This post is fat too long which is why I never published it. Please try and read it … pretty please …all 6 of you who still visit this site.
Your first day in medical school: three subjects for one year: biology, physics and chemistry, mostly rodents, reptiles and Schiff bases…stuff I can’t remember anymore, nor will I ever need.
Your second and third year in medical school: You’re finally seeing a human body for the first time, you see the parts (anatomy), the mechanisms (physiology) and the witchcraft (biochemistry).
Your fourth and fifth year: You analyze diseases, study about pathology and microbiology but barely see twenty patients a year; half the time you don’t know what they are doing or what you’re doing to them just taking a general patient history (interview) and physical exam (forget the diagnosis, that’s miles off).
The final year: you read, read, read and read – realising that you’ve barely seen enough to know what or how to recognise what you’re reading if a patient even suffered from it.
Graduation Day: You’re happy! YOU ARE DONE! But what now? Where do you go from here? You’ve passed, you know your stuff but don’t know what’s next ; The reasons why you went to medical school are forgotten and you’re not all that inspired, you want to treat people but don’t even know how to prescribe yet.
That’s a summary of my medical “education” and as most of you can tell, I’m not exactly satisfied by it. Now, I’m not an educator, I’m no teacher. They need to inspire, to possess that ability to make you trust them enough to guide you; they have to have that gift that lets them build a mental structure in which information can be stored and eventually made useful. Sadly, few of my superiors did – and looking around at the new batch of interns from both Kuwait and abroad – few seem inspired. Don’t get me wrong, they work hard, right to the bone, they have skills but not the useful ones.
How many of the young doctors you see or meet actually make you feel comfortable, know how to ask the right question at the right time, know how to relay to someone they have a grave disease such as cancer or that a loved one died minutes ago?
How many of the doctors reading this (if any.. ) actually feel a sense of awe at what they do? How many of us actually enjoy reading about how IV fluids (drip…or ‘drib‘ as they say in Kuwaiti slang) were originally made, how the inhalers (‘Ventolin’) we use evoloved, why we tend to wear green, blue or green scrubs rather then white or grey ones? Or who the first open heart surgeon and how did he achieve that milestone? How many of us were taught the ethics behind palliative care? Contraception? Experimental treatments? Or how clinical trials evolved and the difference between them and standard treatments?
Medical history isn’t the reason why you went to medical school, it isn’t how you save lives, but in that third year when all you know is the Krebs cycle (the gearbox of your metabolism) and the anatomy of the Brachial plexus (nerves in your arms) you need to feel inspired by people who’ve done it before you. You need to find a reason to read, to debate, to analyse and to understand and during that final year, you need to learn why trying out new treatments for MS and charging people for it is unethical and why the current manager (‘mudeer‘) is a douchebag and why patients blame you for cancer rather than try to understand it…
You don’t learn these things in textbooks on surgery, rheumatology or internal medicine, and contrary to popular belief, you won’t learn them by parading the hallways in your new white coat and seeing fifty patients in the E.R.; you learn them by reading about ethics, sociology and other humanities that underpin our profession.
Kuwait University and others like it have the ability to reshape education and inspire us. The reason why they can is – because unlike other institutions – they were built from the ground up to educate us; other institutions need to attract research grants to survive,we don’t.
We also have experienced faculty, there are people currently teaching who were there when stomach stapling came to Kuwait and can tell us how they tackled it, how they dealt with errors made during those first cases. We have people who saw Viagra become the drug du jour and who saw the eradication and rebirth of tuberculosis in Kuwait.
We need to reshape our education and have graduates who can debate, discuss and be knowledgeable in our field without feeling the need to read about ethics once a day. Maybe then we’ll stop hearing about how doctors who “don’t know my name“, “don’t spend enough time with me” or are “too brash” or “shayif nafsa” (arrogant) – maybe then doctors won’t get slapped around too much.
I’ll leave you with the following quote relayed to me one afternoon years ago, inspiring a sense of awe. John Cardinal Newman describes a university as a citadel built with the purpose of:
‘Raising the intellectual tone of society, at cultivating the public mind, at purifying the national taste, at supplying true principals to popular aspirations, at giving enlargement and sobriety to the ideas of the age, at facilitating the exercise of political powers, and refining the intercourse of private life.’
I only hope that one day the spirit of the above quote materializes at the local university, one whose faculty and students should really expect much more from each other.