Perspectives from Malawian Medical Students
“When someone tells us we are doing a good job, it encourages us to do better.” We sat around a table with the six medical students we have been guiding over the past month. Although this was their fourth year in medical school, the students had just told us that this was the first time they felt like valued parts of the healthcare team. Last week when I thanked one of these students for helping counsel a patient after a difficult case, she turned to me and asked why I was thanking her when she just did her job as a student. I told her I was thankful that she was able to connect with the patient in ways I could not, and I was thankful that she guided the patient through this difficult time. It had been a privilege seeing these students grow in different areas during this month. We were mostly watching for their ability to diagnose and counsel patients, but improvements in their use of evidence-based medicine and in their professionalism brought joy to my heart as well. This meal served as a time to reflect on the past month, and we as faculty were learning a lot from the students from our informal discussions.
We learned that most consultants they worked with had a punitive attitude towards students. “They want you to know that they are the consultant and you are not” one student explained. My colleagues and I who come from the background where even experts are expected to learn and adapt will need to continue balancing what is expected from us as consultants and how we feel we should behave as instructors, team leaders, and human beings.
“When we see you caring for the patients,” a student added toward the end, “it motivates us to go above and beyond in our roles.” Of course these students would feel overwhelmed by a lot of the advanced diseases they saw here in Nkhoma, especially if it was their first time being in a rural setting or a district hospital. Here, they had seen consultants who not only diagnosed the patients but rushed the patients over for tests, sat with them while their results were discovered, and sometimes even had to negotiate hospital bills on behalf of the patients. Quotes from these students will stay with me because I believe that our goals here go so far beyond teaching some doctors how to diagnose and treat disease. If we can help them balance their skills with needs in sustainable ways, without losing their hope or compassion, we will be one step closer to bringing true healing to the most difficult situations.