Rabu, 25 Ogos 2010

Current medical students - the way I see


I left my medical school for almost 24 years now. I still remember my lecturer taught me about pathogenesis of many diseases in reference to the normal physiology and function of specific organs. They taught me to be critical and analytical about every single problems. All the time we were reminded that not everything in medicine is definitely 100% correct. Some of the cases are straight forward and you can make the diagnosis or conclusion almost immediately. However, some of the problems tend to be a little bit complicated that require your ability to formulate and putting a serious thought into it based on your knowledge, experience and your readings to come up with the nearest possible answer. This is where the arguments and discussions are important. Obviously, at the end of the day, you will get the final diagnosis after specific test or gold standard test performed. The process of getting to the final diagnosis require a flexibility in thinking and the student must be able to reason it out to support their argument. That's the reason why in the medical school, first thing that you need to learn during your clinical years is taking a history from the patient followed by physical examination. Occasionally, you don't need to do any investigations to confirm the diagnosis. 95% you will be able to make a correct diagnosis after history taking and physical examination. All the student should develop the skill in getting relevant informations from patient and confirm it with physical examination to further strengthened the evidence. A doctor is just like the CSI officer who are trying to gather all the evidences and come up with the most possible diagnosis. It is an interesting process. Some of the diseases have overlapping clinical features and biochemical derangement, but you need to choose the most likely diagnosis. Of course, if we can do a specific test for the confirmation, finally we will get the right diagnosis. In order to go through these processes, we have to strengthened our basic knowledge on physiology, pathology, biochemistry and not to forget human anatomy. I always reminded my students on the basic things in medicine. We have to remember everything that we have learned in the early years of medical school. In order to recognise abnormalities, we have to know the normality first. Otherwise, we can't make any conclusion out of it. It is not an easy task. Students nowadays, are very poor in applying knowledge to patient. All of them are so call 4 flat students. They read a lot but unable to identify the relevancy of such informations to the patients. They have tunnel vision. Their arguments and discussion on certain diseases are very immature. Overlapping of symptoms and clinical signs are too much to handle. They easily get confused. Mind you, they are 4 flat students. Worse still if they don't have interest in the subject or in medicine. They do medicine for different purposes. Peer pressure or parents pressure. I take final year medical students from the public as well as private universities. They are equally bad but the public university do slightly better.....It is worrying situation. Probably, we need to look back at the presence curriculum or something have to be done. We have seen the prove from the quality of housemen that we have nowadays. The quality of our doctors are deteriorating, not only in skill but in knowledge, soft skill and attitudes. How much we specialists in the government hospitals can teach and guide them in 4 months posting if their basic medical knowledge is almost 0%. It is a tough job.......good luck to all of us ...

8 ulasan:

  1. Salam dr norra:)
    I wonder how a super busy woman like u act hv time to write such insightful posts. May Allah reward u better. I hv to admit that we are a lot weak and need to really backup for the coming exams. Though so we appreciated it so much that we have such dedicated lecturers and consultants to actually not just teach but nurture us accordingly. I wanted so much to b in ur group this semester cause i learned so much last sem when I quietly join ur teahing session especially on how to present our case nicely & how to think thru the case but oh well not my luck this time around. May Allah bless u for all ur efforts dr norra:)

    BalasPadam
  2. I am surprised that you read my blog. If you noticed, I wrote when something got into my mind. Your Dad taught me before when I was in the master programme. He offered himself to teach us. Do you know the reason? The same reason that I have. I felt it is my responsibility to share my experience and knowledge with all of you because you are my brothers and sisters, the future generation of our beloved country. That's the only contribution that I can give. To be a good doctor, you don't need to be so excellent. What you need is good attitude, critical and analytical thinking process.You have to be good in your basic physiology and pathology. I feel that all of you have great potential to be good and successful doctors but unfortunately, your college has minimal number of lectures to guide and teach all of you. However, with your perseverance, nothing is impossible.You have to believe in yourself. I hope all of you will pass this coming exam.Your success is ours too as a teacher. Good luck and may Allah bless you. Selamat Hari Raya.

    BalasPadam
  3. of course we stalk u bigtime! u announce to us about ur blog!
    insyaAllah we'll adhere to ur advices dr norra!
    my dad speaks highly abt u:)

    BalasPadam
  4. yes..we stalk u a lot.. ;) i'm currently in Surgery posting (last posting)...wanted to do Paeds again because we had a great time during ur teaching.. (btw Dr Norra i'm only 3 flat). If we have teacher like u had during your time like (Prof Adib, Prof Raja Khuzaiah) i think we're dead already...We are the first trial from new med school and the curriculum were designed in such a way to stimulate critical thinking with EBM discussion included. However it depends on students to reciprocates..

    BalasPadam
  5. I agree with you 100%. A teacher can do up to a certain limit, the rest up to you. Forget about the marks or merit that you got last time. What's important is for you to make that changes. You see, we don't create our future from the past but we create it from the future. The future, of course, you have to determine the principles and follow them to achieve your destination. With blessing from God and your parents, insyaallah, you will see the bright light at the end of the tunnel. Everyone has potential to be somebody one day. Bad or good,depend on what you do today. Don't forget berdoa for ibu and ayah and for yourself. Your parents and God will guide you along the way. Don't put them aside. Nothing in this world comes easy. I am a bit busy lately to write in my blog. I am glad you like to read and give your comments if necessary.

    BalasPadam
  6. HEHE..I do have read some of ur posts.. I Agreed with u doctor..Nothing is easy in this world...I admit too that we still weak and lack of medical knowledge. As mentioned by shima, we lack of lecturers and our schooling systems was also disorganized. We are pioneer batch who have no reference like senior batch which can guides us in some of weakness that we have, indeed..(SIGH) .I hope all the cucms 1st batch will go through for the challenging that we facing for soon as as medical student nshALLAH.All the best for this coming pro exam.May ALLAH bless all of us. Thank to Dr. Nora bcoz giving us a lot of information and motivation before to get involve the real life in medical field nshALLAH..Please pray for us .not forgotten. I wish u Selamat Hari Raya n maaf zahir batin.

    BalasPadam
  7. I hope and pray that all of you will go through your coming final exam without any problems. If all of you make it to the end, it will be a great bonus for us for the coming New year. Time fly but you are the navigator. Use it to the fullest so that you won't regret in the future. Kita yang tentukan tadbir tapi takdir datang dari Allah yang maha kuasa. Walaubagaimanapun, Allah maha pengasih lagi penyayang. Kebaikan yang kita minta, baik juga yang akan dikurnia, asalkan kita jangan lalai dan leka. Selamat Hari Raya Aidil Fitri, still not to late to wish you. Maaf zahir dan batin.

    BalasPadam