One of my current bugbears is the intrusion of educationalists into medical training. I have a very simple concept of medicine.

 

Medicine is a trade. Like a trade, it is best learnt by doing. Theory is good, and needed. There is a scientific basis for what doctors do. But interviewing, motivating, cajoling and frankly manipulating people who really don’t want to see you (they are in your office because they are sick) is something that is learnt. By apprenticeship. And when I was a young trainee, back in the Jurassic period, we were told medicine was an apprenticeship.

 

But the current fashion is that everything has to meet the standards of ‘best practice”. And best practice is defined by educationalists. We are having to write ‘Learning programmes”

 

I confess I don’t have a learning programme. I have issues that bug me, that I read about. I have journals that I try to cover. I attend a peer group, teach (which forces me to read research, perform audits, evidence-based reviews and research (which means I have to read even more)… but I don’t plan my learning outcomes over a year or five years. Instead, I do a series of projects.

 

All I can see in all this effort is more record keeping. The core need of training has not changed. The art is long, nothing is certain, and the path is difficult.

 

Except for educationalists: However, educationalists do not understand that bright people are rebelling. Alte’s place is one of the more accessible soapboxes on this. The following was two commentators, BF, and CAB..

 

I really cannot understand why so many of my fellow Americans have such low reading aptitudes. All of our tax dollars being allocated to “Education” – it’s not like the government is ignoring said issue.

There is so much that’s messed up about American public schools that I hardly know where to begin. Curricula are written for the lowest common denominator and filled with political propaganda, teachers are more credentialed than competent (and their competence lies more in PC education theory than the subjects they teach), unions are bloated and self-serving, administration is a PC-enforcing monstrosity, high school is geared towards college preparation when we’re already sending far too many to college, elementary school doesn’t let the smarter kids move ahead much (if at all)…

Countless children are being poorly served by a system which expects too much of the least capable, barely helps the average kid (and hurts a lot of them by pushing them towards college debt they’ll struggle to repay), and bores the talented to death (when it isn’t utterly condescending to them). It’s a complete and utter disaster, and that’s putting it charitably.

 

Alte replied

That’s not what we’re seeing in our co-op. In truth, we expect everyone to work at the level of the most talented children. Even the parents (most of whom are college-educated) struggle with the material. The talented children are mildly challenged, the average children are very challenged, and the least capable children have to work their butts off. It’s rare for anyone except the most talented to receive a top-score on any assignment. But in the end, everyone is better-educated than even the most-talented children in the public school system.

When you discuss Aristotle and Tocqueville with high school seniors, you realize just how little we now expect from our children of all races and social classes.

 

So, while most clinical educators are fighting a rear-guard to keep the core of medical training and not let things get dumbed down as our students will be the ones who will treat us when we need medical help,

 

Alte is, in effect using a very old system:- one that existed in most of the world until the educationalists (from Dewey on down) got involved. It has three or four principles.

 

The first is ab origine – to learn a topic read the original text. Do not read the textbook. Do not read it in translation. The task of the grammarian was to teach the students enough Latin and Greek that the ancient texts were accessible.

 

The second is that most kids can do it. It will be hard, but there is not a need for an easy stream. Memorization and rote learning are seen as useful. Formulating and modelling your ideas on noble examples is seen as excellent – a good student in this system can produce a pastiche of an author easily.

 

The third is that relevance has no place. There is no point in getting children to discover. The rules of our grammar (in English or any other living language( do not make sense. Science is not intuitive. You cannot just reduce it to a formula and recite it. The aim of education is to, by the end of primary school, have a child who can read, cipher, and do arithmetic, and by the end of high school, equip the young person with the logical tools that will stop him responding to mere rhetoric.

 

To do this, you teach a bunch of old texts. Written by dead white males.

 

Then you encourage young men, at the end of high school, to enter a trade. The liberal arts degree therefore stops being what high school should be and becomes what it used to be: a method of training scholars. Some people are called to be scholars.

 

But most of us have trades.