End of year 2015: Confusion is not an ignoble condition

I accumulate things to do and write about as the year goes on, and the pile in the corner of my desk gets larger and larger. As does the guilt. So this is is just an attempt at wiping away the sin.

Lovely obituary in the Economist (October 17th,2015) of the Irish playwright, Brien Friel. It ends with his words: ‘Confusion is not an ignoble condition’. Agreed. Fail, fail again……

Kids Company. The story that tells how much political patronage is still alive in corporate UK, and how much professional expertise is frowned upon by the political classes and their hangers-on. But the damage is spread wide. From the Times Higher, 17 December 2015:

However, Dr Maitland Hudson said that many academics commissioned by Kids Company has been placed in a difficult position, particularly when their work was later misrepresented by the media. Academics are encouraged to generate income via grants, so it’s quite hard to turn money down when it is offered”

Well that’s alright then.

University funding in Australia. “The independent senators ‘didn’t understand that there were any financial issues, or that we were so heavily reliant on international student fees to fund research’”. You can work out the context. This story is going to run and run in the UK, where the various cross subsidies within university finance are going to have a hard job staying beneath the radar of students and their parents — and other institutions . As Jeff Bezos would say: ‘your margin is my opportunity’.

Rethinking regulation — might less be more. Nice piece in the BMJ by Christoph Lees and Hilarie Williams. It seems — reading between the lines— that even the PSA (professional standards authority — not your prostate test) is of the view that the GMC is out of control. Wait for the GMC to start wanting to regulate school children who might choose medicine as a career. I haven’t read the report they refer to, but am just surprised that anybody with any sense can still be allowed to voice an opinion ( ‘A dog at the master’s gate predicts the ruin of the state’).

“Every doctor a scientist and a scholar’. Gee, when do these people sleep — or practice medicine. Again, I haven’t read the report but somebody surely has been drinking the kool-aid. Guzzling it more likely. (BMA news 18th April 2015).

On being the right size. Well, in this case, on why eyelashes are the length they are. Wonderful. What natural science is all about. And fun, too. (Economist February 28th, 2015).

You’re here to teach. Save the trainspotting for the weekend. David Oldfield in the Times Higher 12 February, 2015. His argument is more nuanced than the title. I am not a trainspotter, either.

A prescription for change. Article by Alastair Buchan arguing that universities should play a bigger role in postgrad medical education. Universities once did, but serious education and NHS management are uneasy bedfellows. (Times Higher 11 June 2015). Contains the usual flimflam of ‘producing the best doctors in the world’. I wondered if he was after the job (‘National Institute of Health Education’). I always say that I was clinically trained in a university department, but then came Thatcher and Griffiths. Education doesn’t scale easily, let alone when it answers to politicians. Control is the single biggest priority of the NHS and its political masters: if you allow  universities in, it tells you something bad has happened to universities.

National examination would benefit medics. More 1984 stuff from the GMC. You could spend a day or more wondering about the motives behind this short letter. Let me stick to one point. The chair of the GMC says that the ‘public would like to be reassured that, in terms of core knowledge, skills and competencies all doctors meet the same standards’. This is simply wrong, and I assume the public have more sense. Little islanders, despite all the talk of world class. As for an exam, I am open to persuasion. As ever with the GMC, the GMC is concerned about the GMC, not doctors. Doctors are just the substrate. (Times Higher, 14 May, 2015).

Practice is going to kill your creativity. Barbara Oakley in the Times Higher (April 16, 2015).

‘There is this feeling that we should make maths and science [at school] fun, because we want them to go into it. And then what happens is that students hit university and it’s like the math and science death march, and they fall right off’. There is a need in the teaching of STEM, she said to encourage ‘procedural fluency’ — the use of repetition to understand processes. ‘You would never say to someone learning the piano, ‘Practice is going to kill your creativity.’ But when it comes math and science.. it is somehow thought to ne very different, and it’s not.’

I would add that if you want to think hard about the acquisition of medical expertise, look hard at Masterchef or how some of use learned — or didn’t learn —to play a musical instrument (See Geoff Norman’s article on “Mashed potatoes and medical expertise”). We have known the basics for a long time and dare I say it: more research is not needed.

Bowing to pressure. Sad, depressing account of what has happened to teacher training / education, by Anthony Kelly (Times Higher, 12 February, 2015). I have said for a long time, with more intuition than rationality, that the destruction of teaching in the UK is what the government has in store for medicine (nursing went belly up a long time ago). The parallels between the various professions and the role of the universities in being the home for the development of professional expertise is worthy of lots of thought. Think about lawyers, medics, business MBAs and so on. I do not think anybody should be too confident of what will unfold — least of all the universities.