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A teaching counterpoint in response to “Whom should we really call a ‘doctor’?”
A number of interesting points were made by the authors of the letter. Although the latin root of the word doctor does indeed have the meaning of teacher, the same root is used to refer to a person who is learned or skilled1. It cannot be realistically stated that a physician would not meet this definition. The authors correctly point out that medical school is considered undergraduate education, however no physician can practice solely with this degree. The physician’s offices that they enter and so blithely remark that only they are “the real” doctors in, are operated by persons who have completed a residency, which is always a post-graduate degree requiring additional years of study and practice.
Ironically, one of the authors appears to hold a PhD in Engineering, which a recent study2 showed is the academic field where PhDs are least likely to become professors. It would seem strange to try and take sole ownership for a term describing a teacher when the majority of individuals in some fields with that designation do not actually have teaching as a part of their professional practice.
In contrast, the CanMEDS framework3, which “identifies and describes the abilities physicians require to effectively meet the health care needs of the people they serve” has a key role of “Scholar.” This is defined as “a lifelong commitment to excellence in practice through continuous learning and by teaching others…”. Additionally the Hippocratic oath explicitly states that it is the role of the physician to teach (“that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art…”)4. This teaching role is essential to the training of physicians who are instructed, mentored and supervised by other physicians through every step of their training.
Perhaps of greatest significance however is the simple fact that the meaning of words change over time. Sometimes this is through legal interventions, such as the modification of the definition of marriage in Canada to include non-heterosexual unions, while at other times it is due to a shift in cultural understanding. For example, if someone were to yell on an airplane “Is there a doctor on board?!” it would be implicitly understood that there is a medical emergency, not an urgent need for teaching.
I do agree with the authors that a careful evaluation of the definition of doctor should be undertaken. In fact, it should be carefully regulated to avoid misconceptions and confusion, especially when the health and wellbeing of the public is at stake, regardless of the historic origins of the term.
References:
1. Wheelock F. Wheelock’s Latin. 6th ed. New York, NY: Harper Resource; 2000.
2. Chiose, S. Engineering, science PhDs least likely to work as professors, study finds. The Globe and Mail. https://www.theglobeandmail.com/news/national/education/new-study-sheds-.... Published April 26, 2016, Updated May 16, 2018. Accessed December 5, 2018.
3. Royal College of Physicians and Surgeons of Canada. About CanMEDS http://www.royalcollege.ca/rcsite/canmeds/about-canmeds-e
4. Nuland, S. Doctors: The Illustrated History of Medical Pioneers. New York, NY: Black Dog & Leventhal; 2008.