There I was, almost at the end of the night, having spoken to a few hundred hand-picked, talented high school students about my life as a doctor. Their youth was no barrier to their determination to be the best – I met budding astronauts, focused scientists, concerned environmentalists, and as usual, a horde of kids who dreamed of becoming doctors.
The students asked penetrating questions about everything from the ethics of million-dollar drugs to whether children compromised one’s career. These were teenagers! With each question, my admiration grew and I briefly dreamed that one day, in my household, there might be such questions to replace, “Have you seen the remote?”
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I was signing books when I noticed a girl, who hovered on the side, waiting till the crowd had cleared.
“I don’t know how to ask this without being rude,” she ventured, before my silence enabled her.
“My parents really want me to do medicine but I’m not interested. How do I say no?”
It was the curliest question of the night.
“I think I can get in but my heart is not in it.”
“It’s great that you recognise it,” I said. “Have you tried talking to your parents?”
“I’ve tried and tried, but they have invested their whole life in my brother and me.”
“What would happen if you said no?”
“They would be really disappointed in me. That would break my heart.”
“But if I did medicine, I wouldn’t be honest to myself. And I’d take the spot of someone who really wanted it.”
She faced a wicked dilemma: whether to obey the urging of her parents or rely on her own, admittedly young, instinct. A momentous decision hung in the air, the sort parents can help address, but of course, the parents were the problem. And though she relaxed at the opportunity to voice her dilemma, I knew that the knots in her stomach would return soon.
I wished that I could sweep away her problem; I wished I could convince her parents that a child of her poise and humility would do well in whatever she chose. I told her to see the school counsellor again and I reminded her to be true to herself but when she left, I felt hollow, musing whether she would one day be the troubled student or the depressed intern I encounter.
Although I don’t know her parents, I meet them regularly. I meet them at social events and medical talks. I meet them at seemingly benign movie nights and picnics when the conversation turns to medicine.
“He’s got the marks, he’s all set with the entrance test, all he needs is a coach for the interview,” a mother breathlessly explained. “Do you know anyone?”
“No,” I deadpan.
“I just want her to be happy,” says another. “You’re happy, aren’t you?”
“I am but she isn’t me.”
Another time an acquaintance of an acquaintance knocks on my door, a tired son in tow. “We want last-minute tips for his interview.”
Students pondering a career in medicine, I have always welcomed. Parents who do it on behalf of their child, I am increasingly wary of. The students are largely altruistic; the parents aspire to status, money and job security. I don’t blame them but what they don’t realise is that in the hyper-competitive world of medicine, even those with the marks and motivation battle to get in, so there is even less room for those with the marks but scant motivation.
Some years ago I interviewed a young man who was obviously bored, even in our eight-minute high-intensity interaction. His opening salvo: “Can I just tell you that I want to be an accountant?”
“Wrong interview then,” I said lightly.
“I got the marks and my dad made me come. My dad is a doctor.”
“Did you tell him you aren’t interested?”
“No point, but I hope to fail the interview.”
I was left reeling but I was told that no selection process can filter out pushy parents; we wait for the students to find their voice.
Doctors are often asked if they would recommend the profession to their children. A survey of American doctors by the Physicians Foundation found that more than half say no, citing the triumph of paperwork and bureaucracy over time with patients.
When I talk to my Australian colleagues, I hear similar sentiments. Doctors sign up to help people but are faced with growing mountains of paperwork, mindless compulsory modules and maddening meetings to satisfy performance indicators that make a mockery of patient-centred care.
Many doctors are burnt out, bullied and demoralised. Work is stressful and demanding. A 2013 Beyond Blue survey put paid to the notion that these are merely the groans of a self-indulgent, richly rewarded profession. Australian doctors have a substantially higher rate of high psychological distress compared to the general population and other professionals. An astonishing quarter have considered suicide, double the comparable figure in other professionals.
These figures are not just statistics – they are my friends and my residents. My professional landscape is strewn with doctors in trouble with alcohol and prescription drugs, doctors with broken relationships, sick of work and exhausted at home. I attend funerals and wonder how no one ever knew and I learn that no one is immune.
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And yet, I love being a doctor because there is something undeniably special and enormously satisfying about helping people at their sickest and lowest. Amid the gratuitous noise and politics, every day the door in clinic still closes and it’s just the patient and you. And you can’t help realising just how sacrosanct is the trust invested in you and how extraordinary that a complete stranger might let you into the most intimate recesses of his life, hoping that you might just mend the most fragile parts.
A friend who left medical school to pursue a lauded career in banking thirsts to this day to hear my ordinary stories about patient care. He says he’s comfortable but misses the sense of calling. This is something I have heard said many times.
A career in medicine has vast and varied promise but the happiest doctors I know have narrowed it down to one thing: medicine not merely as work but a calling. This doesn’t melt away the challenges but it puts them in perspective. On good days, it creates indelible memories; on bad days, it’s a handy shield.
If you are a parent and your child desperately wants to study medicine, the greatest favour you could do her is help her distinguish between a job and a vocation. On the other hand, if your reluctant child has a parent who desperately wants him to study medicine, step back for a moment and consider the statistics. Forcing your child to become a doctor might turn out to be the worst parenting decision you ever made.
