Medical Residents and medical students can be irreverent, and I admire this in both groups. Medical Fellows are more likely to hold their mentors, senior fellows and department professors, in reverence.
Irreverence in medical training is important to me because so much reverence is often bestowed on eminence rather than evidence. That is, the teachings of professor X who has treated three generations of patients with disorder Y, are more likely to be instilled in his/her trainees than the findings of some upstart Dr. Z whose understanding of disorder Y will revolutionize the management of those who have it.
Medicine progresses slowly, deliberately, and most often painstakingly. Established practices and beliefs yield ground only reluctantly. This is both a blessing and a curse.
Most large medical centers have a ritual known as Grand Rounds. The ritual can take several forms. In one form, an expert is invited from another institution to discuss a case that is presented to him/her at the Grand Rounds event. This expert serves as a discussant who considers the possible diagnoses and recommends a course of action. After the discussion, the home medical center presenter reveals the final diagnosis and treatment, if any. In another form, the out of town expert simply gives a lecture on a subject within his/her field of expertise.
After attending our first handful of Grand Rounds during my first year of medical school, my irreverent classmates decided that an Expert for Grand Rounds was a Sonofabitch from Out of Town with Slides. I never forgot that definition, and I always suspected that my classmates got it from a medical resident and propagated it, as I have, in subsequent generations of medical trainees.
A few years ago, I took Robert Reich’s 14-week online class on Wealth and Inequality. Reich was Clinton’s Sec of Labor, and for subsequent decades has been a college professor. His most recent (and final) teaching stint has been at UC Berkley. This year, he again recorded his lectures and put them on YouTube for your benefit and mine. Today, he posted his final lecture – a review of the highpoints from the other 13 lectures that he gave this year.
I find Professor Reich’s lecture style both entertaining and engaging. I invite you to view/listen to his last lecture and to explore his other 13 lectures if you too find his approach to the subject matter interesting and informative.