Should Medical Students be called "Student Doctor"?
As I have noted on previous postings on this blog, there has been a change in recent years in how patients relate to the medical profession and vice versa. Along with the rise of consumerism, society has shown that it wants to deminish paternalistic behavior by physicians and assure informed consent on the part of the patients. Therefore the current ethical consensus is that there should be a clear understanding between patient and physician regarding all that is transpiring in medical care. This also means that any words or behavior on the part of the caregiver which may lead to deception is not right and may defeat attempts at informed consent.
Medical students have long been identified by the words "student doctor" or "student physician". Medical students, of course, have neither obtained as yet their M.D. degree nor have the legal responsibility of a physician. In keeping with the societal consensus described above, there is some concern whether using these words by medical students in identifying themselves either orally or on their name tag or by others identifying these students may itself be deceptive. The issue here is whether patients or families would misinterpret the qualifications and responsibilities of the student by these descriptions. Would you agree that these words may be deceptive and that medical students should only be identified by the words "medical student"?
My own opinion is that that "student doctor" or "student physician", as examples of student titles, are deceptive and only "medical student" should be used. I have posed this question to visitors to my "Bioethics Discussion Pages" website and I have received a number of responses. If you would like to read them, click here. ..Maurice.
posted by Maurice Bernstein, M.D. @ 7:03:00 AM
4 comments
4 Comments:
I think that the issue of whether to call a medical student in the clinical years of his/er training a "medical student" or "student doctor" is more complex than it has been made out to be in these comments. The arguments seem to swing between the accuracy of the role versus whether a student is deserving of the latter title.
There is a more complex training issue at stake both for medical students and nursing students.
In the role of a medical student during a clinical clerkship (Year 3 or 4 of medical school), the student is expected to acquire (procedural, diagnostic and) communication skills at the bedside as an apprentice to the trained physicians who are expected to supervise the student carefully and progressively. To that end, medical students receive medical malpractice insurance coverage under an umbrella policy of the institution e.g. medical school.
When learning to communicate as physicians, if they identify themselves as mere "medical students" they are likely to be treated by patients as "observers" of the clinical care process and invariably addressed by their first names by the patients rather than as "Mr." Of course, the flip side is that they might be erroneously addressed as "Dr." when they are not.The reduction in formality of address deprives them of their "apprentice" or "clerkship" status and they are, therefore, at risk of not being able to gain a "transference" role that is essential for the acquisition of the skills that they are expected to master upon completion of their training.
One might argue that a "doctor-patient" encounter is merely a consumer-provider encounter and, if so, my argument is irrelevant. However, if the dyad is seen to have more gravitas and responsibility on the part of the physician than a purely business relationship, we need to look closely at the nuances of this relationship.
An analogous situation might be that of a "student teacher" during fieldwork in a classroom. If the kids do not see the "student teacher" as a teacher but only a "student" as themselves, how will s/he acquire the expertise needed in managing the education process in a classroom?
Lee wrote me the following yesterday. ..Maurice
My response to the question of student doctor vs. med student is NO to student doctor. It is very deceptive...I would think a student doctor was a doctor who was studying and trying for some special certification...You might have gathered from my comments on your other blog that I have a real issue about trust...and I really think that all of the talk about patient trust of physician being important is Extemely critical. All of the skills a physician can bring to bear won't be much good if the patient can't develop a strong sense of trust in him/her. And that can include being careful of semantics. If I had had to go where I had to guess whether my doctor was a student or a full doctor...it would have been difficult for me to agree or follow through with the doctors course of treatment...If I had thought I was a training model that wasn't informed that I was being used for training...I do not think I would have the confidence in anything I was told. I might have been able to catch the difference but I might not have....I had the health issues plus a real reluctance to get medical help anyway. For those like myself, for those aged, and for those extremely ill the term doctor should only be used by one. The Med student, if he/she completes their training then and only then would be able to use the doctor title without the risk of serious misunderstandings. I suspect that in saying student doctor the word student would most likely be said a lot softer than the word doctor. As a patient, I am already having to process a lot of information..and have a lot of things on my mind..don't make it harder.
Guys you are all talking from the inside. The plan truth is that "Student Doctor" or "Medical student", Mean student to most people. In fact most people think of Student Doctor as a Medical Student. I asked about 20 College graduates what a Student Doctor is and 100% said a Medical Student. Most poeple are not aware that a Doctor can be a Student after Graduating as a Doctor. To them a student is a student, and a doctor a Doctor. It is only miss leading to Doctor's themselves.
Dr.M
Just for clarification, Dr. M posting above is not from me, however I would agree that "student doctor" would be generally accepted as a "student"..however, in the medical school where I teach, the students are referred to a "medical students" which I think makes their role as students unambiguous. ..Maurice.
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