22 April 2022

Thank you to Katie Thornton and Thomas McCabe for their letter about my article and for stressing the importance of the hidden curriculum in equipping future doctors for a life working so close to death, despair and disability. The authors make the very important point that remote working – where caring and learning are reduced to a series of clicks – is not the same as mixing with, learning beside and modelling the behaviours of our peers and trainers. I also agree that online isolated learning is not the same as mixing with others and does nothing towards learning the vital defence mechanisms that sustain doctors in their future careers. The authors mention reflection. I too am concerned about the drive towards online ‘reflection’, where students and qualified doctors are meant to record their most intimate thoughts about their clinical practice in a sterile, impersonal (remote) space. Surely reflection done as an isolated activity is nothing more than rumination and does nothing to enhance our understanding or fresh ways of thinking about our work. I chose to submit my article to a psychiatric journal in the hope that the specialty most able to bring back the psychological soul into our work must be psychiatry. Given the responses I have had following publication, I am hopeful of this.