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Making Physicians displays the pedagogical practices that formed students into physicians, debunking longstanding myths by showing how much anatomy, sense experience, and materials mattered to Galenic medicine. Humanist book learning combined with hands-on training with medicines and exploring bodies, both living and dead.
In the late nineteenth century, medical educators intent on transforming American physicians into scientifically trained, elite professionals recognized the value of medical school design for their reform efforts. Between 1893 and 1940, nearly every medical college in the country rebuilt or substantially renovated its facility. In Building Schools, Making Doctors, Katherine Carroll reveals how the schools constructed during this fifty-year period did more than passively house a remodeled system of medical training; they actively participated in defining and promoting an innovative pedagogy, modern science, and the new physician. Interdisciplinary and wide ranging, her study moves architecture from the periphery of medical education to the center, uncovering a network of medical educators, architects, and philanthropists who believed that the educational environment itself shaped how students learned and the type of physicians they became. Carroll offers the first comprehensive study of the science and pedagogy formulated by the buildings, the influence of the schools’ donors and architects, the impact of the structures on the urban landscape and the local community, and the facilities’ privileging of white men within the medical profession during this formative period for physicians and medical schools.
Few outsiders realize that student illness is frequently, and ironically, a by-product of medical training. This unique study by a medical doctor and trained anthropologist debunks popular myths of expertise and authority which surround the medical establishment and asks provoking questions about the acquisition and dissemination of knowledge within the field. In detailing all levels of basic training in a London medical school, the author describes students' 'official' activities (that is, what they need to do to qualify) as well as their 'unofficial' ones (such as their social life in the bar). This insider's exposé should prompt a serious reconsideration of abuses in a profession which has a critical influence over untold lives. In particular, it suggests that the structures and discourses of power need to be re-examined in order to provide satisfactory answers to sensitive questions relating to gender and race, the dialogue between doctor and patient and the mental stability of students under severe stress.
Decision making is a key activity, perhaps the most important activity, in the practice of healthcare. Although physicians acquire a great deal of knowledge and specialised skills during their training and through their practice, it is in the exercise of clinical judgement and its application to individual patients that the outstanding physician is distinguished. This has become even more relevant as patients become increasingly welcomed as partners in a shared decision making process. This book translates the research and theory from the science of decision making into clinically useful tools and principles that can be applied by clinicians in the field. It considers issues of patient goals, uncertainty, judgement, choice, development of new information, and family and social concerns in healthcare. It helps to demystify decision theory by emphasizing concepts and clinical cases over mathematics and computation.
Both genetic and environmental factors play important roles in one's life. Genetics remains a fixed entity, whereas environment is a variable. Environmental experiences in life can have a positive or negative influence upon the genetic makeup of a given individual. Decision-making in the preschool environment is predominantly controlled by parents. Eventually, the individual, being influenced by the many past environmental factors, becomes the responsible choice maker as to which path in life he/she wishes to travel. It is my belief that it is providential that one is given these experiences to aid in our decision-making. This concept was supported by five of the physicians who shared their stories (chapter 10). All were greatly influenced by role models whom they encountered in their earlier life. This influence factor is not a single event, but a continuum. This forms the basis of the concept that the making of a physician is not a one-time event but represents a continuum. For some of us, becoming a physician was understood as a calling. The stories in this book were shared so that others may develop a greater appreciation of their own environmental experiences and consider them as influential factors in the decision-making of their lives. It is also my hope that this book might be of positive help to the young person considering the medical profession as his or her vocation.
In Healers in the Making, Kira Robison investigates medical instruction at the University of Bologna using the lens of practical medicine, examining both the formation of medical authority and innovations in practical medical pedagogy during the late medieval period.
Does the art of medicine matter? Does it really help us become better doctors and improve results? Dr. Claudia Welch explores how the effectiveness of a physician extends far beyond the ability to prescribe correct treatments, and how mastering the art of doctoring can make the medicine more effective. Drawing on Eastern medical traditions and experience as well as on Western science, Dr. Welch examines how we know what we know, the mechanics of doctor-patient emotional contagion, and the degree to which a patient's sensory experience in a medical office affects their experience of treatments delivered. Dr. Welch also offers practical steps that doctors can take to cultivate more refined perceptive abilities and improve results. Dr. Welch's book will be essential reading for all health care practitioners interested in understanding the art of their practice and how it can enhance therapeutic outcomes, including doctors of Ayurveda, Chinese medicine, Naturopathy, as well as western medical professionals and other complementary health practitioners.
The United States does not have enough doctors. Every year since the 1950s, internationally trained and osteopathic medical graduates have been needed to fill residency positions because there are too few American-trained MDs. However, these international and osteopathic graduates have to significantly outperform their American MD counterparts to have the same likelihood of getting a residency position. And when they do, they often end up in lower-prestige training programs, while American-trained MDs tend to occupy elite training positions. Some programs are even fully segregated, accepting exclusively U.S. medical graduates or non-U.S. medical graduates, depending on the program’s prestige. How do international and osteopathic medical graduates end up so marginalized, and what allows U.S.-trained MDs to remain elite? Doctors’ Orders offers a groundbreaking examination of the construction and consequences of status distinctions between physicians before, during, and after residency training. Tania M. Jenkins spent years observing and interviewing American, international, and osteopathic medical residents in two hospitals to reveal the unspoken mechanisms that are taken for granted and that lead to hierarchies among supposed equals. She finds that the United States does not need formal policies to prioritize American-trained MDs. By relying on a system of informal beliefs and practices that equate status with merit and eclipse structural disadvantages, the profession convinces international and osteopathic graduates to participate in a system that subordinates them to American-trained MDs. Offering a rare ethnographic look at the inner workings of an elite profession, Doctors’ Orders sheds new light on the formation of informal status hierarchies and their significance for both doctors and patients.
On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong—with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can—with our help—avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.
An orphan leaves Dark Ages London to study medicine in Persia in this “rich” and “vivid” historical novel from a New York Times–bestselling author (The New York Times). A child holds the hand of his dying mother and is terrified, aware something is taking her. Orphaned and given to an itinerant barber-surgeon, Rob Cole becomes a fast-talking swindler, peddling a worthless medicine. But as he matures, his strange gift—an acute sensitivity to impending death—never leaves him, and he yearns to become a healer. Arab madrassas are the only authentic medical schools, and he makes his perilous way to Persia. Christians are barred from Muslim schools, but claiming he is a Jew, he studies under the world’s most renowned physician, Avicenna. How the woman who is his great love struggles against her only rival—medicine—makes a riveting modern classic. The Physician is the first book in New York Times–bestselling author Noah Gordon’s Dr. Robert Cole trilogy, which continues with Shaman and concludes with Matters of Choice.