I was a student for a long time. Perhaps I still am, and perhaps I always will be.
After high school I did a four-year degree in physics before medical school. Internship and surgical residency then consumed nine years, including two years’ research training at the University of California in San Francisco. I joined the neurosurgery staff at Toronto Western Hospital in 1985. In addition to being a student, I have also been a teacher. During the last 25 years as an academic neurosurgeon, I have been a professor at the University of Toronto. I have taught high school students, undergraduate science students, medical students, graduate students, neurosurgery residents, clinical fellows, and peers. I have lectured all over the world and have had the thrill of teaching other surgeons in operating rooms in Asia, Africa, and North America.
Being both student and teacher is a big part of who I am. So when in 2001, a senior colleague recognized my growing interest in bioethics and suggested, “Bernstein, why don’t you enroll in the two-year professional masters in bioethics at Toronto’s Joint Center for Bioethics?” it took me 13 seconds to say, “Wow. Neat”. Thirteen days later, I submitted my application and paid my tuition. I started in September 2001 and graduated in 2003. It was a professional, non-thesis, masters, and it was based on classroom learning with voluminous reading and many written assignments. I was still head of neurosurgery at my hospital, engaged in the practice of neurosurgery, as well as teaching and research.
My class included six local students and six international students. I met and became friends with several international students: a neurologist from Zimbabwe, a family physician from Uganda, a research administrator from India, a Pakistani obstetrician. The local students were also diverse: doctors, nurses, and administrators. The classroom in many ways was a microcosm of the global village: male, female, straight, gay, white, black, Protestant, Jew, Catholic, Muslim, Hindu, idealist, pragmatist, Utilitarian, Kantian. The age of the students ranged from 32 to 55; I was the second-oldest student.
The courses included material ranging from the extremely conceptual to the very practical. One could bring issues from their own lives and jobs and previous life experience so that in many ways the master’s became highly personalized, which made it especially relevant.
There are obvious challenges to mature learners going back to school. The most obvious and important is time management. How does one carve out the average 20-plus hours per week required while working at one’s “day job”? The answer is simple. Good time organization and the passionate desire to learn the material are the main ingredients. Motivation allows any possibility; time constraints are trumped by passion every time. Another challenge is financial, both the real costs of tuition and reading materials and the income lost from time spent at studies. Perhaps the most subtle challenge is the stress stemming from the fear of failure, the concern that being a student again after a long hiatus will not be like riding a bicycle, that the skills needed will not come back quickly.
The advantages of going back to school as a mature learner, however, are myriad and mitigate in spades the challenges described above. First and foremost, when mature learners go back to school they do so because they really want to, not because their fellow high-school graduates are going to university and they need to follow suit, not because their parents expect them to, and not because they need training for a job (because they already have one). Consequently attending school as a mature student is in many ways a much richer and less confining experience than the educational experience most of us have had as undergraduate and graduate students. There are no, or minimal, outside influences, coercive forces, or prescriptive texts at play, only internal drive. The material becomes more relevant because a mature learner brings perspective and life experience to the questions asked and the lessons learned in class. The older learner can also try to solve problems using methods and knowledge acquired through career and life experience. Other advantages of returning to school later in life include personal reinvention, not just to improve one’s enjoyment and productivity in the work place but also to improve one’s self-esteem and sense of personal value. Re-education is also an excellent way to help combat career burnout.
A return to school can also lead to academic advancement, partly as a result of professional colleagues becoming more aware of one’s work, especially those fields a returned scholar may be exploring for the first time. For example, in the case of my own work as a student of bioethics, I chose to address various ethical questions and dilemmas encountered in the day-to-day world of neurosurgery. This not only helped me explore difficult problems using new vocabulary and new thinking but also, after an assignment was turned in and marked, I polished and converted most of the essays into manuscripts that became published in peer-reviewed publications. This elevated my ethics profile in the surgical and neuroscience communities and exposed colleagues important to me to ethics, a field of study exceedingly rare in the surgery and neurosciences literature. How many articles in the clinical literature had addressed the moral philosophy of full disclosure of surgical error, from a Kantian perspective? Now at least there is one, mine.
Another ineffable joy was the ability to relive the student experience, such as animated chats with fellow students and professors, social events at people’s homes, the excitement of meeting a deadline for an assignment, the satisfaction of doing meaningful and creative work, the reunion with new-found soul mates when classes reconvened, the wearing of jeans and running shoes during the weekday in downtown Toronto. Networking and friendship are also very rewarding for academics. Since my masters studies ended, I have maintained contact with classmates in Africa, India and, of course, Toronto.
My return to school as a mature student has had an immense and positive impact—both practical and philosophical—on my life as a neurosurgeon, educator, researcher, administrator, and person. My challenge after graduating was to keep up my momentum in reflecting, and acting on bioethics, but I have managed to do so. Since graduation, I have taught ethics to surgery residents and bioethics students, ranted about ethics to my neurosurgery partners and other clinicians every chance I get, mentored the students who help me perform research in ethics, written and published extensively on various topics in ethics, and lectured around the world on ethics. It was a life-changing move for me at age 51 and has made an enriching career in academic neurosurgery even better.
I highly recommend further education for mature professionals and academics. They just have to make sure they are motivated and well organized, so that the student life doesn’t get in the way of a “day job.”
Mark Bernstein is a professor of surgery at the University of Toronto and a neurosurgeon at Toronto Western Hospital. He has a strong interest in caring for patients with brain tumours, in bioethics, and in teaching surgeons in the developing world. He is a perennial student.