Most people, asked whether parental involvement benefits children academically, would say, “of course it does.” But evidence from our research suggests otherwise. In fact, most forms of parental involvement, like observing a child’s class, contacting a school about a child’s behavior, helping to decide a child’s high school courses, or helping a child with homework, do not improve student achievement. In some cases, they actually hinder it.
Over the past few years, we conducted an extensive study of whether the depth of parental engagement in children’s academic lives improved their test scores and grades. We pursued this question because we noticed that while policy makers were convinced that parental involvement positively affected children’s schooling outcomes, academic studies were much more inconclusive.
Despite this, increasing parental involvement has been one of the focal points of both President George W. Bush’s No Child Left Behind Act and President Obama’s Race to the Top. Both programs promote parental engagement as one remedy for persistent socioeconomic and racial achievement gaps.
We analyzed longitudinal surveys of American families that spanned three decades (from the 1980s to the 2000s) and obtained demographic information on race and ethnicity, socioeconomic status, the academic outcomes of children in elementary, middle and high school, as well as information about the level of parental engagement in 63 different forms.
What did we find? One group of parents, including blacks and Hispanics, as well as some Asians (like Cambodians, Vietnamese and Pacific Islanders), appeared quite similar to a second group, made up of white parents and other Asians (like Chinese, Koreans and Indians) in the frequency of their involvement. A common reason given for why the children of the first group performed worse academically on average was that their parents did not value education to the same extent. But our research shows that these parents tried to help their children in school just as much as the parents in the second group.
Even the notion that kids do better in school when their parents are involved does not stack up. After comparing the average achievement of children whose parents regularly engage in each form of parental involvement to that of their counterparts whose parents do not, we found that most forms of parental involvement yielded no benefit to children’s test scores or grades, regardless of racial or ethnic background or socioeconomic standing.
In fact, there were more instances in which children had higher levels of achievement when their parents were less involved than there were among those whose parents were more involved. Even more counterintuitively: When involvement does seem to matter, the consequences for children’s achievement are more often negative than positive.
When involvement did benefit kids academically, it depended on which behavior parents were engaging in, which academic outcome was examined, the grade level of the child, the racial and ethnic background of the family and its socioeconomic standing. For example, regularly discussing school experiences with your child seems to positively affect the reading and math test scores of Hispanic children, to negatively affect test scores in reading for black children, and to negatively affect test scores in both reading and math for white children (but only during elementary school). Regularly reading to elementary school children appears to benefit reading achievement for white and Hispanic children but it is associated with lower reading achievement for black children. Policy makers should not advocate a one-size-fits-all model of parental involvement.
What about when parents work directly with their children on learning activities at home? When we examined whether regular help with homework had a positive impact on children’s academic performance, we were quite startled by what we found. Regardless of a family’s social class, racial or ethnic background, or a child’s grade level, consistent homework help almost never improved test scores or grades. Most parents appear to be ineffective at helping their children with homework. Even more surprising to us was that when parents regularly helped with homework, kids usually performed worse. One interesting exception: The group of Asians that included Chinese, Korean and Indian children appeared to benefit from regular help with homework, but this benefit was limited to the grades they got during adolescence; it did not affect their test scores.
Our findings also suggest that the idea that parental involvement will address one of the most salient and intractable issues in education, racial and ethnic achievement gaps, is not supported by the evidence. This is because our analyses show that most parental behavior has no benefit on academic performance. While there are some forms of parental involvement that do appear to have a positive impact on children academically, we find at least as many instances in which more frequent involvement is related to lower academic performance.
As it turns out, the list of what generally works is short: expecting your child to go to college, discussing activities children engage in at school (despite the complications we mentioned above), and requesting a particular teacher for your child.
Do our findings suggest that parents are not important for children’s academic success? Our answer is no. We believe that parents are critical for how well children perform in school, just not in the conventional ways that our society has been promoting. The essential ingredient is for parents to communicate the value of schooling, a message that parents should be sending early in their children’s lives and that needs to be reinforced over time. But this message does not need to be communicated through conventional behavior, like attending PTA meetings or checking in with teachers.
When the federal government issues mandates on the implementation of programs that increase parental involvement, schools often encourage parents to spend more time volunteering, to attend school events, to help their children with homework and so forth. There is a strong sentiment in this country that parents matter in every respect relating to their children’s academic success, but we need to let go of this sentiment and begin to pay attention to what the evidence is telling us.
Conventional wisdom holds that since there is no harm in having an involved parent, why shouldn’t we suggest as many ways as possible for parents to participate in school? This conventional wisdom is flawed. Schools should move away from giving the blanket message to parents that they need to be more involved and begin to focus instead on helping parents find specific, creative ways to communicate the value of schooling, tailored to a child’s age. Future research should investigate how parental involvement can be made more effective, but until then, parents who have been less involved or who feel uncertain about how they should be involved should not be stigmatized.
What should parents do? They should set the stage and then leave it.
Keith Robinson, an assistant professor of sociology at the University of Texas, Austin, and Angel L. Harris, a professor of sociology and African and African-American studies at Duke, are the authors of “The Broken Compass: Parental Involvement With Children’s Education.”