Making of better doctors

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Making of better doctors

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Making of better doctors

  1. 1. Making of Better Doctors *Dr.T.V.RaoMDIndia is a fast developing economy, where people aspire abetter health and fortunes than in thepast. The developmentof Nation depends on the Gross parameters of health index.There is an ever growing need for Medical colleges anddoctors to serve the rural areas. Last four decades has seenmushrooming of the Medical colleges in the private sector,hardly there were any new Government medical institutions. The 1960s witnessed a dramatic growth in the number ofmedical colleges in India, and in the past 40 years thenumber has doubled.The Medical Council of India currently(2011) fully recognizes 335, with a total capacity to train 40,525 Indian medical students.New private colleges account formost of the growth in the number of colleges.The suddengrowth of medical colleges in the country has also resulted inan increased need for medical teachers, with vacant facultypositions in many medical colleges. I was a studentof bothprivate and Government colleges. I find teachers have greatimpact on the future of any individual student and theNational health, I do not think good doctors can be self-madeit needs the good support of a mentor who is also a Teacher.Our Medical inspections are more of measurements ofinfrastructure and head count of teachers adding to existingproblems the MCI, has increased the age of eligibility to serve
  2. 2. as teachers till 70 years which has brought hope for severalprivate Institutes to survive. However system runs, but thestudents are at the receiving end. We senior teachers shouldintrospect the difficulties of students; we have least idea toconsider the problems the students face. I feel Merit hasdefinite foundation but individual effort of the students tomake difference. We all in private sector as teachers getbetter salaries than we have started our career, a realintrospection, we can plan our students future withcurriculum redesign which should emphasize social andclinical context, including a greater focus on bedsideteaching. Improved vertical integration through problem-based organ system design of the curriculum can also helpaddress this issue. Formative student assessment should beadded to the predominantly summative examinations. In theera of privatization teachers are blamed for failure ofstudents, many studies have proved problems rooted inindividual student characteristics, such as depth ofknowledge, clinical reasoning ability, personality style, orprofessionalism, were felt to be extremely difficult toremediate. Students loose skills, learning time duringinternship, with preparation for Post graduate studies whichreally kills the Indian system of medical education.Internships must be used for skill-oriented training andshould include meaningful supervision and assessment. If theinternship is truly considered part of the medical collegeexperience, this may be accomplished by revising and moving
  3. 3. the last medical college examination to the end of theinternship. The Government is proposing one year ruralservices, it may fulfil the political ambitions of Governmentto provide doctors to rural population, already PHC’s are sickwith lack of resources, and political interference, andcompensating to fill a with young doctors brings inunpredictable results. We should have more doctors to takeinterest in research on Medical education and it should havethe requisite resources for faculty development, research inmedical education, curriculum design and implementation,student assessment, and program evaluation of institutionaleducational policies and programs.Measuring and improvingquality care needs to be embedded into the cultures ofmedical education and patient care; an important step hasbeen the designation of practice-based learning andimprovement as one of the required competencies forresidents.The current emphasis on evidence-based care mustbe integrated with, rather than replace, a firm grounding inthe scientific and pathophysiologic principles underlyingclinical medicine.Although training in ethics is currentlyprovided by medical colleges, this training relies heavily onan abstract, philosophical view of ethics. Although theconceptual clarity provided by a traditional ethics course canbe valuable, theorizing about ethics contributes little to theunderstanding of everyday human experience or to preparingmedical students for the multifarious ethical dilemmas theywill face as physicians. A true foundation in ethics must be
  4. 4. predicated on an understanding of human behaviour thatreflects a wide array of relationships and readily adapts tovarious perspectives, for this is what is required to developempathy. Ethics courses drawing on narrative literature canbetter help students prepare for ethical dilemmas preciselybecause such literature attaches its readers so forcefully tothe concrete and varied would of human events.Informationtechnology is another big challenge that demands its ownsolutions. In many ways it is a moving target because thetechnology constantly changes, improves, gets faster, getsmore wireless, gets more pervasive, and becomes allencompassing. We believe that medical schools have to be asinnovative and demanding. Many senior teacher oppose theadvances in technology believe that medical colleges aregoing to have to confront the issue of distance learning in thenear future. While it may not be possible to teach entirecourses through distance learning(e-learning), medicalcolleges should explore the advantages of such technology.For example, during clinical rotations when students aredispersed at various clinical sites, there may be distancelearning and video conferencing.Better orientation toexamination expectations would also likely reduce theincidence of some poor performances, freeing remediators tofocus on students with more extensive needs. The clinicalteachers have greater responsibilities. Early identification andcharacterization of concerns may facilitate timelyremediation of underlying problems and facilitate acquisition
  5. 5. of effective clinical skills. Many of the ideas may be difficult ina complex society, while there are no easy solutions, thesechallenges can be met and even ameliorated by theapplication of creativity and diligence.Email*doctortvrao@gmail.com

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