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CORRESPONDENCE Are we making asses out of racing horses in
medicine?
This question was asked by a thinking medical faculty member (a
rare breed!) in a national institution. As usual, the majority of medical
teachers were too 'busy' and missed it. Of those who did read the newspaper
report, a minuscule few dared to air their views on the subject. Some medical
teachers whose neurons still had intact myelin sheaths reacted positively. But
it did not register for the vast majority with atrophy from disuse.
This
indifference is not abnormal, as health policy has never been an important
agenda item in this country. Our nervous system is not used to reacting to
health issues. The medical profession has failed to influence health policy. It
is content to participate in programmes like pulse polio drives and observe
international health days and those of some popular diseases.
Health policy
should be a topic of public debate. After all, it concerns the health of the
citizenry. Since we do not feel concerned, discussion is restricted to the
cognitive domains of a few health officials who rise to their own level of
incompetence according to Peter's principle. Then there are rotating bureaucrats
who by sheer chance get the opportunity to warm the chair of the health
department. There was a time when health ministers were chosen from among
eminent doctors. The less said about today's politicians, the better.
But
one cannot blame only the bureaucracy. Medical activism has become an endangered
species. The medical profession looks askance at 'ambulance chasers' because it
does not want its doings and 'undoings' examined under a microscope. It is
unfortunate that those who should be charting the health course of the country
have hardly any sensitivity.
Students entering medical colleges on merit are
considered to be the cream of the student population. Unfortunately they do not
get any opportunity to refine and demonstrate their skills. Instead of teaching
them how to use their intelligence to solve problems the present system converts
their brilliance to mediocrity. As skills are hardly put to use they eventually
start rusting.
Medical teachers are
responsible
Our medical teachers should share some blame for this.
They did not cherish individuality and freedom of thought.
It is unfortunate
that medical teachers have mortgaged their brains. Most are content to deliver
10 lectures per six-month term. Many senior teachers do not teach at all, though
they have teaching assignments on paper. In 25 years of medical teaching, I am
yet to see a departmental head or a dean devoting even one hour a week to pure
teaching. Some medical teachers are 'out of circulation' because they are busier
with administrative, academic, university or political work, which for them is
more important than teaching. There are some privileged ones who obtain various
kinds of leave when their lecture series starts. One popular escape is known as
'oblique practice': teaching timetable planners write two names against each
assignment, and the senior teacher always has a junior 'assistant'. When it
comes to self-assessments, both will claim to have conducted the same classes.
They even manage to get awards for 'ideal' and 'best' teacher. If such is the
aptitude and attitude of medical teachers what altitude is expected from them?
Those entering medical teaching today are mostly mediocre, ineffective
communicators with neither knowledge of the subject nor teaching skills. They
choose teaching because they cannot do anything else - even after having been
gifted medical degrees. Those who have never run a race themselves become in
charge of the stud farm. An average teacher stays in service for 30-35 years.
Imagine the impact of inefficient teachers on the many batches of students
handled by them. A whole generation of brilliant students is affected and
afflicted with mediocrity.
If we do not wake up to correct this
malady, our young colts and mares, with the potential to win races, will
be reduced to asses.
Vijay Thawani, Associate
Professor in Pharmacology, Government Medical College, Nagpur, 440 003, INDIA.
e-mail:thawani_ngp@sancharnet.in
Subscription number 001
I was
surprised to receive a copy for which I was given a subscription number 001 for
the state of Bihar. I had seen a specimen copy of the journal in our college
library and found it very interesting and worth subscribing to.
But it is
the subscription number which has made me think and write about the lack of
medical ethics awareness (although many doctors may be subscribing to other
medical ethics journals and also reading them). People in this state are
among the most deprived in India. It is a state where private practice is
allowed and this has led to the worst conditions in health institutions. In our
hospital, patients who are admitted think it a boon if they escape death.
The worst medicine is practised in this
institute. We doctors have no sense
of responsibility towards patients and in turn patients and their attendants
have no faith in government doctors here. Prescriptions are irrational, patient
input is very low and output even low for emergency admissions.
Bipin
Kumar, Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar.
ErratumWhile we credited the cover photograph in
the January-March 2005 issue to http://www.planetwire.org, from where it
was obtained, we omitted to mention that the photograph was taken by Raghu Rai,
on behalf of the David and Lucile Packard Foundation. The error is
regretted.
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