Profile with Ayelet Kuper

 Doug Nicholson/MediaSource

Doug Nicholson/MediaSource

Dr Ayelet Kuper (Quebec and Magdalen 1994) is an Assistant Professor in the University of Toronto’s Department of Medicine. Her current research program addresses how “legitimate” knowledge is defined and transmitted in medical education.  Dr Kuper received a Masters degree in Research Methods in 1995 and a DPhil in 1997, both from the Department of Medieval and Modern Languages of the University of Oxford, before undertaking medical training (MD 2001, FRCPC 2005).

Rhodes Project: Where do you call home?

Ayelet Kuper: Toronto, Ontario.  I was born in Jerusalem and grew up in Montreal, studied in Boston and Oxford, and I’ve been in Toronto since I left Oxford.

Rhodes Project: What is the last book you read for pleasure?

Ayelet Kuper: I’m in the middle of two, which are a little bit different from each other.  Firstly I’m reading Ian Rankin’s The Impossible Dead – I think I developed a love of British murder mystery novels whilst I was in Oxford.  I’m also listening to Robert Fagles’ translation of The Odyssey, read by Ian McKellan, which I’ve read before but never listened to.

Rhodes Kuper: Can you tell me about a favourite memory from Oxford?

Ayelet Kuper: There are so many!  I’ve been back in Canada for over 15 years now, so most of my favourite memories now revolve around people I met (many of whom I’m still friends with).  I have fond memories of trouping out of the Taylorian Library after the seminars that all of the first year graduate students in my Department had, over to the Eagle and Child to hang out and really get to know each other, having a beer and talking about life, the world, books, literature.  I was on the Magdalen Ball committee, so I have amazing memories of organising and then going to the Magdalen Commemoration Ball.  I have some great memories of doing things like going to boat races, having guest dinners, and hanging out with the girls – just having a wonderful time, interspersed with phenomenal conversation about almost anything in the world.

Rhodes Project: When did you first become passionate about medical education?

Ayelet Kuper: I became interested in medical education when I started medical school.  I had just finished my DPhil in Modern Languages and defended my thesis over the summer, and I started medical school at the end of August – I went from one end of the world to the other academically.  I was very taken aback by what we were learning and how we were learning it – not so taken aback that I changed my mind about becoming a physician, but taken aback enough that I felt the need to question it.  Unlike many of my peers I had gone through such different forms of education, between a Liberal Arts university degree and a DPhil, that the M.D. program didn’t just seem like the inevitable continuation of a science degree as it was for many of my colleagues, and so I questioned why we were learning what we were learning and the way we were learning it, and got quite involved in the practise of medical education, and medical education administration committees, even as a junior medical student.  I put away those interests for a little while, whilst I was actually learning medicine, and then came back to it when I was done.

Rhodes Project: Can you tell me about a favourite past project?

Ayelet Kuper: I’ve just finished a project now that I’ve really been having fun with.  We have this notion now that physicians can’t just be experts in the science behind medicine, they also have to be experts in all the human sides of being a physician - collaborating with others, communicating with patients and colleagues, advocating for their patients, managing their care, being professional and being scholarly.  This is something that’s now quite prevalent as an idea in the UK with the Tomorrow’s Doctors reports from the GMC, and it’s something that’s quite well understood in Canada with a concept called the CanMEDS Roles which are multiple different roles that a physician has to play, and yet our medical schools are almost entirely scientific in terms of what they teach. 

Many people attribute that disconnect to saying that they don’t know what they could teach because the medical educators have themselves only been trained in the sciences, so they don’t know what they’d teach to underpin all of these other things that doctors need to be good at.  I actually set out to find a cohort of social scientists and humanities scholars, to teach them about medicine’s current conception of what doctors should be, and to learn from them what other knowledge needs to be in our curriculum to underpin that - what kind of knowledge from sociology, or anthropology, or literature, or religion, or architecture, or English.  We interviewed people from about 20 different disciplines, and tried to figure out what knowledge would contribute to making a well rounded doctor who meets all the socially accountable requirements for being a contemporary physician.  We’ve just finished putting all that together and analysing the data and are writing up the paper.  It has been a fascinating journey speaking to all of these people and learning from them in a really interdisciplinary way.

Rhodes Project: Can you tell me what you’re currently working on?

