Unbeliveable. What a group of consultant colleagues said during lunch regarding the quality of training of junior doctors. Many universities are now using a problem based learning (PBL) approach Apparently studies suggest that it should produce doctors who are more independent in their learning and thinking, putting them in the right path for the rest of their careers. There is much more emphasis on modules organised in systems (eg cardiovascular system; they are meant to study all about anatomy, physiology, pharmacology and pathology).
Unfortunately the PBL system is far from thorough in its coverage, and it does require a lot of maturity and self discipline from medical studies to self study topics which are not necessarily discussed in the PBL tutorials.
There was this consultant doing a ward round with a first year doctor. They were seeing a patient with liver failure. When asked about the signs of liver failure, the consultant got a “I don’t know”. Exasperated, the consultant tried to teach VERY BASIC symptoms and signs of liver failure. Then asked the houseman about causes of liver faillure. Got a shrug of the shoulders.
The consultant couldn’t believe it anymore, and asked the doctor how is it possible that he doesn’t know something so common and basic.
The simple reply was “It wasn’t one of the clinical scenarios covered in the medical PBL course”. The consultant tore out his hair in disbelief.
Trained in the traditional medical system, even a lazy medical student would have at least seen 50 patients with alcholic liver failure in their first clinical year (3rd year in medical school). Nowadays, a graduate from medical school, after spending 5 years “studying medicine” cannot answer very basic questions about liver failure and its causes. And they claim that PBL produces doctors who are just as good, or possibly better. I remained unconvinced..
hey im currently a 4th yr medical student in the pbl system as well but i think we covered that topic and alot of others as well..
but i guess it just depends how ur medical school handles it. i did my pre-clinicals in a msian university so it was more like a combo of pbls and lectures (independent studying plus some spoon feeding haha!)
so i think that my msian uni did cover alot of ground in 2.5 years.. hmm not sure abt foreign universities though~
It is not easy for someone who is already in the PBL system to gauge how this system compares to traditional medical education. However I have worked with junior doctors who graduated with PBL and doctors who graduated with traditional training system, and there is a difference. I examine final year medical students and I can tell you their standard is far far below what was expected of me when I was in final year. Interestingly it wasn’t just my own opinion, but almost every single consultant I spoke to agrees.
Those who are in educational research and those close to the system (academics, who do research or teach more than see patients) are the ones who strongly support PBL.
The good thing about traditional system is even with a lazy unmotivated student, you can’t graduate without a reasonably sound foundation in medicine; this however is not necessarily true in PBL. As a final year student examiner I can tell, cause I see what OSCEs and MCQs med students get nowadays.
If you are already studying in the PBL system, you need extreme dedication you can become an excellent doctor. You need to read a lot outside of the prescribed syllabus. Most importantly you need to see loads more patients on your own initiative, and practice regularly presenting the cases to critical consultants or junior doctors for feedback. That will help you along the way…
hey i guess u are right… it would probably be difficult for me to gauge i guess.
i’m from imu, have u heard of tat uni in malaysia? coz they hv 2 programs, partner medical sch program (which im in now) and a local program.
if u ask me, i feel my frenz who are doing the local program are learning far more than me, coz they are forced too, in a way. while here, in aus, u are supposed to be really motivated to learn on ur own.
which is quite difficult sometimes. btw its not easy to get to present to consultants coz they are quite busy (or maybe lazy) and since its not scripted into the timetable, its not a must for them.
but thank you for ur tips! i will try my best to study hard to be a good doctor