Intellectual stimulation in family medicine: an international qualitative study of student perceptions

Kiran Sahota; Patrick Goeres; Martina Kelly; Eugene Tang; Marianna Hofmeister; Hugh Alberti

doi:10.3399/bjgpopen20X101045

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"The most intellectually stimulating of any of the disciplines" - medical student, Calgary
William R. Phillips, Joanne Reeve and Elizabeth Sturgiss

Published on: 09 July 2020

Published on: (9 July 2020)
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"The most intellectually stimulating of any of the disciplines" - medical student, Calgary
William R. Phillips, Professor Emeritus, Department of Family Medicine, University of Washington, Seattle, Wa, USA
Other Contributors:
Joanne Reeve, Professor

Elizabeth Sturgiss, Senior Lecturer
Medical students in focus groups at these two universities spoke vividly about the attractions and distractions in the intellectual life of the general practitioner/family physician. [1] The themes are familiar to many of us who have long worked to share the excitement of a career in general practice. [2]

It would be helpful to know what involvement the students had in clinical general practice prior to participating in these focus groups. It appears that exposure was very little at Calgary, where most students were in their preclinical studies, and perhaps substantial at Newcastle, with more advanced learners. Did the investigators find any association between student experience in GP and their perceptions about GP?

It would be interesting to hear the student conversation if the question has been framed differently: What do you find to be intellectually stimulating in medicine and patient care? We suspect many students would include in their answers the foundational values of family medicine. It is our job as clinician-scholar-educators to help ignite their passions in the work we do and the challenges we face.

It would also be interesting to frame the discussion around clinical scholarship more broadly than about research, not about academia but about the life of the mind. How many more students would see excitement in a professional life energized by mindfulness, reflection, innovation, teamwork, critical questioning and the enduring quest for the b...
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Medical students in focus groups at these two universities spoke vividly about the attractions and distractions in the intellectual life of the general practitioner/family physician. [1] The themes are familiar to many of us who have long worked to share the excitement of a career in general practice. [2]

It would be helpful to know what involvement the students had in clinical general practice prior to participating in these focus groups. It appears that exposure was very little at Calgary, where most students were in their preclinical studies, and perhaps substantial at Newcastle, with more advanced learners. Did the investigators find any association between student experience in GP and their perceptions about GP?

It would be interesting to hear the student conversation if the question has been framed differently: What do you find to be intellectually stimulating in medicine and patient care? We suspect many students would include in their answers the foundational values of family medicine. It is our job as clinician-scholar-educators to help ignite their passions in the work we do and the challenges we face.

It would also be interesting to frame the discussion around clinical scholarship more broadly than about research, not about academia but about the life of the mind. How many more students would see excitement in a professional life energized by mindfulness, reflection, innovation, teamwork, critical questioning and the enduring quest for the best of care.

We need to help students to see that the intellectual challenge of generalist medicine comes not just from what you know (“the challenge of having to know a little about everything” [2]) but also how you use what you know – the Bananarama principle, as the phrase we coined in a recent RCGP article [3].

For the students in this study who are attracted to family medicine because they “would not have to engage in research”, perhaps we need a new discussion on what is research? For students who struggle to know “what topics they would research”, we encourage them to explore the new GEMs library (https://www.wisegp.co.uk/what-is-a-gem) to gain a flavour of the diversity of topics and research methods used in general practice.

Recognising the challenges and stimulation of everyday clinical scholarship [4] is the central goal of the WISE GP programme (www.wisegp.co.uk), developed jointly by the Society for Academic Primary Care and the Royal College General Practitioners.

1. Sahota K, Goeres P, Kelly M, Tang E, Hofmeister M, Alberti H. Intellectual stimulation in family medicine: an international qualitative study of student perceptions. BJGP Open 23 June 2020; bjgpopen20X101045. DOI: https://doi.org/10.3399/bjgpopen20X101045
https://bjgpopen.org/content/early/2020/06/23/bjgpopen20X101045

2. Phillips WR. Medical students in family medicine research: A resource and a responsibility. Family Medicine 1984;16(4):152-153.

3. Reeve J. WISE GP: Championing the Bananarama principle in general practice. RCGP 8 October 2019. https://www.rcgp.org.uk/clinical-and-research/about/clinical-news/2019/o...

4. Reeve J, Firth A. Revitalising general practice: unleashing our inner scholar. Br J Gen Pract. 2017 Jun;67(659):266. DOI: 10.3399/bjgp17X691145. https://pubmed.ncbi.nlm.nih.gov/28546403/
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Competing Interests: None declared.