Medical Education: The Bridge of Transition.
There is a vivid portrait sketched in our minds. The portrait of a social legend- the great physician. The doctor who can diagnose an array of diseases within a few minutes, the surgeon who performs lifesaving operations. He/she is the hope a son has for his father’s advanced illness, or a mother’s respite for her child’s broken arm. With their skills, immense knowledge and philanthropy, our ideal predecessors urge us to set our sights on excellence beyond the horizon. We enter medical college, amidst the shared joy of family and science teachers, embarking the glory road of white coated heroes and high minded notions. Fast forward 2, 3 years and look back: all you see is a blur of difficult, alien terminology in enormous textbooks, a multitude of monthly tests salvaged by short books, and the exam time dilemma of which answer spells right. So far, the study forever drill carries on as you chase the redirected pursuit of trying to pass exams, let alone achieve the dream 4.0 G.P.A (Grade point average).
One day, in a rather enlightening moment, a clueless patient, obviously enamoured by your white lab coat uniform asks you “Doctor Sahib, what is wrong with me?”You stare back blankly, speechless, as the tirade of textbook knowledge and medical jargon parades through your mind. The truth hits you as a realization that your ultimate burden is not the weight of monster sized textbooks, rather the hope and trust society places in your capability to help them!
Indeed, the medical profession and medical education are two parallel, entwined phenomena. The ideal attitude undoubtedly is a clinical problem oriented approach at an individual level. However, the practice of medicine is a brave new world for students whereby medical college is the absolute, all important bridge of transition. Following this clinical approach, medical education comes across as an elaborate puzzle meant to be constructed as an amalgamation of basic science knowledge of normal human anatomy, physiology and biochemistry as a foundation for Pathology and Pharmacology paving the way for disciplines like Medicine and Surgery. Step by step, we learn the origin and identification of good health and poor health and its course of treatment. In this MBBS course of five years, a layperson is meant to transform his/her lifestyle, mindset, even their social skills into that of a doctor.
Clearly aiming for a clinical approach in studies-the new curriculum of a few medical colleges in Pakistan is set to teach basic and clinical subjects simultaneously since day 1. This maybe a practical step in theory. However, the ground reality turns out to be quite a speedy whirlwind of knowledge for students who feel overburdened due to the increased course workload and consequently gain the shortsighted goal of merely passing exams, instead of focusing on firm concepts. So the debate ensues, precociously teaching clinical and basic subjects to the knowledge naïve students or apply the widespread, classic divided system of 2 years of Basic sciences with 3 years of Clinical studies? There are opinions from both sides. Students of the unified Basic-Clinical system complain of burnout and poor recall given the rapid rate of course coverage, while exhibiting somewhat clear ideas regarding Clinical problems. Students in the divided system claim the ease associated with reading advanced level Medical and Surgical books, with their patient understanding of the basic sciences, Pharmacology and Pathology established in the first four years of MBBS;while lamenting about the downside of encountering difficulties in grasping actual clinical scenarios.
Conclusively, the answer lies in following senior doctors, who repeatedly exemplify and emphasize the need of being thorough in basic and clinical science knowledge, along with a good grasp of patient skills like history taking and examination; no matter what university, system or designation you are associated with. Such a grasp can only be established, according to senior doctors’ advice, by utilizing five years of MBBS effectively by investing in good, recommended books, memory techniques and concepts rather than rote learning, along with adequate attention paid to clinical postings as real life demonstration of textbook knowledge.
There is an absolute need to revise and update basic and clinical knowledge with the view that in the ever changing dynamics of medicine, every patient’s case requires the best of our knowledge as the moral and social responsibility of a doctor. Our job to work and study does not end with a passed exam, a single great G.P.A (Grade point average) or one happy patient sent home. For the work of doctors is a performance against a challenging workload similar to a bizarre stock exchange index; the unpredictable complexity never ends, adding to the very thrill and beauty of this profession. As students, we need to realize at a personal level, that the real life challenges ahead need more than just textbook knowledge, freshly inked degrees or star studded CVs.
In a few years, we shall hold sway as workers with the greatest responsibility in society. A good approach and attitude for learning coupled with hard work build a solid medical education-all leading to good doctors ensuring safe lives for tomorrow. In that bright future, the clueless, ailing patient shall have your well educated answer and help, while you truly live up to the white coat label!!
About the author: Maleeha Javed is a 3rd year MBBS Student, Dow Medical College, Dow University of Health Sciences and an aspiring young writer.
She can be reached at: [email protected]
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