What’s in a letter?
One of my favourite annual events as a CCFP(EM) program director was reading the personal letters of the applicants to the residency program. The letters were often idealistic, many contained stories of events that had inspired the writer to go into medicine, and some wrote of difficult lessons learned along the way. Over the years I received letters from athletes, Olympians, scholars, and once even a rock star—the breadth of talent among our trainees is amazing. The letters were always inspiring to read and reminded me to reflect on my own reasons for choosing a path in medicine. Almost every letter spoke to the writer’s values, beliefs, and motivations. They were a wonderful window into the minds and ideals of some of the brightest learners I have had the fortune to meet.
My favourite letter ever was only a single paragraph long. It stood in stark contrast to its literary peers and made a singular, clear claim. “Dr Johnston,” it read, “I promise to be the hardest working resident you have ever had in your program.” Sometimes fortune does favour the bold, and that resident did turn out to be one of the hardest working people I have met.
Each academic year ended with a graduation ceremony, and I always took the opportunity to read a few passages from each personal letter and then to return the letter to the writer. Residency can be a challenging experience for anyone; there are new concepts to learn and many demands on a resident’s time. It is easy to see how someone could lose track of things as lofty as ideals and personal motivations. I always returned the letters because they were never really mine; they were a piece of each resident that they had shared with me, and returning them helped to remind that these lofty ideals were still an integral part of them.
If there is a lesson to be learned from personal letters, it is that knowledge is not everything. As teachers we often teach about concepts and skills but that is not all there is to being a good family physician. From time to time we should ask our learners bigger questions: Why did you choose to be a family physician? What motivates you to be a great doctor? The letters prove that our learners already know the answers to these questions, but in the bustle of residency these are questions that are, from time to time, worth considering.
Dr Johnston is Director of Distributed Learning and Rural Initiatives and Clinical Associate Professor of Emergency Medicine and Family Medicine in the Cumming School of Medicine at the University of Calgary in Alberta.
