I have always believed that teaching works best when people feel at ease. Learning, in my experience, is most effective when there is no communication barrier. When trainees are comfortable, they ask questions freely, including the ones they worry might sound silly. That openness matters. It allows uncertainty to surface early, before it turns into error.
I also try to know my trainees beyond their roles. Their circumstances, pressures, and lives outside the hospital matter. I want them to feel seen as human beings, not just as residents moving through a rotation. For a long time, I believed this was not just compatible with good teaching, but essential to it.
Over time, I began to notice a discomfort I could not easily name. The same approachability was sometimes being read differently. Ease was mistaken for leniency, and familiarity began to blur expectations. When I tried to correct that perception, I would become more assertive, and almost immediately a different label would follow. The strict teacher. The consultant who asks too many questions. The one who does not spare anyone for a lapse. A communication barrier would form, and word of mouth would do the rest.
What troubled me most was not the shift in reputation. It was the sense of being misunderstood. My intent had not changed. The message was always the same. Our primary duty is to the patient. Quality of care is not negotiable. Questions are welcome. Repeated basic mistakes are not. Yet the way this message landed was often very different from how it was meant.
I felt this tension most clearly with a resident who was otherwise keen, capable, and engaged. Someone who worked hard, asked questions, and was invested in learning. There was mutual respect, and a sense of trust that had built up over time. When simple mistakes began to repeat, it was not alarming in isolation, but it was concerning in pattern. My first reaction was disappointment. Not in the system. Not in myself. In the resident. And that disappointment was uncomfortable, because addressing it meant risking a relationship that had been built carefully, and mattered to both of us.
The hesitation was not about what needed to be said. That was already clear. It was about tone. A firmer tone might damage trust or alter how I was seen as a mentor. A softer tone might fail to convey the seriousness of what was at stake. Sitting in that space, it was tempting to preserve ease, to smooth things over, to hope that things would improve on their own.
What finally pushed me to choose clarity was simple. Patient care. If I did not act, similar mistakes could recur, with other patients. Warmth could not be allowed to dilute responsibility. So I chose to be clear, even if it meant discomfort, even if it meant being misunderstood.
What anchors me now is something quieter. I am more at peace with knowing that I act in patients’ interests. Being a teacher is not about being liked, and it is not about being feared. It is about guiding people with clarity and responsibility, even when that guidance is uncomfortable.
The promise I feel I owe my trainees is this. I want them to set high standards for themselves, and I want to help them reach those standards. Mediocrity is not acceptable, not because it reflects poorly on anyone, but because trainees deserve the chance to excel, now and in the future, in whatever fields they go on to shape. That role requires warmth, but it also requires boundaries. It demands empathy, and accountability.
I am still learning how to hold warmth and authority together, without losing either. Perhaps that tension never fully resolves. Perhaps it should not. Boundaries protect both sides, and authority does not require coldness. Accepting that may be part of what it means to grow into the role of a teacher.
Dr K.
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