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The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires.— William Arthur Ward
As a full-time medical educator for the past 56 years and counting, I have been called many things. But not until a year ago did someone call me a guru. That someone—a former trainee of mine—sent me the following letter on my 80th birthday:
Dear Dr. Fred,
As your cardiologist, I congratulate you on reaching yet another milestone in your journey forward.
I was reflecting on what you mean to me and will share the meaning of guru as some of us from India understand it. A guru stands third only behind the mother and the father and is placed ahead of God (who is in fourth place!). A guru is not just a teacher. If you will indulge me, I will highlight some of the differences:
A teacher leads you by the hand. A guru leads you by example.
A teacher sharpens your mind. A guru opens your mind.
A teacher instructs you. A guru constructs you.
A teacher answers your questions. A guru questions your answers.
A teacher takes responsibility for your growth and education. A guru makes you responsible for your growth and education.
To my guru, Happy Birthday.
Before receiving that letter, I had never thought of myself—or any other medical educator—as a guru, probably because guru is not a conventional term in the lexicon of medical education. In that sense, the letter surprised me. It also humbled me and made me grateful, appreciative, and proud.
And it gave me reason to wonder, to think, and—ultimately—to offer this response.
Because I've had personal communications with Dr. J. Willis Hurst over the years and agree with his educational philosophy, I would tend to substitute true teacher for guru in Ramesh's letter. In Teaching Medicine: Process, Habits, and Actions,1 Hurst writes that teachers announce information in lectures and brief meetings, keep order, record grades, and worry about the curriculum. Yet they may know little about how people learn. A true teacher, as he defines it, understands how people learn and recognizes the difference between memorizing facts and thinking and learning. Hurst emphasizes that true teachers are filled with curiosity, pursue answers to questions that they or others raise, give their time to those being taught, show interest in many subjects, are good observers and communicators, continually study, enter the minds of their trainees, and retain a sense of wonder and awe.
Throughout high school, college, and even medical school, I thought that learning depended on having a good teacher. When I became an intern, however, I learned that the most active role in my education belonged to me: my resident regularly one-upped me by quoting pertinent articles he had abstracted on cards. His knowledge and method of storing facts impressed me, so I asked to duplicate all of his cards. He refused, encouraging me to devise my own filing system. I did. Now, over a half century later, I have what I suspect is the largest general medicine reprint file anywhere—upwards of 3 million articles, all catalogued and easily retrievable. Working daily on these files keeps me abreast of new developments, refreshes my memory on many aspects of medicine, and helps me enormously in my teaching.
When I became a full-time medical educator, I began to realize that good students make teachers look and feel good. But I also realized that all students must learn what their instructors cannot teach them. For that purpose, good questions are far more effective than good answers.
Consequently, I strongly support the Socratic method of teaching, firmly believing that we teachers don't teach; at most, we stir students to learn.2 And we promote learning more by the questions we ask than by the answers we give. Again, the most active role in education belongs not to the teacher but to the student.
One final point. Instructing a student is easy. “Constructing” a student is hard. Even harder is the goal of a true teacher: enabling students to construct themselves. For that process to work, the interaction between student and teacher must be ongoing.
As for my own “construction,” I had the good fortune to spend 5 years working closely with my medical mentor, Dr. Maxwell Myer Wintrobe, the man who was primarily responsible for making hematology a subspecialty. He demanded much, both of himself and of those around him. He abhorred excuses, expected top effort, and rewarded only exceptional performance. He was always firm, but always fair. Never satisfied, he would often say, “No matter how good a job we do, we can always do a better one.” He taught by the Socratic method, asking many questions and supplying few answers. He taught best, however, by setting examples, particularly examples of hard work, self-discipline, self-education, clear thinking, intellectual honesty, and intellectual curiosity. In short, he enabled me to construct myself.
Address for reprints: Herbert L. Fred, MD, MACP, 8181 Fannin St., Suite 316, Houston, TX 77054