Medical education in India: From fact-based learning to effective communication

H Iyer 
 Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia PA, USA

Correspondence Address:
H Iyer
Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia PA
USA

Full Text

Sir,

I applaud Hira et al. for their work. [1] Indeed, it fills a void that everybody seems to be experiencing but has not been objectively documented thus far. Having been trained in a government medical college in Mumbai and thereafter in the UK and US, I feel that I have firsthand experience in this regard.

I commend the authors for recognizing the need for a more "rounded approach" for selecting students for medical courses. From a pure knowledge point of view, my personal opinion is that the theoretical knowledge gained by Indian medical students is second to none. We are experts at remembering and reciting esoteric facts, lists and eponyms. In the US, the American College of Physicians conducts an annual competition testing these obscure and random factoids, and my personal observation is that a significant number of successful candidates have had undergraduate and/or postgraduate training in India.

Having said that, I feel that students trained in India do lack in practical case-based learning skills, and are not effective communicators or appreciate the concept of "team work". This is almost certainly due to lack of training in these aspects. These so-called "soft traits" are absolutely vital and form part of what is known as "etiquette-based medicine". [2] I am certain that very few Indian institutes provide structured training on how to deliver bad news to patients and their relatives or on how to talk to patients about end of life issues. These skills are part of the medical education in the US and UK, and I feel that it goes some way to bringing them closer to their patients. These are also skills that are routinely tested in examinations that test communication skills such as the United States Medical Licensing Examination (USMLE), the Professional and Linguistic Assessments board (PLAB), and the Membership examination of the Royal College of Physicians (MRCP).

I strongly feel that this kind of training should be made part of the curriculum in medical schools in India, and this would go a long way in making us more complete physicians and turn the science of medicine into an art of healing.

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