Another academic year is about to conclude and certificates will soon be handed over to a new generation of medical trainees. For those of us at the mentor/educator end of the process, this is time for global reflection and review.
Ideally, this should also be the time to reassess the selection process by comparing prerecruitment expectations and predictions with achievements realized by every trainee. Such an assessment can help answer the important question: Is it possible to foretell applicants who will flourish and excel from those who won't?
Having gone through this annual exercise time and again, gathering observations, collecting data, and completing statistical analysis, I arrived at what I felt, at the time, to be novel answers:
Among applicants who meet basic requirements, the strongest predictor of exceptional success is motivationVirtually all candidates follow a common learning curve, but highly motivated trainees follow a significantly higher curve regardless of their starting pointThe initial few weeks of training are highly predictive of the general curve or pattern the trainee will follow.
In a moment of triumph, I dreamt of summarizing my findings with granular detail into a grand manifesto. On hectic workdays, my mind would occasionally take a few seconds to daydream about releasing this motivational curve theory to the medical field. Plotting an applicant on this motivational curve, I surmised, will certainly provide a powerful tool for predicting an applicant's future course, much better than a curriculum vitae (CV) alone. While CVs are retrospective, the motivational curve (Kahwash Kurve, if you will) has the advantage of being forward looking and predictive. The business field should be eager to apply this novel curve as well (it would be fantastic if a curve applied first in the medical field becomes a contender for the Nobel Prize in Economics[INSIDE:1]).
I was still riding a wave of excitement about all this when COVID-19 burst onto the scene. With life around me grinding to a halt, I had time to reflect and read, within and outside the field of medicine.
A mere coincidence led me to dig out a book of old legends, where I found a story that made me open my eyes and pause. The story in summary is as follows:
A young man from Palmyra (Palmyra: An ancient city and a past trade hub along the Silk Road, extending from Asia and the Far East through the Middle East to Europe. The city was built around an oasis in the Syrian Desert. Palmyra is renown today for its ruins), traveling the ancient Silk Road to Aleppo (Aleppo: One of the world's oldest cities, an ancient trade hub and currently a major cultural center in northern Syria), got separated from his caravan and lost his way. He walked for hours in uninhabited wilderness before he finally spotted an old man diligently plowing his field [[Figure 1]].
Figure 1: Photograph taken by the author of a piece of art exhibited at a museum in Syria. Artist in not known
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“I am sorry to interrupt, but I got separated from my caravan. Would you be kind enough to tell me how far am I from Aleppo?”
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“I'd be glad to.”
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“Great! Are you going to tell me?”
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“Sure. I'd be glad to. Keep going!” The old man replied as he turned back to his oxen and plow.
The young man asked for a third time, only to get the same reply. Convinced that the old man was either a fool or a victim of advanced dementia, he decided to continue on his way.
He must have walked no more than a hundred yards when he heard the old man shout to him:
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“You are 2 ½ days away from Aleppo!”
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“Why did you not tell me earlier when I was near you?”
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“I did not know then. I needed to observe you walk and gauge how motivated you are to get there! Now I know!”
Evidently, an early precursor of the motivational curve has been well known in Palmyra for millennia. I am glad I had the chance to dust it off!
Authors' contributions
Single author.
Compliance with ethical principles
Not applicable.
Editor's Note
This personal paper represents a letter that was sent by the author to his 2020 fellows. He kindly shared it with the readership of the journal.
Reviewers:
Khadija Hafidh (Dubai, UAE)
Abdul Fattah Lakhdar (London, UK)
Editors:
Elmahdi Elkhammas (Columbus OH, USA)
Salem A Beshyah (Abu Dhabi, UAE)
