What the post-Covid doctor must know

Source: The Indian Express

Relevance: To cater to the demands of future medical needs, India has to reform medical education.

Synopsis:

The lessons learnt during the Covid-19 should catalyse changes in medical education, enhance the profession’s orientation towards scientific sensibility and compassion.

About the Western model of medical education:

• Major reforms in Western medical education began after the Flexner report of 1910.
  • The report advocated structured, science-based and laboratory supported learning, replacing the apprenticeship model inherited from apothecaries.
  • It also influenced training methods in medical colleges of colonised countries.
• The western model of medical education imposed the reductionist approach that increasingly focused on partitioning the human body into organs, tissues, cells, and sub-cellular structures.
• The integrated functioning of the human body and its interconnectivity to other life forms and the natural environment became obscured from the visual field of medical education.
• Further, Indian medical colleges, usually located in an urban ambiance and linked to tertiary care hospitals, are disconnected from the real-world functioning of a multi-layered health system.
• But, the Covid-19 pandemic could provide the catalytic spark for more reforms by throwing light on many areas that medical education must address.
• In 2010, the Commission on Health Professional Education in the Twenty-First Century advocated a multi-disciplinary, socially responsive model of education. But the recommendation in medical education is not yet imparted.

How does the pandemic demand change in medical education?

There are new competencies that a young doctor must develop and display in a world with changing channels of demand and delivery of health services.

• The pandemic has reemphasised the scientific precepts and moral values of the medical profession, which had been obscured by the greed of commercialized healthcare.
• The ability to judge the quality of new scientific evidence for correctly guiding clinical practice and future research is essential for a doctor in training.
  • This requires a good understanding of research methodology and the skill of critical appraisal that can distinguish good science from bad. This is much needed when new claims inundate medical journals and social media.
• Medical education must teach the essential principles of epidemiology and statistics that underlie good research design and interpretation.
• Many inappropriate tests and ineffective medicines are prescribed by doctors in the misguided belief that they are doing good to their patients — this has been noticed in the pandemic. For instance, unnecessary use of chest CT scans in many persons. This has to be controlled.
• Telemedicine has emerged as an important bridge to clinical care during periods of restricted mobility. Post pandemic, telemedicine will be an established component of health systems. Medical education must impart the needed technical and social skills to make teleconsultations effective and safe.
• The need for imparting skills of effective public communication and empathetic conversations with patients has been highlighted by the pandemic. So the Medical education must now enhance scientific sensibility and compassion amongst physicians.