Ayelet Kuper: The next thing I’m actually working on is developing ways to try to implement these ideas into actual curricula.  It’s all well and good for me to write a paper saying these experts from outside of medicine say that just as we teach people about chemistry and physics in medical school we should be teaching them bits of these other disciplines as well, but publishing an article in journal doesn’t actually do anything.  So now I’m going to collaborate with people who create curriculum and try to work this material into curricula here in our medical school, and in other medical schools and other health professions schools.  I’m also starting the process of gaining legitimacy for these kinds of ideas because they are a little bit different.  But at the same time our medical school, like everyone else, is trying to figure out how to teach these non-science based roles and so hopefully there’ll be an appetite for it.

Rhodes Project: If you weren’t working in medicine, what would you be doing instead?

Ayelet Kuper: Well, it’s funny because I already feel like I do about three different things “instead” - I work as a physician for about two to three months a year, spread out, then I do this research for part of the year and teach for part of the year.  When I was being interviewed for the Rhodes twenty years ago I was asked what I would do if I couldn’t do my PhD or go to medical school, because I’d already said I was going to do both of those, and during the interview I said I would write crossword puzzles.  I don’t think I’d do that anymore, but I think I would do something that involved spending a little more time thinking and writing.  I already spend a lot of time thinking and writing, but I think if I didn’t have administrative, teaching and clinical responsibilities I would spend more time focused on thinking and writing, maybe going back to some of the work I did that’s more closely linked to my PhD.

Rhodes Project: Can you describe a memorable teaching moment?

Ayelet Kuper: I’ve learnt something about my teaching recently, which goes back to the research I was talking about.  My DPhil is in Modern Languages, but essentially I’m a social scientist now – I did another Masters degree in Theory and Policy Studies in Education, and most of the work I do now is within the social sciences.  Yet, I do a lot of my teaching as a clinician on the ward, so I’m on a general medical unit and I have residents and medical students, and I’m responsible for teaching them every day for the weeks at a time when I’m on service.  For years I’ve been teaching them standard medical stuff – what to do when someone has low sodium, or has chest pain, or shortness of breath.  This is all very important and very valuable, but it’s the same material they learn from everybody else. 

Over the last couple of years I have started talking to them more about social scientific ideas about how they practise, how they acculturate into the medical system, and the interactions they have with other people on the healthcare team – quietly educating them in that way.  It’s now come to the point that when I start a rotation I say to them “Would you like me to teach you about hyponatremia (low sodium) and heart failure – to give you the same lectures that everybody else has given you – or would you like me to teach you this other material that you’re not going to get in other places, but is not currently part of the core of our medical curriculum?” They absolutely lap up the social science material.  They are so fascinated by how physicians professionalize, how physicians relate with other professions, their experience of the hidden curriculum of medicine – how, for example, their work in the hospital teaches them very subtly what is and what isn’t important and how to behave in their professional lives. 

So I’ve learned that if I think something is really important and I’m passionate about teaching it, even those people who I wouldn’t have thought would be interested, because they’re so focussed on becoming doctors and learning their “medicine”, can actually see how important and relevant this material is, and to find this less traditional material really interesting.  The feedback I’ve gotten from them has been really phenomenal.  They’ve been really excited by these kinds of ideas, much more than I would have thought.

Rhodes Project: What is the most challenging part of your job?

Ayelet Kuper: I’d say the most challenging part of my job, or jobs, is trying to be done every day at five so I can go home and see my two year old son.  I know a lot of my colleagues work from 6am to 10pm, and I’m not at a stage in my life where I’m willing to do that, so I have to squeeze all of those jobs into a normal work day, with some work from home after my son’s bedtime, trying not to sacrifice family life.  If there’s a sick patient, that’s the one thing that I will of course stay late for, but if there’s a grant application due, or a paper to write, or someone wants to have a meeting about a project, it’s just not worth it.  The hardest part of my job is balancing the amount of things I’d like to do in my work life, and the importance of my family life.

Rhodes Project: What brings you the most joy in life?

Ayelet Kuper: The thing that brings me the most joy in my life is absolutely, positively my two year old son.  Just listening to him chatter on about how Fireman Sam is coming with him to go rescue someone, or singing songs to me and pretending to play his little guitar, or talking to his stuffed animals and telling them stories.  Taking him places and showing him the world – that’s what brings me the most joy.

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