1/14/2014 5:41:00 PM

Improving Our Career in Medicine
Dr.T.V.Rao, MDIndia with many educated manpower continues to be
wor...
improved my ideas of practice in the most narrow circumstances to work in a
dispensary. Many of us neglect our priorities ...
ask our students how comfortable you are, the majority answer I am fine which
means that he is in his comfort job which re...
visibility as a problem-solver in the organization, but you might also expand your
skills in the process. Each of us has a...
should be able communicators both in good and as well in critical times and
student must be able to speak, to hear and to ...
prescription, joint mobilisation / manipulation techniques, radiographic
positioning, radiographic image evaluation and in...
structured cases located in ‘stations’, at each of which specific tasks have to be
performed, usually involving a clinical...
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Improving our career in medicine and CHANGING TRENDS IN THE MEDICAL EXAMINATIONS

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Improving our career in Medicine and CHANGING TRENDS IN THE MEDICAL EXAMINATIONS

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Improving our career in medicine and CHANGING TRENDS IN THE MEDICAL EXAMINATIONS

  1. 1. 1/14/2014 5:41:00 PM Improving Our Career in Medicine Dr.T.V.Rao, MDIndia with many educated manpower continues to be world’s greatest Human resource; however people get stagnated and apathetic to work, the reasons are many, the reasonmay the individual apathy, great bottle necks include red tapeism, bureaucratic control, lack of infrastructure, poor working condition and interpersonal conflicts in many Government and even private establishments. In the era of privatization it is utmost important to improve our career or we will certainly perish with our own lack of desire to progress. I find life is interesting just doing our day to day work just to satisfy the job requirements, it is important that we should invest at least 10% of our life and time to find a better way to progress in life, which may look difficult as many of us are satisfied with the present earnings and job security. Life teaches the best lessons when we are placed in disappointing circumstances, we should take up a call to improve the career.Careers can improve or completely change direction over time, but long term changes don't just happen overnight - you need to work at it. When new opportunities arise - sometimes raise up without notice - will you be ready for them? There are many things you can do to increase your chances of being prepared for these opportunities when they appear. The great draw back many of newer generation of students and young Medical professionals just read what is essential for performing well in examination, if you wish to know better world, Read: books, magazines, and Professionaljournals related to the profession of either the job you have now, or from an organization you would like to be employed in future. Reading will help you acquire a better perspective of the Profession and your place in it.I wish to state how I was inspired,improved, by reading many scientific articles. Just I wish to state, what made me what I am Today, as an example, how The Lancet the well-known medical journal contributed to my career when I was placed as Medical officer in Andhra University in Visakhapatnam in 1973, the administrators of the Library wish to discontinue subscription to the journal, The Lancet as nobody is reading the journal, and it is not a Medical College, and I requested the Librarian that I will borrow the journal every week to fulfil the administrative formalities to continue for the subscription, he did it and I greatly
  2. 2. improved my ideas of practice in the most narrow circumstances to work in a dispensary. Many of us neglect our priorities certainly we can never become masters of our work and continue to remain slaves of our Jobs, just try to think about priorities.Re-evaluate Your Priorities: Take some time to stop and think about what your priorities are in your career and your life in general. Don't be side tracked by something that sounds good on the surface but won't take you where you want to be with you career. Just because someone else may do this, that or the other thing to develop their career path, doesn't mean you need to. Do what is best for you, many students ask what is good speciality for me to proceed in my higher studies, and I always tell do not look at some one look to self and decide, if we take medical specialities every branch needs different temperament, take an Anatomist, he is very cool as nothing serious happen in the profession however a Surgeon cannot be like aAnatomist as everything is serious to handle.Communication has become part of our lives, from facing the Viva to patient interaction as an examiner if I asses the students, who really good in the subject are poor in communication and they will be overtaken by well communicating students, The good GOD not made all equal in life still try to be better communicators and certainly succeed in many ventures you take up.Develop Your Communication Skills: Good communication skills are essential for all endeavours in life, especially for career development. This includes verbal, written and body language communication. Consider to increase your public speaking ability by taking more active part in many Seminars we take up. You will learn a lot from listening to other members speak also. Many books are available to help with writing skills and good body language. Remember, people who appear relaxed and composed, and can communicate their ideas clearly are more likely to get promotions and raises.Medical professionals are poor in up keeping their health with exercises, in view of demanding time schedules, Exercise Regularly: Exercise will make you feel better and be healthier. It will help you increase your stamina when working long hours or taking weekend or evening classes - or just getting through a typical work day. Right or wrong, healthier feeling people radiate an energy that is more likely to get them promotions and raises. Just walk a while when you are free, as the world / nature teaches many lessons than when we glued to our chair and bed. If we
