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Indian Pediatr 2019;56:
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Pediatric Education and Present Day Predicaments
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B Shantharam Baliga
Department of Pediatrics, Kasturba Medical College,
Mangalore, Karnataka, India.
Email: [email protected]
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With changing socio-cultural and politico-legal systems across the globe
there is a need for medical professionals to adapt to these changes. The
compassionate, elegant and trustworthy community, seeking medical
advice, is fast fading away, and is being replaced by demanding reactive
community under the influence of three ‘isms.’ Over the past two
decades, trust between medical professionals and patients has eroded,
because of (i) increasing consumerism [1] – a result of
re-christening of medical services as healthcare industry, (ii)
media reactivism [2], and (iii) judicial activism. Today
we have a well- or ill-informed, legally and physically reactive
society, expecting high standard of care at ‘affordable’ cost.
Progressive medical science, with newer techniques,
interventions and treatment modalities has not only increased the life
span but also cost of healthcare. Political agendas and legal reforms
have brought the field to limelight with element of suspicion at all
stages. Ineffectiveness and insensitivity of individual doctors to live
up to situations and societal needs is now coming to forefront. This is
coupled with our insensitivity to social diseases at large and not
realizing the need for a change in our approach. We have moved from
patient/societal welfare to mere investigation- and treatment-centric
approach. Dictum of yester era – ‘diagnose to investigate’ or ‘diagnose
to treat’ is replaced by ‘investigate to diagnose’ or ‘treat to
diagnose.’
National Conference on Pediatric Education was
conceived in India to bring a change in the system of education in
Pediatrics. Sixth conference organized at Sri Guru Ram Das University of
Health Sciences, Amritsar, Punjab (26-28 October, 2018) focused on above
mentioned issues. Medical educators need to analyze our system of
education and deliberate on the following: Are present day graduates
responsive to community? Are we bringing out a confident graduate who is
empathetic, humane and can critically think for individual/patient or
healthy person, perform triage, and deliver appropriate care? Medical
education in India has been stagnant while globally it has transformed
in to learning process of critical thinking. Educators also need to
bring back the ‘role model’ concept [3]
and say no to ‘rude model.’ Younger generation of doctors
need to be trained as ‘master clinicians’ [4] and not ‘marketing
clinicians.’ Graduates need to be mentored [5]. Adopting a
student-centric approach and to break hierarchy in day-to-day
functioning and training requires only attitudinal reforms from within.
Hopefully, the recently released competency-based curriculum by the
Medical Council of India (with all its plus and minuses) may trigger the
change process.
References
1. Ganesh K. Patient-doctor relationship: Changing
perspectives and medical litigation. Indian J Urol. 2009;25:356-60.
2. Gholami-Kordkheili F, Wild V, Strech D. The
impact of social media on medical professionalism: A systematic
qualitative review of challenges and opportunities. J Med Internet Res.
2013;15:e184.
3. Berghout MA, Fabbricotti IN. Medical leaders or
masters?—A systematic review of medical leadership in hospital settings.
PLoS One. 2017;12:e0184522.
4. Heinz D, Alexander V, Peter F, Walter FR, Christoph
HS. Toward a more professional and practical medical education: A novel
Central European approach. Adv Med Educ Pract. 2015;6:459-67.
5. Dhaliwal U, Supe A, Gupta P, Singh T. Producing competent doctors
– The art and science of teaching clinical skills. Indian Pediatr.
2017;54:403-9.
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