Intended for healthcare professionals

Practice The Competent Novice

Lifelong learning at work

BMJ 2008; 336 doi: (Published 20 March 2008) Cite this as: BMJ 2008;336:667
  1. P W Teunissen, medical education researcher and junior doctor1,
  2. Tim Dornan, professor of medical education2
  1. 1Institute for Medical Education, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT, Amsterdam, Netherlands
  2. 2University of Manchester Medical School, Manchester M13 9PT
  1. Correspondence to: P W Teunissen pwteunissen{at}

The importance of lifelong learning in medicine is well recognised. This article explores how junior doctors can develop learning strategies for use throughout their working life

Key points

  • Lifelong learning is a process of continuously scrutinising and building on your practice to be the best doctor you can be

  • Always have three questions in your mind: where am I going? how am I getting on? where to next?

  • Use electronic tools that provide filtered information at the point of care because you cannot hope to stay up to date on everything

  • Keep a learning portfolio so that you can see how you have already developed and how you can develop in the future

  • Keep your learning efforts alive by discussing them with your peers and supervisors

Most doctors are aware of the aphorism that learning should continue from the cradle to the grave. However, medical school does not prepare anyone fully for the responsibilities, long hours, and challenging tasks that qualification brings.1 2 The fittest survive by learning from their practice, whereas those who do not continue to learn become dissatisfied and burn out.3 Current restrictions in working hours, changes in the organisation of health care, shorter hospital stays, and the breakdown of the medical firm make it ever more necessary to learn efficiently from practice.4

Numerous editorials and descriptive articles have stated the importance of lifelong learning, but research has not yet provided a definitive answer to the question “How can trainees develop lifelong learning strategies?” We have drawn on medical education theory and empirical studies of both facilitating practice change and the effectiveness of feedback for best evidence on effective lifelong learning. Those sources show that one size does not fit all. Our article does not therefore offer quick fixes such as organising group learning sessions or …

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