David M. Kaplan MD, MSc, CCFP
“… medical practice is not knitting, weaving, and labor of the hands, but it must be inspired with soul, filled with understanding, and equipped with the gift of keen observation and compassion.” ‐ Moses Maimonides (Simon, S. Archives of Internal Medicine. 1999; 154: 1841‐45.)
During the course of my undergraduate studies, my family and friends often were surprised to learn that I was pursuing a degree in the humanities, even though I aspired to be a physician. This humanities background has grounded me in the basic sciences, allowed me to examine the human condition, and fostered a rich understanding of what is humane. It is through this lens that I guide my medical trainees in their quest for knowledge and clinical skills acquisition.
When I first meet a medical trainee, I explain to them the notion of graduated responsibility. They understand that as I gain confidence in their knowledge and skill, I will allow them to do more clinically on their own. I believe that establishing responsibilities and setting expectations are key for students to not only enjoy learning but also be successful in their clinical placements.
The patient-centred approach developed by family medicine forms the foundation of my teaching philosophy. However, my recent work in ‘Experience-Based Design’ has impressed upon me the need to capture an understanding of the patient experience within a teaching clinic setting and then co-design their care with them. As such, I encourage my trainees to present patient histories and physical examination findings to me in front of patients and their families. I do this for two reasons. First, I believe it instills in the trainee an appreciation that the medical information they glean from a patient’s history and physical examination belongs to the patient. Second, it allows the patient an opportunity to correct what we may have incorrectly understood. This technique allows me to develop in my students the natural filter that clinicians have as they collect medical data. Lastly, this technique allows for the patients themselves to engage as learners. Specifically, I ask my students to analyze the differential diagnoses in front of the patients (when appropriate) – to elucidate for the patient not only the most likely diagnosis but also the diagnosis we can’t afford to miss. Undoubtedly, it is insightful for patients and their families to appreciate the process by which clinicians think about medical problems.
Our job as medical educators is complicated not only by an exponential increase in medical knowledge, but also by the professional competencies we must model and help our trainees to develop. I have observed that as medical trainees acquire biomedical knowledge, they can become overwhelmed with the social and ethical dimensions that need to be integrated with this newly acquired knowledge. Therefore, even the brightest and most promising students we see in clinic have something valuable to learn from their preceptors. We must instill in our students compassion and empathy, and inspire them to treat the human before them and not the disease.
Dr. David Kaplan, Deputy Family Physician-in-Chief at North York General Hospital, won the 2013 for Excellence in Community‐Based Teaching (office setting) Award. Learners nominated Dr. Kaplan for the IME award, and provided stellar testimonials. Comments included:
“Overall, my experience as a student with Dr. Kaplan was the best community rotation I had and one of the best overall in my training so far. I still consider Dr. Kaplan a mentor and admire his enthusiasm in his multiple roles in the community.”
“Dr. Kaplan’s passion for his work is infectious and his commitment to his patients is inspiring. He is an excellent role model both as a family doctor and as a teacher. He focused his teaching both on clinical knowledge as well as professional competencies and was clearly an expert in both.”