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'Rejection' in Medical Education

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Being new to any field is tough. I remember treating my first patient - boy was that a sweaty situation at the time. But seven years on, my seniors were right when they told me it gets easier. Of course, I'm no master clinician - in fact I don't think one exists, but I am certainly more confident and experienced when treating the acutely unwell that's for sure.

So as I decide to mix it up a little and side step on occasion into the field of medical education, I feel like a new challenge has dawned, a challenge that I thoroughly enjoy, because as a doctor being part of teaching and training the next generation is, well, simply put, amazing. When your students master the art of cannulation, ECG interpretation or constructing differential diagnoses, it is wonderful to be part of their progress.

I wanted however to share something less wonderful. As a newbie to education, I was prepared for the hard slog. I have no formal qualifications in education because, I can't afford it, despite how the media may claim junior doctors are sitting comfortably on their hordes of wealth. And I was also prepared for 'rejection' - we have all been there I assume... I hope. 'Rejection' - when a journal responds to inform you that your research paper is not suitable for publication. Now don't get me wrong I can live with such an outcome and am happy to receive worthwhile feedback. After all I'm not so concerned with the publishing side, more so how I can enhance student learning. But, and I hope I'm not alone in saying this, receiving a tirade of criticism from reviewers isn't exactly what I would deem professional. I know the General Medical Council has a huge interest in doctors maintaining their professional etiquette when it comes to patient care but this seems less so with the domain of doctor vs peer reviewer. OK, so my methods are slightly simplistic, or they may not have all the weird and wonderful statistical approaches that I doubt even the doctors using them fully understand. But why be so negative? Is that what academia has become - a battle of the brains fighting among ourselves. Are we not forgetting that the work involved was simply based on attempting to better the next generation? So for any reader who may relate here are some thoughts of conclusion.

If I was younger I would retaliate in anger, reminiscent of a rebellious teenager when they are not allowed to attend the 'house party of the century.' After all I should be happy to defend my work with vigour and prove this to the very end. However I'm 30 and don't feel so young so I'm putting this plan of action to one side.

Shall I give in and keep the peace? 'Dear X, thankyou for all your feedback. I will certainly take this on board. I feel so ashamed of my worthless efforts and I shall continue to hold my head in shame. Hmm, again slightly sap like. So, here it is, my deciding point of view. Everyone is entitled to their opinion right? My thought process is of course different to the person sitting next to me, well I'm currently sitting alone at my desk, but you get my point. And the field of medical education isn't so concrete really. Right now I can only think of the OSCE being pretty much universal across the globe. So whether or not I agree with reviewers' comments is of no consequence on a personal scale. And if my paper isn't printed, well no real damage done to me I suppose. No matter how simplistic a study I think all findings are worth reporting if only to enhance further enquiry. I guess I would encourage reviewers to communicate in an appropriate tone without unnecessary critique, exclamation marks and capitalisation to name but a few. If the review process is inducing such a stinging response I would beg to ask whether they are best suited to the role. After all I'm guessing all it really boils down to in the battle of the brains is maintaining their niche in the field ensuring their reign is supreme. Well, the reality is such that one day their stronghold will no longer be concrete and in today's independent society, well people will soon forget their presence.

I choose therefore to follow this mantra - if it is raining where you are, it is sunshine and rainbows where I am and I intend to keep it that way. So if my next reviewer intends on punishing me behind the comfort of their laptop at least provide me with an umbrella.

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