Reforming Medical Education in India: Do we Alumni have a Role?
Eighteen is this the time to be confused. Some say “yes” and some say “no”. Yet others say any time is fine to be confused. Biologically, 18 is the peak age for endocrine changes in the human body, the time for all sexual energies to be expended on romance and love and the time for “experimentation”. Is this the age to begin a professional course whether it be in engineering, law or medicine?. The Indian academic system largely influenced by the British legacy has copied the notion of 10+2 of higher secondary schooling followed by professional courses. This system of education has generated some outstanding engineers, lawyers and scientists. On the other hand there have been some fantastic mismatches: these include IIT graduates like L. Subramanian and Fusion Guitarist Prasanna who are outstanding Carnatic Instrumentalists of the highest possible caliber and no longer engineers and physicians like Deepak Chopra who have become holistic gurus rather than practice his subspeciality as a trained endocrinologist.
On the other hand are these true mismatches? Are these these "mismatches" the consequence of the confusion that comes with "forcing" teenagers to choose professional courses when they are "confused"?
On the other hand are these true mismatches? Are these these "mismatches" the consequence of the confusion that comes with "forcing" teenagers to choose professional courses when they are "confused"?
One could argue an education of the highest quality is never a bad thing and regardless of what happens in life later, such education will hold one in good stead. While this is true, the success of nations like USA, Russia and United Kingdom can be attributed to their talent pool of intellectuals that cultivate and grow their talent further in a particular discipline and a system that encourages the cultivation of talent in individual disciplines among their youth. The highest quality of medical professionals in USA did not come as sheer accidents from engineers and lawyers changing their disciplines of study upon completion of their professional education. Same is true for engineers in Russia and Lawyers in England. The cross fertilization of disciplines could occur as a minority outcome but cannot be expected as the majority outcome in any professional educational program. Just imagine if the majority of management schools in any nation churning out outstanding diplomates that never end up as managers, but choose to become doctors, engineers, cooks, carpenters and accountants. Would such a management school be considered a success? Surely by any standards this would be considered a colossal failure.
In a similar vein, medical schools have the mission of generating the highest quality of physicians. This is their stated mission. If a very small minority of graduates from a medical school become politicians, movie actors or home makers, this would be quite acceptable. But if greater than 10% of any graduating medical student class were to become homemakers and never practice medicine anytime in their life, would it be acceptable? Most medical administrators and educators would consider this an enormous failure of the medical education system. Either this represents poor selection process or a poor mentoring process. Either way, it is a failure and should be recognized as such. The lack of anyway to track what happens to medical graduates exiting medical schools in India is a major handicap. This leads to the inaccurate an often unrealistic notion that everything in medical education in India is okay.
If our goal is to produce the next generation of physicians that provide the highest quality of medical care to Indians, then the time to act is now. We need to have accountability for medical education, educators and administrators. We need to track everyone that enters medical schools from the time they send in an application to enter medical school. We need aptitude tests and interviews no matter how subjective they may be to complement entrance examinations. Even if we use only entrance exam scores as the sole criteria to admit students to medical schools, the aptitude tests and interviews will be helpful to mentor and guide these students in medical school. So, at times when the 18 year old is confused and has excess sexual and romantic energies, they can be channeled in positive direction by medical educators, psychologists or other support personnel. A complete psychosocial profile of every medical student must be confidentially obtained and available to school counselors to help medical students. These are things we as medical school alumni can provide to our alma mater. We need accountability in numbers. How many students succeed in their ambitions that form at the time they spend completing their MBBS?. What can we do make sure that these dreams come true and that these dreams form the nidus of realistic achievable goals? In particular the more vulnerable groups like women, minorities, economically disadvantaged and the physically challenged must get more support from medical educators and administrators. Everything must be done to ensure that no medical student fails to accomplish their dream. Afterall, these are the brightest and best among our youth. If they cannot achieve their goals in life who else will be able to in our society?
There must be goals and targets for each medical school. A certain percentage of students need to choose primary care (family medicine, general practice, etc.), a certain percentage become specialists, a certain percentage become physician scientists and a certain percentage become medical administrators. These careers must be discussed and explained to students and they must choose them willfully rather than sheer accident. The next generation of medical students must not be products of accidents that happen due to confusion that occurred at the age of 18. They must be an informed generation of smart choosers who know everything that need to be known at the stage of choosing a career.
Let us start with some accountability ourselves, let us at CMC set the example of providing accurate numbers to our administrators on the success of our graduates. Fill out the survey that I developed if you have not yet done it. Here is the link
Ask all your friends to complete the survey. We need a minimum of 5% of all CMC alumni to date (~50 years x 200 students = ~10,000 CMC alumni) to complete this survey to get any accurate statistics. As of today (June 10, 2011) only 49 Alumni have completed. We need at least 500 Alumni to complete the survey. So, let us start with you if you have yet to complete it and get your CMC friends to complete the survey as well if they have not done so.
If you have ideas on how we can implement change medical education at CMC come forward, participate and give your ideas more voice and act on it.
If you have ideas on how we can implement change medical education at CMC come forward, participate and give your ideas more voice and act on it.
Let us goad our medical administrators to act on our data, Let us encourage additional accountability. Let us provide mentorship opportunities. Knowledge is power goes the old wise saying. So, let us enpower our current generation of CMC medical graduates with the knowledge and wisdom that we gained over the years. It can only make them stronger. Enpowered youth will take care of themselves. Our job is simply to enpower them for the future. Let not the “confusion” of an 18-year old lead to accidental careers and accidents that end careers. Although all of life cannot be planned, a bit of planning can never hurt in life. Moreover, the brightest and the best in India should have “ambition made of sterner stuff” than mere confusion of the 18-year old. So, let us get together, participate and goad medical education in India to a new frontier.
