Dr Louise Younie
Meet Dr Louise Younie, Clinical Reader in Medical Education at the Institute of Health Sciences Education, who talks about her work on 'flourishing in medicine'.
1) You work as a GP and Clinical Reader in Medical Education and are actively involved in Faculty Development and Innovation within Community Based Medical Education (CBME). Could you tell us more about your work here?
I have the privilege of being part of the Community Based Medical Education (CBME) team within the Institute of Health Sciences Education, leading faculty development across our frontline GP educators in primary care. We seek to develop our community of committed educators through, for example, creating space for sharing best practice, hearing from students, curriculum innovation, leadership and role-modelling. Our ethos is to flatten hierarchy, inspire curiosity, enable questioning and to work co-creatively with our students. The Queen Mary SEED award, launched in 2021, emerged from working with students in this way. So too did CIRCA Med Ed, an arms-length Medical Schools Council group which I co-lead with Dr Rofique Ali. This national group has grown out of iterative, design-based piloting of virtual clinical placements locally with students and tutors since 2020.
2) You have been developing the field of human flourishing through creative enquiry in medicine. What does flourishing in medicine refer to?
As a medical educator, I have been seeking to move the conversation beyond individual strength to ‘bounce back’ (the usual framing of resilience), towards a more humane, interconnected and ecological take on wellbeing. I describe this as flourishing. Flourishing connects our inner lives metaphorically with trees, flowers, gardens and their seasonal ebb and flow of loss and renewal, death and growth. To flourish, is not necessarily to be happy or have every need met (hedonia) so much as about purposeful and meaningful connection with our values and each other through the ups and downs of life. To flourish, we need to move away from perfectionism and embrace ‘what is’ rather than what ‘should be’. I call this ‘shadow work’: engaging with parts of ourselves, our team-life or organisational-life that we might prefer to ignore and forget.
Conceptually flourishing builds on Aristotle’s eudaimonia (meaning and purpose), Neff’s self-compassion (accepting our flawed humanity) and Acceptance and Commitment therapy (e.g. be present, open up) and it is supported metaphorically by archetypal tree imagery for example the Biblical flourishing tree planted by water in season and out (Jermiah 17:8, Psalm 1:3).
‘Flourishing is a kinder way to grow’ (Creative arts SSC student, 2021)
Practically, my engagement with the concept of flourishing has emerged out of many years of innovation with students in the field of creative enquiry. Creative enquiry involves engaging with lived experience through the arts. The metaphorical and symbolic work of creative enquiry enables images, ideas and memories to emerge from the fringes of our consciousness. To create and share is often personal, as one student said, ‘you cannot create without putting something of yourself into it’. If a safe environment is created, for example through vulnerable leadership, ground rules and attention to boundaries, a place of rich dialogue and solidarity may ensue.
3) Tell us a bit about your educational and training background and what advice you would give to a student wanting to follow in similar footsteps.
My journey in medical education has been meandering and part serendipitous. Prior to fully qualifying as a GP I took the option of a 6-month extra placement in fields that interested me. After making contact with the head of primary care at the University of Bristol, a 3-month placement ended up with successful application for a clinical lecturer post and the opportunity to study for a masters and subsequently doctorate in education. Then an email from our external examiner of the time, Dr Sandra Nicholson, invited application for a senior lecturer post and brought me from Bristol to Barts and The London, Queen Mary, in 2011.
My educational path was punctuated with two years away, living through cancer and its treatment. This was a time of personal suffering and vulnerability that endorsed the importance of relationship, compassion and kindness to our patients and the need to similarly role-model compassion and kindness to our students, because actions always speak louder than words.
Some of my ideas and approaches to medical education have been unconventional, but I have sought to stay curious and do work that was meaningful above strategic. Perhaps as a result, educating medical students still engages and inspires me 20 years down the line.