It has been a long and busy week and I did not have time to put pen o paper….or for that matter type 🙂 Above is a pretty relevant topic in the current day and age , hence I feel it is good time to put my thoughts down!
Medical school was hard…at least for me. First 2 years we learned basic sciences – Anatomy – structure of the normal human body, Physiology – normal function of the human body, and Pathology – The abnormal structure and function of the human body in diseased states. We spent hours dissecting out cadavers with Atlas by the side…we spent many an evening trying to identify the minute details of a histology slide …we tried to comprehend the delicate but complicated works of the human body in normal and diseased states …….Are these really necessary? I mean according to the above, school leavers can directly join apprenticeship schemes and work as healthcare providers. Is this a viable options? Is this a “Briliant” idea to save health care or is it ” the beginning of the end”?
After spending more than a decade of my life in various different healthcare settings I feel I am qualified to answer this question – and I will do so truthfully.
On the surface the above is an attractive idea- I mean after spending 6 years in medical school, doctors still need to do 2 years of foundation year, core trainee years and a variable length of specialty training years / or a variable length of residency training , depending on where you are in the world, to become independent service providers. Even after all of these years as a supervised trainee, most will go on to do a one or two year fellowship before independent practice! So why not start with school leavers and save all the time and money? In these wierd times of ” instant gratification” and ” shortcuts” most would say – Why Not?
Lets look at things logically – Medical school teaches basics of medicine and surgery as a whole, based on a sound education of basic science, to all medical graduates. I am a general surgeon – I don’t treat medical conditions anymore , only diseases treated by surgery. However I still need to retain a basic understanding of medical disorders – humans are an incredibly complex creation of multiple integrated systems – often interdependent on each other – often there are complex interactions between medical and surgical diseases. Often operations we do can bring about changes that lead to medical disorders and vice versa. More often than not surgical patients we operate on develop medical conditions that we need to recognize……We cannot excuse ourselves by saying ” I am not a physician”.Ultimately the responsibility of identifying and referring appropriately lies in our hands. Thus having the basic medical knowledge is fundamental for any surgeon, and vice versa for any physician.
That is where holistic education, a sound understanding of basic sciences are helpful for health care providers – for example, an apprenticeship model will remove the wholistic approach to patients totally – If one is an apprentice in a surgical discipline he or she will not have even a basic understanding of a medical disorder or a presentation , he or she will not have a background knowledge to work out things – in essence he or she will not know normal from abnormal for anything outside the limited scope of his practice- Already an alarming situation!!
Secondly without the detilaed understanding of anatomy , physiology and pathology , we would breed a new generation of surgeons , who will be able to do “procedures ” without the understanding of ” Why”. Infact these new generation of surgeons will be merely “technicians”- I see this as a very dangerous trend as it will breed a generation of physicians without ” understanding or insight ” into the consequences of their actions on the human body.
So what is the solution? I feel there is no easy answer, but what is clear is there should be a balance of both basic medical education an apprenticeship model. One cannot survive without the other ! May be starting apprentice ship concurrently with formal medical education in early years to reduce the length of surgical training may be a solution- whatever it is both must co exist- Atleast in my opinion!!
Enough rambling from me -What are your thought or views on this? I would love to hear them….
With that I am going to wind up- Have a great weekend and safe surgery !!
TC
LBS
Surgery-the good bad and ugly 