Candidate of Medicine as deputy municipal doctor and the experience of medical uncertainty
Abstract
The paper studies how medical students faced medical uncertainty when working as deputy municipal doctors in Finland between the 1930s and 1970s. The article is based mainly on physicians’ autobiographical writings, collected by the Finnish Literature Society in 2004. The other important primary source is the medical students’ Medisiinari magazine. Having obtained the candidate of medicine degree (the lower medical degree) and serving the required period at university clinics, a medical student had the right to deputise a municipal doctor, which most students also did. Municipal doctors worked independently, and usually alone, in the countryside. The situation often gave rise to feelings of uncertainty, excitement and even fear. In their autobiographical writings, physicians described patient cases that had made them uncertain. Medical uncertainty can be personal, or it can be linked to intellectual ability, medical decision-making or patient-related issues. In this context, it was commonly connected to the candidate’s lack of knowledge, competence or experience. Being faced with their shortcomings, medical students criticised their education for being too theoretical, and their complaints led to some revisions in the curriculum. For candidates of medicine, working as deputy municipal doctors was an important experience and a crucial informal educational period on their path to becoming physicians.
Keywords: medical education, medical uncertainty, medical students, municipal doctors
