By Lynfa Stroud (@LynfaStroud)

“He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.” – William Osler

Lately I’ve been thinking about some terms that we frequently use in medical education: service and education.  In these discussions, “education” usually refers to teaching in a formal setting (such as classroom during an academic half-day) or informal setting (e.g. at the bedside), whereas  “service” usually refers to “clinical service”, or the process of caring of patients and all that this entails (paperwork, phone calls, dictating notes, chasing down tests, etc, etc). These terms come up often during individual meetings with residents, committee meetings, and accreditation reviews. Large amounts of time and talk are taken up with ensuring that rotations and programs have an appropriate “education to service” ratio. My perception is that over time these have evolved to the point that they have become somewhat of a false dichotomy, with the implication that “education” is good, and that “service” is bad.

This puzzles me.