Dr Fazal Ghani
Head Department of Prosthodontics, Khyber College of Dentistry, University Campus, Peshawar 25120 (Pakistan)
*Corresponding author: “Dr Fazal Ghani” : fazalg55@hotmail.com
These days, despite the claimed better quality of medical and dental education, the resulting healthcare provision, by medical and dental professionals, is increasingly becoming of grave concern to many members of the general public. Use of knowledge and conventional clinical skills and methods for knowing about the conditions having rendered their patients ailing, speaking softly, kindly and in an exploring manner with patients, educating and counseling patients, doing the minimal, the needed but the effective, and repairing the repairable are considered virtuesand values of our predecessor doctors and dentists. Ill-practices of doctors and dentists reflect pooreducation of medical students by medical and dental teachers (hence after medical teachers) in medical and dental (hence after medical) institutions and this cause loss of money, time, health, peace of mind, and even health.When properly educated, the doctors will be better able to provide appropriate and the needed care.
It demands too much time and resources to qualify as specialist doctorand in most cases not before the age of 32 years. Despite this, his post-specialization education continues throughout his active professional life and career. Pursuing a specialist career path in medicine or dentistry puts one at a great opportunity cost. For example those opting for a career in business, not only they would spend little but soon would earn more than what he would have spent on becoming a medical or dental specialist.Most doctors and dentists including specialists routinely delay marriage and parenthood. Many of their school class-mates in other areas acquire homes, families, and established careers much earlier than them. Despite this great investment of their effort, wealth and personal sacrifices, a specialist doctor or dentist has to ensure that as a specialist, hehas received the best education and training possible. All this enormous investment of money, time and personal life sacrifices can be truly justifiable because, a doctor or dentist is the benefactor of humanity, a great wish that can be inspired only by people wishing to become great. For a doctor or dentist to remain truly of the kind, firstly he must be firmly committed to the noble cause of medical and dental profession, and secondly and most importantly, as a student of this noble medical profession, he should have been educated by great medical teachers.1-4This would means that one should not simply pursue a career in medicine simply for the sake of having the prefix of “Dr” with his name.
Medical and dental institutions and their specialist faculties continue to focus on three key educational ingredients:
- Curriculum facilitating the acquisition of knowledge and skills necessary for medical and dental students.
- Teaching and training approaches facilitating knowledge and skills acquisition.
- Techniques determining how well the graduating doctor will have acquired the knowledge and skills.
But the very fact is that educating medical and dental students is much more than these three approaches.In medical institutions having perfect curriculum, modern instructional methods, and valid, credible and honest testing, all do a poor job of educating future doctors if they fail to give,their trainees,creative, committed and inspired minds and attitude.1These qualities obviously will be acquired by the trainees, if their teachers were, in the first place, creative, committed and inspired. Unlike an industrial process where substances are uniformly processed in shape, medical education is a human development process. Each medical student brings unique and distinctive interests, abilities, and experiences. Like the practice of medicine itself, great medical education must relate human beings to each other.2-3
The money needed for medical schools is coming mainly from state and patients. Another source of money is that earned for and acquired through sale of research. This approach of financing medical education also gives a rank and status to the institution. However, in this quest, some medical institutions and their administrators see education as a loss and resort to saving money and restricting expenditures mainly through compromises in quality and size of faculty and institutional standards.The administrators of medical institutions then shift the in-hand funds away from education to purposes that can generate additional revenue. The overall effect of this is seen mainly as; undermined and stagnant performance of medical teachers.
