"The dominant question is can the skills required to be a successful medical practitioner be selected at entry point – or are they only acquired after long hours on the job?"At age 46, after two decades of life as a doctor, I’m roughly mid-career (or about where my colleague Prof Con Michael no longer calls you a “junior doctor”, while he contributes enormously to medicine well into his 70s!). I wonder what constitutes a good doctor, given that contemporary medical schools, undergraduate or postgraduate, have extensive selection processes for the next generation of would-be doctors.

Interviews and aptitude tests now supplement the old-fashioned entry exam grades. If you’re a good listener and problem solver, you’re in with a chance. Being socially aware and having strong ethics and values is an added bonus.

But does the ‘all-rounder’ selected today necessarily want to be on call or working antisocial hours two or three decades on? Does this prototype have any interest in laboratory medicine or research? Will they study the extra decade to develop specialist skills? Will they accept the long and often arduous apprenticeship of any area of clinical expertise - before becoming the boss?

The attributes selected now – listening skills, empathy, problem solving – are not exactly controversial. The question is whether they match the reality of the time poor, overworked and often sleep-deprived doctor needing to act decisively (often with scant information)? Is the next generation of doctors up for this challenge?

Hopefully, well before the end of my career the answer will become known and selection processes adjusted accordingly. The dominant question is can the skills required to be a successful medical practitioner be selected at entry point – or are they only acquired after long hours on the job?

My experience interviewing potential medical students reveals an articulate, confident and very capable bunch (“Is it OK if I call you Lachlan?”). I find it quite disconcerting to reflect on a candidate’s skills, compared to mine at a similar age and stage. In my hands, the interview has not been particularly useful in terms of triaging potential candidates – almost without exception they have all been very capable.

A word of caution. Doctors deal with adverse events more these days, some of their doing. What personality traits or skills equip them to face, say, a hostile family or relative? Well taught communication skills will assist but the most important trait required is insight. The safe doctor exercises caution and reasonable deliberation in treating patients. They must also reflect wisely and show good judgment when they interact with patients because things have not gone according to plan. I’m not sure whether these attributes are genetic or can be acquired - or if they are on the interview scoring sheet!

Ed. Dr Henderson graduated UWA, 1989, and interned at SCGH before working 15 years in general practice – doctor-owned, university and corporate general practices. He is now Group Medical Director for St John of God Health Care after a stint as CEO at the Mount Hospital. He has positions within aged care, pathology, medical defense and a medical school, and is married to a child psychiatrist.