LEARNING A B C OF MEDICINE

Dr.T.V.Rao MD
Curriculum of Medicine is an occasion of knowledge; one can never swim to reach the other shore, however we have to have minimum competency. The biggest problem in medical education today is an old one: There is too much to know, and not enough time to learn it. The problem is more acute today than it has been in the past, because of the great increase in Medical colleges without many competent Teachers, increasing medical information and even the addition of new courses in medical colleges. When we were students we have no university papers on ENT, ophthalmology or Paediatrics. MBBS degree stands, it was really to know something of everything. Today students turn to little books in Medicine as guides and while memory aids such as mnemonics, certainly can help, it is more important that you really understand the material rather than just memorize it, Moreover, once one understands, it becomes much easier to pick up and remember more esoteric facts, as opposed to just trying to remember isolated bits of information. Today we never do well with reference books despite the importance of reference texts; it can be difficult to go through them in the short times allotted for medical-college courses. Also, the information can be so overwhelming that it becomes difficult to see the forest for the trees, and acquire an overall understanding. While it is important to have the reference text, the initial phase of acquiring understanding is best achieved through the small books that help you see the big picture. Once youre on the wards, the question is how to make the most efficient use of your time in continuing your medical education, that the best way to learn and retain medicine is through patient interaction. But to supplement this learning experience, it is important to do a certain amount of critical reading. Today, the Internet provides a much quicker and more efficient way of searching for information. By using a general or medical-specific search engine, it is now possible to find important, current and practical information about virtually any medical condition. Indias problem of less competent doctors, continue to hamper the efficient medical care in spite growing number of basic physicians, many were good in theory but lack the skills to practice and tide over many critical situations. In built curriculum emphasises in theory of learning not proportionate to the practice. It is certain we have to improve on learning clinical skills by our Students ,as Clinical teachingthat is, teaching and learning focused on, and usually directly involving, patients and their problemslies at the heart of medical education. At undergraduate level, medical colleges strive to give students as much clinical exposure as possible; they are also increasingly giving students contact with patients earlier in the course. For postgraduates, on the job clinical teaching is the core of their professional development. How can a clinical teacher optimise the teaching and learning opportunities that arise in daily practice? Every Medical graduate should be proficient; Learners are motivated by its relevance and through active participation. Professional thinking, behaviour, and attitudes are modelled by teachers. It is the only setting in which the skills of history taking, physical examination, clinical reasoning, decision making, empathy, and professionalism can be taught and learnt as an integrated whole. Despite these potential strengths, clinical teaching has been much criticised for its variability, lack of intellectual challenge, and haphazard nature. In other words, clinical teaching is an educationally sound approach, all too frequently undermined by problems of implementation, due to poor quality of teachers and indifference towards responsibility The following are observed as hindrance even in developed countries

Challenges of clinical teaching

Time pressures Competing demandsclinical (especially when needs of patients and students conflict); administrative; research Often opportunisticmakes planning more difficult Increasing numbers of students Fewer patients (shorter hospital stays; patients too do not cooperate with students

Patients too are our Teachers - Sir William Oslers dictum that it is a safe rule to have no
teaching without a patient for a text and the best teaching is that taught by the patient himself is well known. The importance of learning from the patient has been repeatedly emphasised. For example, generations of students have been exhorted to listen to the patient he is telling you the diagnosis. Traditionally, however, a patients role has been essentially passive, the patient acting as interesting teaching material, often no more than a medium through which the teacher teaches. Wish to Learn how to Teach Medicine better - the best article is ABC OF LEARNING AND TEACHING IN MEDICINE Edited by Peter Cantillon, Linda Hutchinson and Diana Wood ( BMJ ) Email doctortvrao@gmail.com