, mastered and taught just about every existential aspect of what it means to become a safe, reflective and humane doctor. Their book offers a mixture of personal narratives from across their own careers – often exposing their own vulnerabilities – with an encyclopaedic literature review alongside their own critical commentary on this. Together, they examine the whole field of education across the medical life cycle. They do so under a range of different categories including developmental theories, adult learning, expertise, moral development, narrative and identity. A chapter on the effects of the Covid pandemic on doctors’ lives focuses particularly on moral distress. A final chapter brings together many of the constructs presented earlier, under the heading of professional identity formation – an idea that now dominates the field. It’s hard to imagine this book becoming anything less than a core reference text for postgraduate degrees in medical education and a handbook for aspiring career educators.
Their book offers a mixture of personal narratives from across their own careers – often exposing their own vulnerabilities…
Intriguingly, an epilogue by Ron Epstein from the University of Rochester, New York, rounds off the book in a different vein. Epstein commends the authors for an important step in providing a philosophical and moral basis for developing the doctors of the future, but he places a polite question mark over the intellectual frameworks that the authors have so comprehensively presented. He writes about his own passion as an amateur harpsichordist and confesses that he has never felt he fitted in the culture of medicine or medical education. He describes formative moments that occurred for him in very brief contacts with teachers and colleagues who were engaged in quiet rebellions and refused to submit to rigid definitions of physicianhood. “Part of the work of professional identity formation,” he writes, “has a paradoxical quality to it, encouraging sufficient civil disobedience, anarchy and subversiveness to follow one’s inner compass while at the same time enacting our own collective need to create and participate in communities of care, learning, enquiry and practice.”
I’m impressed that the book ends on this note. As Reis and his co-authors show, medical education as a discipline has come a long way, establishing itself as a legitimate academic and research field to support clinical practice from medical school entry to retirement. But perhaps no amount of systematisation can precisely pin down the elusive nature of what it means to be an outstanding doctor or to encourage others on that path. There is no guarantee that those of us who take pride in the title of educator will have a more profound or positive impact than some colleagues who might happily say “I’m just a GP” but can still inspire their students and juniors to be effective, courageous and kind.
Featured book: Shmuel P. Reis, Adina L Karet, W Wayne Weston. Becoming and being a physician: a developmental journey. London: CRC Press, 2025. ISBN 9781032830568 RRP £45.99 Paperback
