NEW Book Blog! The Long Arc of Training by Deb Simpson

BOOK BLOG: The Long Arc of Training (Dorene F. Balmer)

Deborah “Deb” Simpson, PhD | Member AIAMC Programming Committee & Book Blog Editor

One never knows when they are talking with a good colleague about their work how it’s going to turn out. Sure, there are presentations and publications – but a book? That’s what happened to me. Dorene Balmer, PhD is recognized internationally as a superb qualitative researcher in medical education and a delightfully kind human. Over the years she would tell me about this study that she was doing as a ‘labor of love.’  Initially it started by interviewing about twenty students every 6-12 months throughout medical school. Then it evolved- continuing with smaller group through residency, fellowship (if applicable) and into practice! It was fascinating and had never been done before using rigorous in the moment qualitative approach through time.

Then of course Dorene submits that papers and gets multiple manuscript rejections – we’ve all been there! But Dorene – like those in the book (The Long Arc of Training) - is driven by values, amazing stamina and persistence eventually succeeds after some key colleague's guidance away from journals towards a book. This is not a traditional academic book, but is a narrative telling the stories of six medical students over 12 years of training into practice.

Who Should Read This Book and Why? As Dorene writes “It’s not just what these six aspiring doctors learn, but how they become who they are.”  I invite those who are interested in becoming physicians, and their friends and families to read it. Individuals interested in human growth and development. People who are interested in understanding the journey to “becoming” a physician (it doesn’t stop). And those, like me, who are already active in medical education. All should read this book. It deepens our understanding of practicing medicine beyond that portrayed by Grey’s Anatomy, The Pitt, and/or Scrubs. What Dorene’s writing has in common with these cinematic physicians, is she makes you feel like you “know” these six people while seeing the crossing cutting threads in their development.

This blog gives a few of the many things that struck me as a read this delightful, insightful and short but superbly written book about how these individuals struggle and resolve the tensions and paradoxes of medicine and being human.

Social Structure: You’d think that going to an elite medical school would open doors to pursue one’s dreams. Elite schools often focus on research and discovery, rather than serving the underserved. Staying true to your dreams can work but it may not look exactly as you thought!

The Power of Using One’s Agency to Make Medicine Work:  We all struggle with juggling one’s career within the larger whole of what brings one the richness of life – family, friends, creativity, health. The lockstep nature of medical education makes achieving this goal challenging but as one of the physician’s learned to “graciously says no” to other’s expectations he succeeded.

Discoveries: These physicians' journeys are full of discoveries. One that stood out for me, given all the literature about decreasing empathy as one proceeds through medical education, is that empathy for patients doesn’t have to decline. It can increase! Beginning in medical school, students are expected to maintain a professional distance while showing empathy for their patients. Is that possible for those aspiring physicians who see the human connection as one of those value elements of their profession? Yes, it can be done but not without the hard work of managing emotions while staying true to one’s deep commitment to care. Side Note: The president of the Society of Teachers of Family Medicine recently about why AI will not replace physicians as there are five enduring roles that take a human who cares.

Ultimately this book lets us see the changes in how these 6 individuals deal with the tensions that emerge, stagnant, resolve and often remerge on their continuing journey to becoming physicians and fully human. Thank you and congratulations Dorene for narrating their expedition(s) and completing yours.

Brief Bio: Deborah “Deb” Simpson is a former AIAMC Board member and honored as team recipients of the AIAMC Innovation Award, National Initiative Impact Award, and humbled to receive the Ethel Weinberg Award. Currently she is Director of Education for Academic Affairs at Aurora Health Care (now a part of Advocate Health) and Deputy Editor of the Journal of Graduate Medical Education. In all her positions, she focuses on working with faculty to optimize the design, delivery, assessment, and evaluation of medical education - and have some fun. Beyond work, Deb is an enthusiastic sports participant and observer aided by a strong network of family, friends, and dogs across the U.S.