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May 21
2010

‘Icing’ on the cake or a ‘mirage’?

Posted by: Anuj Mishra

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Anuj Mishra

In our practice of Radiology, and especially in another country where the radiology services are quite not at par, we are under pressure to teach the fellow colleagues.

A ‘consultant’ is seen as a source of ‘new’ information and fellow medical colleagues are attracted like ‘bees’.

Often the situation becomes difficult to handle as in the case of my friend JS, who was travelling for the first time out of country to work in a new place. The pressure to teach on him was so overbearing that he succumbed to it and resigned from his job.

How should we deal with ‘pressure at work’?

Pressure can come from different quarters. It could just be ‘work pressure’, ‘peer pressure’ or pressure from the boss!

Out of these, ‘peer pressure’ is most difficult to handle, I personally feel.

A senior colleague of mine advised me on my first day at new job against teaching anyone.

I was taken aback!

We have always been taught in medical school to impart teaching to our junior colleagues and technicians. As junior resident, we have taught fresh residents of radiology and then as senior residents, we have taught junior residents.

We have always ‘tried’ to teach our fellow technicians to improve their skills.

In my private practice, I have taught numerous technicians and medical doctors the skills of conventional radiology and abdominal ultrasonography. To the extent that one of the medical doctor trained by me started his own ‘diagnostic centre’ close to mine and began competing with me by offering high ‘cuts’!!

It was then that I had vowed not to teach anyone the ‘art of ultrasound’!

New job?

When I took my new job, I was flooded by junior and senior colleagues showing interest to learn from me.

I decided to follow my conscience and stick to my vow.

But how could I have done it?

If I refuse bluntly, that would sound rude.

I once again turned to my senior colleague for advice.

He advised me against teaching any one the skills of radiology. Everytime anyone came up with a question, I was supposed to say –“Go and read from the books!”

Sounded little rude at first, but then I got used to it and found a softer way to say that.

This has also helped me to ward-off “keen nephrologists” approaching me to learn the technique of renal biopsy.

Or the ‘gastroenterologist’ or ‘hepatologist’ keen on learning techniques of ultrasound and liver biopsy. To the extent that one day I had to tell my colleague that I will teach ultrasound only on the condition that he teaches me endoscopy. He never came back to me with his request.

Thanks to my senior colleague, my work is quite peaceful now.




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‘Icing’ on the cake or a ‘mirage’? 2010-09-21 15:56:10 anuj mishra
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Reviewed by anuj mishra    September 21, 2010
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‘Icing’ on the cake or a ‘mirage’? 2010-05-24 19:57:12 Anuj Mishra
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Anuj Mishra Reviewed by Anuj Mishra    May 25, 2010
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‘Icing’ on the cake or a ‘mirage’? 2010-05-22 10:39:39 Dr. Sridhar V
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Dr. Sridhar V Reviewed by Dr. Sridhar V    May 22, 2010
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Dr. Sridhar V said:

Dr. Sridhar V
...
Thank you very much Dr.Anuj Mishra for your article which hitherto none of us raised or thought about.

The following categories can be considered.

1.Radiologists giving training to Other Radiologists.

2.Radiologists giving training to Medical professionals ( MBBS doctors and other consultants like hepatologists, Nephrologists etc)

3. Radiologists training non medical personnel,but related to radiology ( Like radiographer/ Dark room assistance....of course no more dark room assistants since CR/DR system entered the market )

4.Radiologists giving training to non medical personnel who are no way connected with radiology ( Attractive Secretary / Receptionist etc ).

In the first category.. Radiologist can give training to radiologists provided it is in the college atmosphere where training is imparted to the Radiology students.Here Future radiologists are immensely benefited courtesy their dedicated teachers who are selfless and can afford to be so.

In the second category....the problems starts if the training is given to MBBS/other consultants....since these same people can open a shop next door to your center and cause constant headache, as Dr.Anuj has experienced.

The third category ie imparting training to the radiographers can also result in surprises and I have seen situations where Radiographers have started their own CT scan centers employing radiologists.

The last category ..ie giving training to ones own lady secretary,though sounds attractive proposition can have interesting fall out.

Worst possibility is ... Imagine a ref physician who is your solid supporter( giving 80% of your business) requests you to train, his MBBS relative and you oblige and later this MBBS relative starts a scan center in the house of this referring physician ...thus cutting of all the support earlier given, all of a sudden.... how do you feel ?

"There are three things to remember when teaching: know your stuff; know whom you are stuffing; and then stuff them elegantly".
Lola May

No doubt teaching is a 'Noble Profession' but in Private practice set up it is become dangerous profession'
 
May 22, 2010
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Dr. Anuj Mishra said:

Anuj Mishra
...
'Benevolence alone will not make a teacher, nor will learning alone do it. The gift of teaching is a peculiar talent, and implies a need and a craving in the teacher himself.'
John Jay Chapman

Can all radiologists be good teachers too?
I never claimed to be a 'good' teacher. Now ever I had any inclination to teach, except in the medical institute, when we were obliged to teach our juniors.
Then why should we be under pressure to teach?
Dr. Sridhar has very well stated the various settings of 'teaching'.
The last one is interesting, i.e. to teach one's secretary! I had taught my medical transcriptionist in India to scan the bladder for post-void residual urine volume.
Learning is an initiative and requires effort.
Here, I have just managed to teach my fellow nurses to change from our preset to another!


 
May 22, 2010
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Alok Varshney said:

Alok Varshney
...
Why not ask your student to sign a no-compete agreement ? E.g. he cannot practice with in so and so radius of area or if he does so, he will have to pay the teacher a royalty fee.

 
May 23, 2010
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Dr. Anuj Mishra said:

Anuj Mishra
...
Well said Dr. Alok.....

But if the student does not follow the agreement???
Also, what is the punishment for a violation of the agreement?
And who decides on what the punishment is?
And is there an appeal process?
And if the student demands a right to punish the teacher?

To me, this agreement contract could lead to a lot of time wasted in the interpretation and enforcement of the rules.

 
May 23, 2010
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Alok Varshney said:

Alok Varshney
...
Actually these contracts are difficult to enforce due to a variety of technical reasons, but the purpose of such an exercise is psychological. Almost every doctor abhors courts of law and few would go to the extent of breeching their given word. Plus the mere mention of signing such a contract will bring forth the true intention of many not-so-genuine seekers of knowledge smilies/smiley.gif
 
May 24, 2010
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Dr. Anuj Mishra said:

Anuj Mishra
...
I agree with you in-toto Dr. Alok.
What you say is true in local setting. But what if one is in another country?
The local physicians maybe trying to learn from you so that they can displace you later on.
Moreover the students who have the hidden agenda of competing with their teacher for the same 'bread-&-butter' do not have a conscience in the first place. So they will be dare enough to breach any contract. And they will easily see through the fluidity of the contract and its unenforceability. Therefore, there is no issue of scaring them with 'threats on paper'.

 
May 24, 2010
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