  3. 3. ask our students how comfortable you are, the majority answer I am fine which means that he is in his comfort job which really means his progress has stopped. Challenge Yourself: Always challenge yourself - step outside your comfort zone. This is the only way you can grow both personally and in your career. Don't be afraid of trying something difficult, even if you fail at achieving what you originally intended to accomplish - you will still learn something new from the experience - and this will help your career. If we wish to progress in life, it is not relaxation and it is just continuous struggle. Many western medical students travel to many developing countries as they live and work in most ideal circumstances with technical advances. I wish our medical students, when they travel to a place away from routine work, just visit a hospital and look at the modalities of work; even the poor people are treated by very committed Doctors in developing countries. Our Indian medical education system we are training our medical students in a protected environment, which makes many of them poor performer when they really work alone in rural health centres. Set Clear Goals and Measure Your Progress – Whether you hope to obtain a promotion, raise, or new job, you won’t accomplish anything in 2013, unless you set and hold yourself to tangible goals. Once you’ve determined your annual goals, identify the more easily attainable intermediate milestones that will allow you to measure your progress.No matter how long you have been at a job or how many times you have proven yourself, you must continually strive to exceed expectations and generate incremental value for your hospital or establishment and above all yourself. Make an effort to go to conferences, seminars, happy hours, and industry events; seek individuals who may be able to help you reach your career ambitions not only today but also tomorrow. I have been both popular and unpopular as I do not agree with many things proposed in the profession by many around or even, my own boss as he may not be always right may be some times we may be good to our patients. In the era of privatization we are more dependent on our employer we may lose security if we differ on every matter try to be accommodative with scientific spirit, Volunteer to complete challenging projects and assignments. One of the best ways to advance your career is to identify an organizational problem and propose a solution. By offering to implement the solution, you will not only increase your
  4. 4. visibility as a problem-solver in the organization, but you might also expand your skills in the process. Each of us has a certain number of years to invest in working and making a living. Having a job is fine, but creating a career will maximize your opportunities for success. To have a successful career requires that you pursue career management strategies. A successful career doesn’t happen unthinkingly. It needs planning, tending, and frequent review. Are you ready to pursue these career development strategies? Try doing something good which improves the life of our patients, it is the best contribution, and career advances without our knowledge CHANGING TRENDS IN THE MEDICAL EXAMINATIONS DR.T.V.RAO MD Methods for student assessment in medical education has changed over the past 50 years. We have moved from a standard of pen-and-paper tests of knowledge and facts toward a more complex system of evaluation. Medical students today are tested on knowledge, attitudes, and skills across multiple settings and methods, which are often triangulated to reach summative decisions. Current educational and assessment strategies include problem-based learning, computer simulations, and checklists, standardized patients, and team-based learning that we call as seminars. When we started our life in Medicine; we were few students in a Unit for training, my teachers who were always willing to spend the time in training us. Patients were poor in many Government hospitals, helpful to cooperate, and willing to answer many questions put many times with our ignorance. Medical council of India wishes that graduates should have the knowledge, skills, professional behaviours and attitudes necessary to enter the unsupervised practice of medicine in India, as Graduates must be able to diagnose and manage health problems and provide comprehensive, compassionate care to their patients. Today we teach the students on comprehensive and integrated care of the patients, as it is desired to be a competent physician as Prospective candidates should be aware that, cognitive, physical examination, management skills, communication skills, and professional behaviours are all evaluated in timed simulations of patient encounters. Doctors
  5. 5. should be able communicators both in good and as well in critical times and student must be able to speak, to hear and to observe patients in order to effectively and efficiently elicit information, describe mood, activity and posture and perceive non-verbal communication. A student must be able to communicate effectively and sensitively with patients, families and any member of the health care team. A student must also be able to summarize coherently a patient’s condition and management plan verbally and in writing. To the students, we should teach to be effectually to use motor functions. A student must demonstrate sufficient motor functions to safely perform a physical examination on a patient, including palpation, auscultation and percussion. The examination must be done independently and in a timely fashion. A student must be able to use common diagnostic aids or instruments either