One of my Facebook friends has asked me to pen a post on comparing the teaching system in the U.K. with that from India. Frankly, there is no comparison. Firstly, the kind of illnesses we see in India and the ones that we see in the U.K. are quite different. Secondly, our healthcare systems are completely different. In India, we work with limited budgets, whether in government/municipal hospitals or in private clinics/hospitals.
In the U.K., too, there are some budgetary constraints, but the supplies are all top-class, and there is no shortage of essential as well as non-essential stuff, except for the items which are in the very expensive range.
Thirdly, and this is the most important difference: the system is driven by evidence - the kind of evidence that comes from research and trials - and is completely based on protocols that are specific to each institution but framed from national and international data that is published by national-level agencies. Such evidence is periodically reviewed so as to be abreast of the current knowledge. This kind of evidence is completely lacking in India. Individual doctors may, from time to time, update their knowledge base and use this to help their own patients. Devising of hospital-wide uniformity of treatment never does occur, so that every doctor treats the same condition differently, based on their own learning, experience, and hearsay from their peers.
Coming to teaching: We have excellent teaching in India as well, but it is fragmented. Doctors learn from their seniors when they are students, but as soon as they start a private practice, they give secondary importance to continuing education. The Medical Council of India and state-level bodies like the Maharashtra Medical Council etc. have recently moved to enforce that every registered practitioner should have a certain number of points to be able to stay registered on the professional register. However, the points can easily be collected by sending the money to the organisers of teaching programs and then receiving the participation certificate in absentia. Many a times, doctors will attend a conference or learning seminar just to get the points, but not use the learning to improve their practice. Occasionally, doctors will, for reasons of expediency, join programs that are not even from their own speciality, just to gather the required points.
In the U.K., learning is referred to as teaching! Thus, when a student says that they are going for teaching, they are actually going for learning. While I haven't done my formal medical training here and cannot, therefore, comment on how their teachers are, I can definitely say that medical students here are far more experienced than Indian medical students are, in practical, hands-on experience. This is because, from their third year onwards, when they attend the wards (just as we did or do in India), they begin to clerk patients in a proforma, taking the patient's history, examine them, etc. and they will, in their fourth and fifth years, be expected to give a differential diagnosis, and formulate a plan of management for that patient. This allows them to think like practicing doctors years before they actually will practice clinical medicine.
What really makes the difference in their training, however, is the fact that they have to collect, and later produce, evidence of their learning. This has to be uploaded by them electronically, and I have often had students presenting a medical case to me and then coming back a few minutes later to take my digital signature on their mobile phones to collect the evidence that they did, in fact, present a case to me. They will also sometimes send us a link to give a feedback on how their performance went. This is a requirement for them and not an option. This enables them to advance professionally in a more structured, evidence-led method than the kind of haphazard learning that we have in India.
I hope this answers the question for my friend, and helps others too, to understand how the system works in the U.K.
In the U.K., too, there are some budgetary constraints, but the supplies are all top-class, and there is no shortage of essential as well as non-essential stuff, except for the items which are in the very expensive range.
Thirdly, and this is the most important difference: the system is driven by evidence - the kind of evidence that comes from research and trials - and is completely based on protocols that are specific to each institution but framed from national and international data that is published by national-level agencies. Such evidence is periodically reviewed so as to be abreast of the current knowledge. This kind of evidence is completely lacking in India. Individual doctors may, from time to time, update their knowledge base and use this to help their own patients. Devising of hospital-wide uniformity of treatment never does occur, so that every doctor treats the same condition differently, based on their own learning, experience, and hearsay from their peers.
Coming to teaching: We have excellent teaching in India as well, but it is fragmented. Doctors learn from their seniors when they are students, but as soon as they start a private practice, they give secondary importance to continuing education. The Medical Council of India and state-level bodies like the Maharashtra Medical Council etc. have recently moved to enforce that every registered practitioner should have a certain number of points to be able to stay registered on the professional register. However, the points can easily be collected by sending the money to the organisers of teaching programs and then receiving the participation certificate in absentia. Many a times, doctors will attend a conference or learning seminar just to get the points, but not use the learning to improve their practice. Occasionally, doctors will, for reasons of expediency, join programs that are not even from their own speciality, just to gather the required points.
In the U.K., learning is referred to as teaching! Thus, when a student says that they are going for teaching, they are actually going for learning. While I haven't done my formal medical training here and cannot, therefore, comment on how their teachers are, I can definitely say that medical students here are far more experienced than Indian medical students are, in practical, hands-on experience. This is because, from their third year onwards, when they attend the wards (just as we did or do in India), they begin to clerk patients in a proforma, taking the patient's history, examine them, etc. and they will, in their fourth and fifth years, be expected to give a differential diagnosis, and formulate a plan of management for that patient. This allows them to think like practicing doctors years before they actually will practice clinical medicine.
What really makes the difference in their training, however, is the fact that they have to collect, and later produce, evidence of their learning. This has to be uploaded by them electronically, and I have often had students presenting a medical case to me and then coming back a few minutes later to take my digital signature on their mobile phones to collect the evidence that they did, in fact, present a case to me. They will also sometimes send us a link to give a feedback on how their performance went. This is a requirement for them and not an option. This enables them to advance professionally in a more structured, evidence-led method than the kind of haphazard learning that we have in India.
I hope this answers the question for my friend, and helps others too, to understand how the system works in the U.K.
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