Pre-clinical medicine
Communication skills & professionalism
Communication skills and professionalism teach doctors how to talk with patients and families, take a history, explain diagnoses, show empathy and behave ethically. For psychiatry, where the interview is the main diagnostic tool, they are central.
Depth by stage, Pre-U → Consultant (details)
What is it?
Medical schools teach communication skills from the first year, usually through role-play with simulated patients, video feedback and supervised patient contact.
Students learn structured history-taking, active listening, open and closed questions, explaining information clearly, breaking bad news, dealing with anger, and working with interpreters.
Professionalism covers punctuality, honesty, respect, appropriate dress and behaviour, teamwork, use of social media, and looking after one's own health.
Why does a psychiatrist need it?
In psychiatry the conversation is the main diagnostic and therapeutic tool. A psychiatrist must build trust quickly with people who may be frightened, suspicious, ashamed or angry, often across language and cultural differences in Malaysia. Skills learned in medical school are refined through every later stage, up to complex family meetings and psychotherapy.
What level is expected at each stage?
Scale: 1. Aware → 2. Understands → 3. Applies → 4. Masters / Teaches. What the levels mean.
- Pre-UAwareAware of communication as a skill; demonstrates it in university interviews.
- Pre-clinicalUnderstandsUnderstands communication models; practises with simulated patients.
- ClinicalAppliesApplies history-taking and explanation with real patients; assessed in OSCEs.
- HousemanshipAppliesApplies communication under pressure: handovers, families, consent.
- Medical officerAppliesApplies skills independently, including difficult conversations.
- Psych traineeMasters / TeachesMasters the psychiatric interview and therapeutic communication; assessed in clinical exams and CASC.
- Specialist / consultantMasters / TeachesMasters and teaches advanced communication, including complex family and multi-agency meetings.
What are the key topics?
Consultation skills
- Calgary-Cambridge and similar consultation models
- Opening, gathering information, building rapport
- Open and closed questions, summarising
- Shared decision-making
Difficult conversations
- Breaking bad news (for example the SPIKES framework)
- Dealing with anger and complaints
- Talking about sensitive topics such as sex, substance use and suicide
- Working with interpreters and family members
Professional behaviour
- Honesty, reliability and respect
- Teamwork with nurses and allied health staff
- Professional boundaries
- Social media and confidentiality
Self-care
- Recognising stress and burnout
- Reflective practice
- Seeking help early
How is it learned and assessed?
- Role-play with simulated patients and video feedback
- Early clinical exposure and bedside teaching
- OSCE communication stations
- Professionalism logbooks and supervisor reports
- In psychiatry: clinical examinations and the MRCPsych CASC
Typical textbooks and resources
- Skills for Communicating with Patients — Silverman, Kurtz and Draper (CRC Press)
- Clinical Communication Skills — Oxford University Press (various)
- Malaysian Medical Council guidance on professional conduct
- The Doctor's Communication Handbook — Peter Tate (CRC Press)
Titles are widely used examples; editions change. Use university libraries or legitimate purchases.
Common questions
Can communication be taught?
Yes. Studies and long teaching experience show that structured training with feedback improves doctors' communication. Medical schools teach it from the first year.
Why is communication especially important in psychiatry?
Because diagnosis depends mostly on what patients say and how they behave during the interview, not on scans or blood tests. Good communication is also part of treatment itself.