Psychology in Medical Education1 (1947)

An important event in the professional life of every medical man, if not the most important event, is his dealing with patients in the first months of general practice. It is the first test of the young practitioner; it is also of course a test of his professional education. This article will discuss some of the difficulties, and the reasons for the difficulties, in the transition from student to practitioner, with special reference to the acquisition of professional skill in and understanding of the relation of a sick person to his medical adviser.

There are two ways in which a doctor can get instruction. He can be taken by his teacher into the patient's environment and be told there what factors have led to the ailment, what difficulties lie in the way of the remedy, and what chances there are, all things taken into consideration, of recovery. The teacher and his pupil make an entry into the patient's life, they enter his region of ‘social space’ and do what they can to bring some easement within it. The apprenticeship was an example of this kind of medical education. The second, the more modern way, is different: the patient is drawn into a region where he is isolated from usual social contacts and interests, and is examined by a number of hospital departments which have specialized on one or other aspect of the mechanism of his body or mind. The criterion on which the laboratory departments report is basically a statistical one: the findings lie within the normal limits for the age group of the patient examined.

Contrasting these two generalized methods of instruction and calling the former ‘individual or apprenticeship’ and the latter ‘statistical or hospital’, we can see advantages and disadvantages in each. When there is but one instructor, usually unsupported by the large and complicated apparatus of a hospital organization,