On the human family physician

Recently I participated in family medicine resident admission interviews. Other family physicians and I evaluated applicants to a residency program. In teams of 2, we met applicants for individual interviews. Applicants were asked to express why they wished to enter family medicine. We were then required to ask them standardized questions evaluating their skills within domains corresponding to intrinsic CanMEDS–Family Medicine roles.¹

My personal impressions could be summarized as follows: Wow!

There were a whole bunch of budding geniuses. Mostly young women. There was only one young man on my list (where are all the young men going these days?). The candidates were all brilliant—super brilliant—young women. They had all achieved everything there was to be achieved at their age. They spoke 2 or 3 languages fluently. They were devoted to music, some being members of a choir or playing in a band, while others had graduated from a conservatory of music. They had climbed Kilimanjaro, Machu Picchu, or some other mountain; crossed Patagonia, Nunavut, or some desert or other; biked across Canada from west to east (or the reverse). Not to mention their extensive experiences working in their communities and collaborating internationally. The only thing really missing to complete their list of achievements would have been going over Niagara Falls in a barrel or walking on the moon (I’m only slightly exaggerating, believe me)! In short, they were an assortment of intelligent young women, each more brilliant than the last. Superwomen, even.

And I said to myself … wow! (Again.)

As I watched them leave, a little voice in my head murmured, “If I had to do this all again, I would not have even the slightest chance of passing this interview and entering family medicine.” And I was not the only one suddenly struck by a bout of imposter syndrome.

Then a second voice challenged the first and whispered, “That is all well and good, but is that what makes a better family physician? Do you need to be a super-high performer to be a good family physician? Do you need to be a superwoman or superman to be a good family physician? Can’t an ordinary person (please note that I do not mean mediocre) become a good family physician?”

I found myself questioning the qualities of a good family physician. No doubt there are large treatises and long dissertations out there that give detailed explanations of the qualities of a good family physician. Instead, I preferred to ask my family, friends, colleagues, and collaborators about the qualities they valued most in their physicians. I will admit, it was a non-random, nonstratified, nonrepresentative, non–evidence-based, even opportunistic sampling. Regardless, I received the following responses: a good family physician is a competent physician (of course!), but is, above all, devoted, accessible, a good listener, humble, empathetic, and makes an effort to help and understand. Try it. Ask your family and close friends and I would not be surprised if you arrived at the same results.

Yet these qualities are certainly not confined or exclusive to the “superhumans” of this world. On the contrary. Could it be that we are taking the wrong approach by only selecting those who are among the highest performing and strongest of our society to become family physicians? And could it be that “ordinary” candidates (I repeat, not mediocre) from a range of social experiences—poor, rich, young, old, men, women, trained in Canada or abroad in health sciences or the humanities—can make excellent family physicians?

A good family physician is, above all, a person who is interested in the well-being of others, who listens and reassures, a person who is devoted and compassionate. A good family physician is a person with emotional intelligence, who is able to laugh, cry, relate, and sympathize.

In short, a good family physician is, simply and before all else, a human being.

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