Doctor Who? Doctor You?

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Each year thousands of students around the world apply to medical colleges and embark upon a new journey. Nimi Jayachandran explores how one can study medicine abroad and how it compares with the Indian medical system

The Indian Way
After receiving admission to a medical college, a student is faced with a five and a half year long curriculum of studying ahead of them. The last year of this is known as the Compulsory Rotatory Residential Internship (CRRI) year, which consists of clinical rotations in different departments. The first two years are focused more on theoretical learning. In the second year of medicine, students are exposed to the practical learning set up and are given basic clinical training. This includes interacting with patients and how to approach formulation of a diagnosis. As the years go on, more importance is given to clinical subjects and training so that by the time students enter CRRI year, they are qualified to diagnose and treat patients, under the guidance of a senior doctor.

Pros and Cons of a Medical Education in India
There are definitely certain unique advantages that come with being a medical student in India. One of the most important learning opportunities as a doctor is the practical skills acquired by seeing patients. That being said, the number of patients admitted to hospitals per day in India is higher than anywhere in the world. Among these patients, students see not only some of most common ailments, but also some rare ones, thus providing a well-rounded practical learning opportunity. Dr T.S.Subbiah, a CRRI at Sri Ramachandra Medical College in Chennai, says, “The quantity of patients we see is definitely an advantage over our foreign counterparts. We are free to examine each patient with his or her permission and by doing so our clinical history taking and examination skills are honed to excellence.” Gayatri Padmanabhan, a Final Year MBBS student at Sri Ramachandra Medical College goes on to add, “Even as students we are given a certain liberty to examine patients under proper supervision of our senior doctors. When theoretical learning is combined with such a practical situation, it helps us to better understand how to approach each patient’s illness and how to best treat them.” When it comes to clinical learning methods and opportunities, students have a lot of freedom to examine patients and to learn by a hands-on approach rather than merely learning from theory how to establish a rapport with a patient. The quantity of the patients seen on a daily basis itself presents such a vast opportunity of knowledge at the students’ disposal.
However, a disadvantage of such a system does exist. As Dr Yuvaram Reddy points out, “In India the resources are limited, as a result of which quality gets compromised due to the quantity of patients.”

How is Medical Education in India Different Around the Globe?
Most medical college systems around the globe follow a similar system. Students undergo a few years of rigorous theoretical teaching which is followed by a year of clinical rotations. The advantage that many Western countries have is in their ability to spend time developing quality patient care. “I love how organized everything was – there was very little margin for error and no matter what, patient care was never compromised,” says Dr. Srividya Maharaj of her experience working as a doctor at Valley Hospital and Medical Center in Nevada, USA. From the start of a student’s medical career, it is drilled into them to provide quality patient care. While the Indian medical education system is modeled to teach students how to successfully treat a large number of patients, the western medical education system focuses on emphasising individual patient care. “In the US, the quality and cost of care is high, in the UK and India there exists a government health care policy,” says Dr Yuvaram Reddy, “this means that students in the US have the luxury of being able to individually treat a patient according to their specific needs, whereas in a place like India, doctors have to focus on the masses.”

And the winner is…
Education has always been a matter of controversy, whether it is with regards to how a certain topic is taught, or whether a topic should be taught altogether. Medical education is no exception to this. In countries like India where the number of patients outnumbers the number of doctors, the existing system of focusing on treating the populace works better. In places like the US, students have the opportunity to learn by approaching each patient’s history individually. Overall, good medical education needs to give our future doctors a set of skills with which they themselves learn to apply quantity or quality based treatment according to what a situation demands.

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Volume 4 Issue 7

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