Narrative candour: Learning from diverse stories of imperfect medical practice

Medical training often induces stress and burnout, exacerbated by competition and imposter syndrome, which can collectively contribute to trainee distress. Drawing from narrative theories, this conceptual paper examines how myths of the heroic doctor and discourses of exceptionalism contribute to this distress, suggesting that little stories may be harnessed to counterbalance these myths and promote more collaborative and inclusive practices.

The doctor as hero myth promotes selflessness and excellence, but it simultaneously overshadows the contributions of day-to-day acts and of the collective healthcare team. A greater diversity of narratives may be needed for valuing doctors in all their various roles. Alternative narratives-including counternarratives-can challenge dominant stories in everyday clinical education and offer new perspectives by highlighting voices that are often less heard, which can provide valuable insights and disrupt conventions.

Narrative candour is presented as an educational approach where revealing less-than-ideal stories of practice can promote learning, within informal practice interactions, formal curricula and even ceremonial occasions. Stories of everyday imperfections-e.g., of moments when the doctor is not the protagonist, of inspiration without greatness, of denied resolutions-are offered as means of bringing narrative candour to life. They can be powerfully conveyed: told at formal events of recognition (e.g., commencement) by senior community members or shared with peer or embedded into the informal stories of daily healthcare delivery.

Narrative candour might have substantial impact on individuals, relationships and broader communities-all in the name of understanding doctors as complex and diverse humans rather than simply the trope of exceptional heroes.