Medical Dementors

Careless dementors: It takes a great deal of effort to mentor someone, Unfortunately in the current residency system, the mentee does not remain with the mentor until the process is complete. The residents are rotated from one unit to another, with the objective of exposing them to different consultants. They are expected to pick up the best from each of consultants. Unfortunately, bad habits are picked up far more readily than the good ones. When I spend six months (the duration of one post) training a batch of residents, I expect them to remember what I teach them, and practice that at least until they find something better. Unfortunately, if they go to some other consultants in the next couple of posts, and then return to me, I sometimes find them adopting some clinical practices that are not found anywhere in the medical books and journals, that do not stand to logical scrutiny that should be a part of every clinician’s practice. There is no explanation of this phenomenon other than that they unlearnt whatever I taught them, and learnt something different while they were away from me. It is unlikely, but not impossible, that the consultants they worked with forced them into doing this. I feel it is unlikely because someone so senior would not openly advise something against standard teachings. I feel it is not impossible, because there are some people who believe that what they feel about any clinical situation at a given moment is the final truth, and then things like evidence-based practice become superfluous, But I feel that a more likely explanation is that such consultants often indulge in practices that deviate from standard practices without realizing the implications. When the residents see such things happen, or are themselves a part of those happenings, they come to believe after some time that those are the norms or standard practices. The seniors who indulge in deviations from standard management guidelines sometimes cause harm to their patients, but many patients get well and never realize that not-so-correct treatment was given to them. But a greater damage is done by these senior clinicians to the residents, who pick up wrong practices, and even teach those to their juniors. Some of the residents are intelligent, and understand the errors of their ways when they read books and journals. But many others do not apply their minds to this and continue with such practices. These seniors who undo the work of good teachers and mentors are, in my opinion, dementors. The dementors are either the victims of senior dementors, or have become so all by themselves. The sad thing is that it is beyond anyone's control to correct either the victims or the dementors. The good thing is that God watches over the patients and generally nothing much goes wrong. But when things go wrong, there is grief for those affected, and even if they go to court and get justice, the damage done cannot be reversed.