Passionate Preceptors || Trevor Day

Getting comfortable with uncertainty an essential part of medicine for family physicians and learners.

FoMD Communications staff - 12 November 2019

Trevor Day, Assistant Clinical Professor of Family Medicine, says he wasn't always comfortable with the idea of clinical teaching.

"I became a clinical teacher by accident. When I was a resident, part of our curriculum involved teaching medical students, and at first I was honestly quite intimidated, but I actually really enjoyed it."

Day has been a practicing family physician in Edmonton for the last five years, having completed his family medicine residency at the University of Alberta in 2014. In spite of his initial hesitancy to teach, positive feedback from his trainees keeps him motivated, and he now sees learners as a valuable part of his role as a physician.

Learn why he values the trainees he works with in the Q & A below.

What would you say is unique about family medicine compared to other specialties?

The most unique thing about family medicine is the breadth of knowledge that we are required to have as family doctors. Other specialties have very deep domains of knowledge, but they don't translate across other domains. For example, a cardiologist knows a lot about the heart but perhaps not as much about the reproductive system. A family physician knows a little about the heart, a little about the reproductive system, and a bit about everything else as well. So I think what makes us unique is that we know a little about a lot.

We also have pretty deep relationships with our patients and we get to know them and their families very well over the years. I think relationship aspect of our specialty is a strength. You get to learn about a person's entire life and family, and it brings a different approach to patient care.

What is your favourite part of being a family physician?

My favourite part is the diversity of patients I see. In any clinic day I see a wide variety of patient ages, demographics and health problems, and I think being a generalist suits my personality and keeps me on my toes.

If you could summarize clinical teaching in a few words, what would you say?

I would say "the map is not the territory." We learn a lot of medical knowledge in school and then when we try to apply it in the real world it doesn't always work the way we thought. There are lots of things that don't quite make sense, and you need to be comfortable with that uncertainty.

How would you describe your teaching style?

My teaching style is very hands on. I try to get my learners involved and working with patients as quickly as possible. Nothing teaches you as quickly as actually doing, so I'm a big proponent of getting them involved and as autonomous as possible. I also try to lead by example, and demonstrate what it means to be a competent practicing physician with a well-balanced personal life.

I think physician burnout is a big problem in our profession, and personally I never want to become burnt out. If there is spillage from your personal into you professional life it can affect the way you interact with your students and patients. I think it's important to draw clear boundaries, protect yourself and your own personal wellness because if you don't, no one else will do that for you. Medicine is the type of career that can encompass your life and take over if you let it, so it's important to make sure that doesn't happen.

Is that something you teach your learners as well?

Yes. Self care is so important as a medical student, as a resident and for practicing physicians as well. I think the personality types that go into medicine tend to be very driven, perfectionist and goal oriented, and it's very easy to push and push and not to take a step back for yourself. I think in the long term that is detrimental to a person's career, so it's important to create those boundaries and to have your own personal time.

What motivates you to keep working with trainees, and what do you find rewarding about the experience?

I find working with trainees to be a lot of fun. It's a great way to meet a variety of people, to learn more about others and about yourself. It keeps me sharp and current, and it's a way for me to better myself as a doctor. The more experience I have teaching the more of a chance I have to master the medical knowledge as well, so it helps me as much as it helps the learners.

Initially when you think about taking on a learner and the level of commitment that's involved, it can be a little bit daunting and that apprehension might inhibit you from doing it. I would say that you should take the plunge and not overthink it, just do it. It might be a bit uncomfortable at first but it is an opportunity for growth and a way to pay it forward, and to make a positive impact on someone else's life.

What do you think makes a good clinical teacher?

I think trust makes a good clinical teacher. You have to have faith in your students, and you have to trust them and let them figure things out on their own and let them experiment, rather than giving the information and giving them the answers. I think it's important to struggle a little bit as well and to experience that difficulty that comes when you're trying to learn something new, and it's through overcoming those challenges that you really learn and understand what you need to learn. If I was to give the learners all the answers it wouldn't help them in the long run, so it's good to give them a bit more responsibility than their current level in order to encourage them to grow.

What is the benefit to the public of having trainees in your medical practice?

I think the patients appreciate it. It gives them a sense that they are actively contributing to the enhancement of their health because they are helping someone else learn from their situation. Generally the patients who work with learners are very happy to do so and find it very rewarding as well, and it helps them feel that they are actively contributing to the next generation of physicians.

Would you encourage other physicians to become clinical teachers as well?

I would definitely encourage other physicians to become clinical teachers. I think it's a great way to continue to learn about medicine yourself, and you're helping others around you and paying it forward, because it encourages the future physicians you're teaching to do it as well.