directly or in an adaptive form (e.g. sphygmomanometer, stethoscope, otoscope and ophthalmoscope). A student must be able to execute motor movements reasonably required to provide general and emergency medical care to patients. Compassion, integrity, concern for others, interpersonal skills, interest and motivation are all personal qualities that physicians must demonstrate and are expected qualities of students.efficient motor function to safely perform a physical examination on a patient, including palpation, auscultation and percussion ability to use common diagnostic aids or instruments either directly or in an adaptive form (e.g., sphygmomanometer, stethoscope and needles)ability to execute motor movements that are reasonably required to provide general and emergency medical care to patients. Many Medical assessment examinations in India and abroad are changing to the new educational assessment for the new generation of students to eliminate the older examination system fraught with poor assessment criteria, designated as Objective Structured Clinical Examinations (OSCEs).An Objectively Structured Clinical Examination (OSCE) is a modern type of examination often used in health sciences (e.g. Midwifery, orthopaedics, optometry, medicine, chiropractic, physical therapy, radiography, nursing, pharmacy, dentistry, naturopathic medicine, Para medicine, podiatry, veterinary medicine). It is designed to test clinical skill performance and competence in skills such as communication, clinical examination, medical procedures / prescription, exercise
  6. 6. prescription, joint mobilisation / manipulation techniques, radiographic positioning, radiographic image evaluation and interpretation of results. An OSCE usually comprises a circuit of short (the usual is 5–10 minutes although some use up to 15 minute) stations, in which each candidate is examined on a one-to-one basis with one or two impartial examiner(s) and either real or simulated patients (actors or electronic dummies). Each station has a different examiner, as opposed to the traditional method of clinical examinations where a candidate would be assigned to an examiner for the entire examination. Candidates rotate through the stations, completing all the stations on their circuit. In this way, all candidates take the same stations. It is considered to be an improvement over traditional examination methods because the stations can be standardised enabling fairer peer comparison and complex procedures can be assessed without endangering patient’s health. Medical schools in many developed countries are increasingly relying on Objective Structured Clinical Exams as a method to evaluate their medical students' clinical skills and communications skills. As OSCE exams are now the method of the licensure examination in the USA, Canada, UK, Australia, and New Zealand and many other countries, most schools are now implementing these clinical skills assessment exams right from the first year for their medical students.OSCEs for Medical Student tend to be system oriented as you move from placement to another, like while they do their surgery clerkship, the topics will be around surgical topics, and so on. However, medical students have to keep their minds open to all possible diagnoses and explore the relevant ones as time permits. Differential diagnosis is still needed to be covered in all medical student OSCEs. The best way for a medical student to prepare for an Objective Structured Clinical Exams (OSCE Exam) is repetitive practicing following a well prepared systematic approach model. Acquire a systematic organized approach that covers clinical skills, communication skills, and differentials. Start as early as possible in your medical education and keep repeating and practicing your approach over and over for months and all through your medical school years. Make it a habit in order to master patient encounters. It will be one practicing for all your coming medical OSCE exams. Does it make sense, The OSCE is an assessment format in which the candidates rotate sequentially around a series of
  7. 7. structured cases located in ‘stations’, at each of which specific tasks have to be performed, usually involving a clinical skill, such as history taking, examination of a patient or a practical skill. The marking scheme for each station is structured and determined in advance. There is a different examiner and a time limit for each station. The basic structure of an OSCE may be varied in timing for each station, use of checklist or rating scale for scoring, use of clinician or standardised patient as examiner, use of real patients or manikins, but the fundamental principle is that every candidate has to complete the same assignments in the same amount of time and is marked according to a structured marking schedule. Many Medical Institutions and some deemed universities are planning for a change. The implemented many aspects of DNB courses have successfully OSCE. My little experience with OSCE in a Medical College, it is far more confusing than the traditional system, for the undergraduates, I think who are implanting the system should be sound in doing the procedures or else it is confusing to the Teacher as well as taught. However Successful OSCEs are often the result of significant planning, coordination of multiple resources, commitment to large-scale testing, and judicious use of assessment data. More research is needed about the best uses of the OSCE method and how to maximize reliability and validity. Advocates of the OSCE method should continue to produce and disseminate evidence of the far-reaching impact that is seen by students and educators. Dr.T.V.Rao MD. Professor of Microbiology, Creator and Designer of e-learning resources in Microbiology and Medicine - a Freelance writer. Travancore Medical College, Kollam. Kerala (2nd Batch Student of J.N Medical College, Belgdical College, Belgaum – Karnataka 1967)

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