Family Medicine in Malawi – Jessie’s Story

Daisy WinnerBlog, Malawi

What are your strengths?  What do you do well?  What are you good at?

My American counterpart and I start every feedback session with medical students with these questions.  And usually the students stare blankly at us.  Some will start hesitantly…  “I come to class.  I haven’t missed a teaching session…”

Yes, but what things about being a doctor are you good at?

They have no idea.

And that is a symptom of the whole Malawi education system.  Never tell a student they have done well.  Ask questions until someone looks bad.  Make yourself look smarter by stumping the other.

The American teachers do it a little differently this year.  We spend the first five minutes telling students what they are good at:  You connect with patients.  You seem to be able to talk with all age groups.  Your instincts are good.  You are hard working.  Detailed.  Willing to risk being embarrassed to learn and ask questions.  You seem to really care about patients.  People are willing to tell you very private details.  You are a leader.  We think you’ll become a great doctor.

Mangochi Hospital-66

…this is one of the reasons I’m in Malawi this year: to encourage students, to see the positive, to be one of the voices that say, ‘You are enough. Smart enough. Strong enough. Hard working enough. Skilled enough. Enough to be a doctor. To be a leader. To make a difference.Dr. Jessie Reynolds, Family Medicine Volunteer – Malawi

Only afterwards do we ask where they need to improve.  That is an easier question for our students.

One of our ten students this week cracked.  He is a good student but had a true panic attack over the time pressure of finishing his logbook and turned it in half blank.  We gave it back to him and told him we thought he should pass and to finish the work by the morning.  He flubbed the redo, and we gave him the chance to spend a morning fixing the work.  He missed his feedback session, so my colleague and I went to him.  And after hearing his story about panic, we asked about him.  Was he ok? Did something happen to trigger this episode?

And then we told him what he was good at:  He’s gentle and kind with patients.  He presents very well and with great confidence.  He held up under questioning by our Malawian doctors better than any other student we’ve seen.  He has improved tremendously over the last month of work.  We think he is smart.

We told him he needed to take the next two days off.  Sleep.  Play soccer.  Watch a movie.  Hang out with friends.  Blow off steam.  Only then, after he is steadier, study.  Go into the tests next week knowing that we thought he should do fine as long as his nerves don’t get the best of him.

He left with this comment, “I never expected to hear positive things from you.”

Oh… that hurts a little.  More in empathy because he was expecting the worst, but also in a little introspection to see if the positive things that I think I’ve said this month have been often or strong enough.

Maybe this is one of the reasons I’m in Malawi this year: to encourage students, to see the positive, to be one of the voices that say, “You are enough.  Smart enough.  Strong enough.  Hard working enough.  Skilled enough.  Enough to be a doctor.  To be a leader.  To make a difference.”

This student passed the course… by one point on his written test.  In the faculty meeting, we were asked if he should pass.  Yes, we said.  He is smart but just anxious.  He is hard working but was caught by the time pressure.  He will be a good doctor.  He is… enough.

– Dr. Jessie Reynolds, Volunteer – Malawi

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