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Editor's Correspondence
January 12, 1998

Outspoken Criticism Enhances Medical Education

Arch Intern Med. 1998;158(1):100. doi:

With respect to "System, Supervision, Standards, and the ‘Epidemic' of Negligent Medical Errors,"1 the author makes the point that there is a pervasive absence of criticism of house staff by chief residents and senior staff at meetings. Such "a kinder, gentler approach that does not threaten self-esteem and that provides mainly instructive information as mini-lectures about the patients' diseases or therapeutic agents"1 compromises both patient care and house staff education. What we are seeing is collegiality in the absence of accountability. Rounds and divisional conferences are replete with "what was done" rather than "why was it done." Questions of "why" are considered impolite. The house staff conference has acquired the ambiance of a Rotary Club breakfast, complete with bagels and cream cheese. Who is responsible for such a deplorable turn of events in medical education? I submit that the unsung culprit is entrenched medical academia.

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