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Opinion: It’s time to revamp medical education in India

It’s a staggering occasion each and every time you pick up on something like the article titled “It’s plain murder, by rote” which appeared in the February 13, 2012 edition of ‘The Outlook’. The report brings into light certain startling facts that appear to be an indictment of our state of education in general. Of a number of reasons cited by a number of respected men and women in this pretty long article, the tradition of ‘rote learning’ has been voiced loud and clear.

Dr Soham D Bhaduri
Dr Soham D Bhaduri

I, personally, have never been a defender of the notion that Indian education is all about rote learning. There isn’t any denying that it does permeate nearly every stratum of schooling, but I see a number of other factors, from the amount of money we pour into education to the traditional attitudes of our men, that constrain our education system to the form it is in today. But the term ‘rote learning’ leads me today to a very conspicuous handicap that plagues our medical education, something that needs to be addressed for it to be able to become a modern, dynamic one. And it has to do with our love for long, descriptive texts and paragraphs.

Our obsession with descriptive questions and answers as the prime tool for assessing medical students is something that stifles our medical education. In an age which centres around the soundness of applied knowledge, in nearly every field, it is astounding to find that we haven’t switched to the more rational, application oriented examination and training system that should have seen light decades ago. We have kept on with our descriptive long- and short answer questions beyond the line where they lose their efficiency, and blindfolded ourselves of the importance and might of application/concept testing exam systems, systems which test the brawn of actual understanding of facts and concepts.

“Modernisation is more than just computers and telemedicine, it entails looking beyond our inveterate practices that thwart a better tomorrow.”

The ramifications of this stretch are far and long, as I’ve portrayed in my article on theory exams. A theory centred system makes the curriculum more cumbersome and voluminous, siphons off fruitful time, and promotes redundant, superfluous practices and activities. It kills the attitude to explore beyond the embrace of the textbook, promotes practices like rote learning and cramming, while being a relatively inefficient method of testing concepts. The most menacing influence is the one it has in shrivelling up the attention given to practical classes.

On the other hand, we have travestysed practical training by keeping it largely to history taking, physical examination and clinics that end in theoretical cul-de-sacs. Despite the fact that a number of centres epitomise and set the standard for excellence in practical education, practical teaching and evaluation is sloppy and dubious in a number of institutions across the nation. We can do so much towards building a strong practical approach by enforcing hospital/patient care exposure as a prominent part of MBBS curriculum, including activities like ward rounds and exposure to actual diagnostic and management protocols. Their benefits are multifold, as I’ve outlined in my article on practical education.

Our medical education has been the target of a number of studies and reports, emanating from multiple areas of healthcare, that aim to explain its wretched facets — and we’ve often thought of having recourse to filters like exit tests to set things right. We need to understand that no measure to vitalize the shoot can bear fruit in presence of the rot that has affected the root. It’s time to open our eyes to the fact that modernisation is more than just computers and telemedicine, and that it entails looking beyond our inveterate practices that thwart a better tomorrow.

Dr Soham D Bhaduri is a medical graduate and a Philosophy of Mind enthusiast, and blogs at www.freethinkingmedic.blogspot.com.

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