Couple with lack of respect for educational resources including its faculty and teachers, a lack of respect for the education contributes to another problem, a dearth of resources. Educating future doctors need time, money, equipment, and more importantly committed, creative and inspired teachers.2-4If the medical teaching faculties are forced to remain busy in caring for patients or doing administration and research, they will not have time to teach;and in fact not doing their prime duty of teaching. Eventually, the size and quality of teaching faculties declines, at least relative to the number of students. Among the remedies include ensuring medical teachers and faculty remaining engaged and challenged
by their work. Secondly, teaching and training has to be devolved with no control from a central authority determining what to teach and how, when, where, why, and to whom to teach. This renders the teaching faculties mere implementers of others’ ideas, thus diminishing their level of engagement and growth. In this regard, the most pertinent is the “Whom to teach” one and is obviously pointing out to “inadequately selected learners”. A grave situation for the healthcare provision would arise if both the medical trainees and trainers are compromised in terms of their learning and teaching capabilities.
Best medical education should establish a friendship relationship rather than facilitating an industry like mass production of doctors.2 The personal commitment of medical faculty to teaching and that of students to learning for good practices are vital factor for achieving this “friendship relationship”.3The moment medical teaching faculty is rendered stagnant,it begins to become disengaged and ineffective.4Medical trainees can tell when their teacher is unprepared. This situation greatly affects the trainees’ enthusiasm. Therefore, it is very important to ensure medical faculty remains maximally engaged with students. A teaching faculty only remains true faculty if worked full time and did full time teaching.2-4 At the same time, the faculty must remain fully excited about teaching and encouraged to innovate and grow in their work. Medical educational institutions not facilitating encouragement and growth of its institutional faculty are neither imparting medical education nor aiming and ensuring proper health service provision.4
For the medical teaching to remain great it must not focus only on inculcating knowledge and its transfer but it should promote knowledge sharing between the trainer and learner. Great medical teachers don’t merely stress on students to memorize things; they promote imaginative thinking. They encourage learners to be inquisitive.2-3 In fact, good doctors use this approach in their work-place including practices, clinics and wards.
Teaching in medicine should provide an opportunity to the students to become medical professionals and human beings.5Indeed, it is a great and pleasing moment for a medical teacher when to see he has empowered his student for bringing positive change in the life of his patient. It is even more so to see a former student as thriving and humane practitioner who regularly brings real difference in the lives of his patients and thus developing himself as a human being. Each medical teacher should be like a candle that had been set alight by his own teacher as a faculty and now he himself is having the opportunity of passing on this “so far the best acquired flame” to his successor, ideally “burning more brightly”.
It is indeed very gratifying for a medical teacher when he sees that his teaching has enabled the doctor to formulate good question. Great teachers cannot be influenced by anything done by his students except by the event of having discovered in themselves the un recognized abilities and powers.” In brief, a great medical teacher doesn’t just teach facts, he teaches to discover, he presents as role model, he teaches students to connect the depths of their capabilities and he would help to train many good doctors promoting on his passion.2
Great doctors feel that the biggest difference, they see in themselves, has been made, during the period of studying medicine, not by the curriculum or technique, but by the character and passion of their great medical teachers to be correctly called “Giant Medical Teachers”. These giants of medical teaching have preferred to teach not just facts and skills but:Empowering their students how to build relation with patients and colleagues, handle mistakes, how to remain balanced as a doctor and as a human being. But most importantly, to know how exhilarating feeling it is upon knowing that he has imparted something important to a patient’s life.
These giant medical teachers, like any great teacher, are not only the benefactors of their students and communities, but they are also the benefactors of humanity.They see the obvious positive effect of their great medical teaching as“a great healthcare delivered by great doctors trained by great giant medical teachers known as the great medical faculty of great medical institutions”.
References:
- Azer SA. The qualities of a good teacher: how can they be acquired and sustained? J R Soc Med 2005;98:67–69.
- Paice E, Heard S, Moss F. How important are role models in making good doctors? BMJ 2002;325:707–10.
- 5. Wright SM, Kern DE, Kolodner K, Howard DM, Brancati FL. Attributes of excellent attending-physician role models. N Engl J Med 1998;339: 1986–93.
- Farmer EA. Faculty development for problem-based learning. Euro J Dent Ed 2004;8: 59–66.
- Paice E, Heard S, Moss F. How important are role models in making good doctors? BMJ 2002;325: 707–10.