This post is fat too long which is why I never published it. Please try and read it …….. pretty please ….. all 6 of you who still visit this site.
You’re first day in medical school: 3 subjects for 1 year, biology, physics and chemistry, mostly rodents, reptiles and Schiff bases ……. stuff I can’t remember anymore ……. nor will I ever need ………
Your second and third year in medical school: You’re finally seeing a human body for the first time, you see the parts (anatomy), the mechanisms (physiology) and the witchcraft (biochemistry).
You’re fourth and fifth year: you go through diseases through pathology and microbiology but barely see 20 patients a year …… half the time you don’t know what they are doing or what you’re doing to them just taking a history (interview) and physical exam ………. forget the diagnosis …. that’s miles off.
The final year: you read and read and read and read …… then realise that you’ve barely seen enough to know how to recognise what you’re reading if a patient even had it.
Graduation day: You’re happy! YOU ARE DONE! but what now? where do you go from here? you’ve passed, you know your stuff ………. but don’t know what to do next …….The reasons why you went to medical school in your first year are forgotten and you’re not all that inspired, you want to treat people …. but that’s it …… you don’t even know how to prescribe yet …….
That’s a summary of my medical “education” and as most of you can tell, I’m not exactly satisfied by it. Now, I’m not an educator, I’m no teacher. They need to inspire, to have that ability to make you trust them enough to guide you; they have to have that gift that lets them build a mental structure in which information can be stored and eventually made useful. Sadly, few of mine did and looking around at the new batch of interns from both Kuwait and abroad few of them seem inspired. Don’t get me wrong, they work hard, right to the bone, they have skills but not the useful ones.
How many of the young doctors you see/meet actually make you feel comfortable, know how to ask the right question at the right time, know how to tell someone they have cancer or that a persons father died minutes ago?
How many of the doctors reading this (if any …… ) actually feel a sense of awe at what they do? how many of us actually enjoy reading about how IV fluids (drip …. or drib) were originally made? Or how the inhalers (Ventolin) we use evoloved? or why we tend to wear green or blue or green scrubs rather then white or grey ones? Or who the first open heart surgeon was and what he did to get there? How many of us were taught the ethics behind palliative care? Contraception? and experimental treatments? or how clinical trails evolved and the difference between that and standard treatments?
Medical history isn’t the reason why you go into medical school, it isn’t how you save lives, but in that third year when all you know is the Krebs cycle (the gearbox of your metabolism) and the anatomy of the Brachial plexus (nerves in your arms) you need to feel inspired by people who’ve done it before you. You need to find a reason to read, to debate, to analyse and to understand and during that final year, you need to learn why trying out new treatments for MS and charging people for it is unethical and why the current mudeer is a douche and why patients blame you for cancer rather than try to understand it…….
You don’t learn these things in textbooks on surgery, rheumatology or internal medicine, and contrary to popular belief you won’t learn them by parading the hallways in your new white coat and seeing 50 patients in the emergency room ….. you learn them by reading the ethics, the sociology and other humanities that underpin our profession.
Kuwait University and others like it have the ability to reshape education and inspire us. The reason why they can is because unlike other institutions it was built from the ground up to educate us, other institutions need to attract research grants to survive,we don’t.
We also have experienced faculty, there are people currently teaching who were there when stomach stapling came to Kuwait and can tell us how they tackled it, who they dealt with mistakes made during that first cases, the second one and the third. We have people who saw Viagra become the drug du jour and who saw the eradication and rebirth or tuberculosis in Kuwait.
We need to reshape our education and have graduates who can debate, discuss and be knowledgeable in our field without feeling that reading ethics 1 day a week is a waste of time.
Maybe then we’ll stop hearing about how doctors who “don’t know my name’, “don’t spend enough time with me” or are “too brash” or “shyif nafsa” and maybe then doctors won’t get slapped around so much.
I’ll leave you with the quote that he read to me one afternoon years ago and introduced me to the sense of awe , the need to read on medical finance, history and ethics; humanities presumed dead by our colleagues and up and comers (yes, student ……. you’re not my colleague yet …..). It was by John Cardinal Newman who described a university as a citadel built with the purpose of:
'raising the intellectual tone of society, at cultivating the public mind, at purifying the national taste, at supplying true principals to popular aspirations, at giving enlargement and sobriety to the ideas of the age, at facilitating the exercise of political powers, and refining the intercourse of private life.'
I only hope that I can one day see this in our local University who’s faculty and students should expect more from each other …….
