So close and yet so far!
Mallika Maria Fonseca
GMC, Mumbai
India of my dreams in 2020 is a place where I can breathe Oxygen and not fall into a pothole while travelling to college:-D
What does the abrogation of Section 370 mean for Kashmir? Where do you stand on the Ayodhya issue? Whom do you think is responsible for Delhi’s pollution issues? Who should be Maharashtra’s next CM? We have next to NO idea what 2020 is going to bring our country. We have no idea what fresh, raw issues will be put on the boil. But as uncertain as the future of our country is, always teetering on the edge of one controversy or another, one thing that will never change, one indisputable idiosyncrasy of the average Indian, is the obsession with Medical School.
Maybe it’s the legacy of Charak and Sushruta, maybe it’s title, maybe it’s the (questionable) benefits, but Indians glorify medicine almost as much as we glorify Salman Khan. And to be honest, for neither does the glory stand much deserved.
India spews out approximately 52,000 medical graduates; an army of fresh young doctors who should be able to handle the healthcare of our country with ease. But something is going dreadfully wrong. Why?
The problem begins at the start of the production line: Though we know the theory of everything, when it comes to putting it to practice- we fail; and this process of mindless learning without practical reinforcement starts right before the medical entrance exam and is continued into medical school. Perhaps this will change in 2020; one of the purposes of replacing the NEET with NEXT was to ensure that medical students give Internship and their practical experience just as much importance as the theory. But until the NEXT includes a practical facet, this goal stands unaccomplished. And of course, with practical exams come the obvious fallacy of subjectivity.
Is a doctor only a brain which has memorized a thousand diseases? When he examines a patient or informs the patient about a probable diagnosis, or perhaps breaks bad news to relatives- is it only a function of the brain? Perhaps so many ugly patient/relative- doctor confrontations could be avoided if the doctor had just been provided with the soft skills to deal with irate and irrational individuals. With the rising number of attacks against doctors, 2019 brought with it the important realization that the medical fraternity can do something to safeguard our own against such attacks. While many medical universities in the country now include Interactive Workshops and CME’S involving communication, facilitation and training sessions for the same, hopefully in 2020, this will be the norm.
Nothing says Innovation as much as research, and as far as undergraduate medical research is concerned, there has been a sea change in the quantity of research produced this decade to last. However, as we all know, it is quality that we ought to be concerned with. The decade of the 20’s needs to bring to Indian medical research the credibility that we ascribe to Western research.
Coming to one of the last (and perhaps most serious) failures of the medical system. One word describes it- Frustration. Indian medical students are made to study for 5 years without a breathing space. Subject after subject, exam after exam. There is no respite at all. The fact that medical students are at the most productive time of their life- youth- is completely ignored. In no other country are undergraduate medical students blinkered like Indian medical students are. There is no scope for mental and professional growth. At a time when these students are teenagers maturing into adults, there is a world of experiences to gain- Work ethic, adult responsibilities, financial independence- this is the best time to learn these skills and they are not skills taught in a lecture hall. With no scope or time for self-reflection, personal growth and self-discovery, is it really surprising that medical students are so frustrated?
While comparing the medical education system of various different countries, one thing that comes to the fore, is the fact that our degree program is shorter than most others but also provides us with a far less valuable degree. Because after all, ‘value’ in medicine, is based on time, based on experience, based on growth. And until we realize that we in India need to learn to give medical education the gift of time, we aren’t going anywhere. Most other medical systems around the world give the student the freedom of extending the course as long as they want to. Gap years are encouraged; to gain practical experience, become financially independent, do research projects which are of real value to medicine. Perhaps then we will have students who are mentally, physically and socially healthy and not merely ‘without disease’. Perhaps then we will create a system where students aren’t just a raw product in a factory creating a standard model doctor. Perhaps then we will heal the disease of the healers and create a medical education system well equipped and efficient enough to produce the best possible doctors of the future.
