Dr. NK Venkataramana, Founder Chairman & Director, Brains Super Speciality Hospital, Bengaluru.
The human body by design and function is marvellous in evolution. Only medical students have the opportunity to learn, understand research, and comprehend the way it works. Over the centuries scientists have put in relentless effort to comprehend what is known today. Though much is known and volumes of literature are available so much need to be known. Certain cellular and metabolic functions are still elusive. Similarly, despite efforts, Brain continues to be an unfathomable organ both in terms of structure and function. The abilities of the brain remain an enigma some remain beyond the boundaries of the current understanding of science and tools. However, the progress that has been made is phenomenal over the years.
Medical education that has started with basic gross anatomy, and diagnostic methods purely based on clinical symptoms has advanced manifold. The development of science has taken medical education to the molecular and nuclear levels from the surface of the body. Apart from the microanatomy, physiological functions and the array of biochemical reactions by which the body executes its complex functions got unravelled gradually. Curiosity and inventions have now taken us to the genes, DNA and RNA. The human genome is fascinating enough to work closely with the concept of creation. Through all these, the intracellular and intercellular communication mechanisms became clearer. Yet there are many unknown dimensions to the functionality of the brain. While we continue to understand the basic mechanisms, the translation of that knowledge to the betterment of clinical practice should be implemented simultaneously. Such efforts will make clinical applications up-to-date and contemporary. Everything is so important that learning, thinking, innovating, and improvising must be a constant exercise in medical schools. These methods are getting more and more sophisticated with time similar changes have to be brought in to experience the progress in the country.
To attain efficiency in every field medical schools must work differently. Medical graduation must focus on a solid foundation in mastering the basics and should be offered a glimpse of modern developments. Whereas post-graduation should focus on basics, evolution, current concepts, future developments, and sufficient skill sets to make them stand on their own feet. Apart from acquiring knowledge, they should be adept in many soft skills to face the contemporary world. Most importantly communication, documentation, ability to handle critical situations, ability to manage unexpected emergencies, research aptitude, and finally motivation is essential to build an effective personality. For this training system should be so robust that everyone that goes through the program will undoubtedly achieve the minimum standards. By self-effort, they can move further and beyond.
This requires a constant change in the current system of medical education. It is not the infrastructure that matters the quality of teaching, quality of teachers, and constant upgradation of methods of imparting knowledge to mould, motivates, and inspire these young minds. Every teacher in a medical school should be a role model, the etiquette of which should be engraved in young minds. Those who aspire to become doctors already are self-motivated. By adopting simple measures they can be made responsible, and innovative with independent thinking and contribution. No doubt to run any system effectively a system, discipline, and enforcement is mandatory. But at the same time, these systems should become a hindrance to individual growth and contribution. They must be made to think and contribute to the system as well as to the institution. Eventually, a stream of thoughts and contributions will make the system better and better. Whereas, undue restrictions and imposing constraints can make them purely mechanical. This can completely remove their creativity.
Among the variety of educational systems that are offered by universities medical education has its special place as it deals with humanity. Therefore tremendous attention must be given to inculcating this among new generations. They must become, sensitive, gentle, and careful, with an ability to use their effective judgment at all times to do the right things. This needs individual effort more than that culture in the organization that builds gradually. Once they are perfect they become efficient not only in dealing with tissues, the human beings as a whole, and even non-living objects such as delicate instruments. This is very relevant for surgeons. Therefore every interaction has to be professional except in leisure time. Medical institutions abroad give so much importance to attitude, behavior, emotional stability, effective speaking as well as writing. This goes on regardless of the trading in the relevant subjects chosen by the students. The quantity and numbers are immaterial. The method of learning, analysing, and executing will make a better doctor with confidence rather than performing tasks routinely without comprehending. Enough time should be allocated to think and perform in such a way that quality is not compromised regardless of resources. Effective documentation thus creates a valuable repository. This in turn should be made available to students and trainees to learn from various scenarios. One can't learn everything in a stipulated time. Once they understand the proper method learning becomes a lifetime process partially for those who are in the health system. Merely going behind numbers is a useless exercise. Sufficient time should be available to understand the methods, think, and solve the problems independently. The current methods adopted are similar to mass education. To attain efficiency and proficiency there should be sufficient interaction at all levels.That is why it is called "fellowship" where the evidence as well as experience is shared enough.
Change is inevitable as the dynamics of the world are changing so rapidly. Holding on to good old habits in the name of tradition will be detrimental. As such medical education in India has no recognition. If we don’t adopt newer trends we will regress very soon. There will be more medical schools but none comparable in the future.