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Where did all the Professionalism Go?
Perspective: Teaching and Mentoring the History of Medicine: An Oslerian Perspective. Bryan A et al. Academic Medicine 2013;88(1):97-101.
Reviewed by Jennifer Koestler

What is the focus of this paper?
The authors fear that the professionalism of young physicians is threatened. They propose that teaching – and discussing - the history of medicine can help by fostering medical professionalism.

What are the authors' conclusions?
The authors propose that the history of medicine can foster two important facets of professionalism: "nostalgic professionalism" and "activist professionalism." "Nostalgic professionalism" develops when learners study the evolution of medical practice and the key individuals who contributed to medical progress. Reflection on this noteworthy history provides needed role models that students can emulate and provides learners with a sense of solidarity with other members of the medical profession (e.g. the authors note that Osler kept pictures of William Harvey and Thomas Sydenham on his mantle to keep his role models in view). "Activist professionalism" emerges when learners study examples of social inequality and health disparities. Deliberate reflection on these examples subsequently fosters a sense of social responsibility and altruism in learners.

Rather than propose a new medical school course on the history of medicine, the authors take a more practical approach and confess that there is not one correct way to incorporate medical history into an already packed undergraduate curriculum. The authors encourage creativity to make the topic attractive to students and suggest using both formal curriculum (mandated coursework) in both the clinical and basic science realms and informal curricular models (mentoring groups) to accomplish their goal.

What is the implication of this paper?
The implication of this paper is a positive one: medical professionalism is not lost! It provides examples of how faculty can use the lessons of our past to inform the next generation of doctors in Oslerian fashion.

Editor's note: I agree that knowing the history of medicine can be inspiring. When we lived in London, Ontario, we toured Banting's home and saw the bedroom where he dreamt about insulin – quite remarkable to be there and think of the lives saved by his thought process (and hard work!!). When teaching about hyperbilirubinemia, I often mention how a charge nurse in Essex, England noticed that babies brought outside were less jaundiced than those that remained indoors (SLB).

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