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| STUDENT’S SECTION |
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| Year : 2020 | Volume
: 1
| Issue : 1 | Page : 61-64 |
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My ideal medical college
Pranjal Garg
Medical Student, MBBS 3rdYear, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| Date of Submission | 10-Jun-2020 |
| Date of Decision | 11-Jun-2020 |
| Date of Acceptance | 16-Jun-2020 |
| Date of Web Publication | 20-Jul-2020 |
Correspondence Address:
Pranjal Garg
Medical Student, MBBS 3rd Year, 3/25 THDC Colony, Bypass Road, Rishikesh - 249 201, Uttarakhand
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JME.JME_91_20
An ideal medical college not only delivers medical education but also introduces new trends in medicine. There are numerous elements of an ideal medical college. In this article, a comprehensive list of some of the elements is given, which are often ignored by medical students and medical institutions. The list includes acceptance to change, medical research, technical advancements in medicine, communication skills, public health, some structural changes in medical education, teaching methods and assessment of students, burnout and mental health issues among students. However, this list is not exhaustive, and only continuous feedback can help a medical establishment to reach the epitome of idealism.
Keywords: Ideal medical college, medical education, medical research, medical students
How to cite this article:
Garg P. My ideal medical college. J Med Evid 2020;1:61-4 |
| Introduction | |  |
A medical college is a place of higher education where students gather to commence a journey of lifelong learning to become physicians and surgeons. However, besides delivering knowledge, an ideal medical college is supposed to harness the potential of those physicians and surgeons to generate new information to innovate and revamp healthcare. Medical students possess remarkable potential to further the cause of medicine and assist society in living a healthier life. Hallmark of an ideal medical college is creation of passionate graduates committed to medicine and healthcare. The following content exhibits the ingredients to make an ideal medical college.
| The Only Constant in the Equation is Change Itself | | |
There is a continuous state of impermanence as theorised by Eastern and Western philosophies, in addition to mathematical formulation in the form of Bayesian statistics. As our perception of the world changes, our knowledge of medicine changes too. Pharmacologic therapies, as we know today, will soon be replaced by nanotheranostics[1] and optogenetic manipulation.[2] Newer grafting procedures such as organoids[3] and assembloids[4] will be introduced, which will replace cadaveric grafts. The medicine we are learning today will eventually go obsolete. Regardless of this, the resistance to the acceptance of change is commonly found even among medical fraternity.[5] Hence, an ideal medical college is the one that prepares its young minds to embrace the future and help them metamorphose out of their cocoon of a rigid belief system.
| Medical Research is the Heart of Medical Education | | |
Continuous change in the anticipation of a healthier world can only be introduced after extensive research. Predictably, medical research lies at the heart of medical education, and its motivation forms the apex of an ideal medical college. They both are inseparable entities, and research should be a necessity to graduate.[6],[7] For research to propagate, inquisitive minds[8] and non-conformity[9] to the rules of science are required. Non-conformity lays the cornerstone of innovation. However, the most necessary condition for inquisitiveness is a welcoming and cordial environment where ideas can be conveyed without fear of getting mocked or worse, going unheard. However, this does not mean that an ideal institution should oppress the voices of constructive criticism. The purpose must be to create a safe environment where discussions can be held to reach a common understanding, rather than to portray the inherent arrogance of position. Position disrupts cooperation.[10] Science tends to reject hierarchy and only acknowledges the power of skill, knowledge and innovation, and so should an ideal medical college do.
| Physicians Without Technical Knowledge are not Good Physicians | | |
Most of the advancements and research we observe today is the result of the interdisciplinary approach to medicine. It boasts the uncanny ability to solve many problems faced by physicians today. However, if medical colleges fail to impart technical education along with intricacies of medicine, these advancements will be a waste. The rise of evidence-based medicine will imminently give a boost to the use of machine learning[11] and artificial intelligence[12] in the world of healthcare. Therapies and diagnostics will all be based on newer technologies. It is not difficult to envisage that the competence of physicians will soon be indicated mostly by their ability to handle these techniques. Therefore, an ideal medical college should prepare physicians to learn the particulars of these techniques.[13] Meaningful collaborations with nearby technical universities can be an acceptable solution.
| Communication Skills are Important | | |
The footing of a multidisciplinary outlook comprises mainly communication between different groups of people, which facilitates collaboration. This can be persuasively understood by the analogy of neurons as described by the theory of Hebb, which dictates, 'neurons that fire together, wire together'. Proper and adequate communication[14] can tirelessly achieve both academic and non-academic goals. A nonchalant aura of the institution plays a central role in communication among groups. The ideal medical college should strive to develop an open environment. Regular public speaking events and group discussions within the institution will undoubtedly help make future doctors more communicative. Specific curriculum for communication skills can also be introduced.[15] Communication with the public can also help improve the rapidly declining doctor–patient relationship.[16] Timely statements can effectively avert violent attacks and abuses faced by doctors. Even though social media is villainised, it can be a great aid in understanding and handling the public if used appropriately. Another tool that a medical institution can use to address this issue is by organising talks by experts from time to time and planning contests of mock case scenarios.
| Public Health is a Crucial Issue | | |
Without public benefit, the above constituents are worthless. This requires active participation from physicians in public services from the very beginning of their education. Volunteering programmes can help inculcate the feeling of duty towards the public effectively. Physicians are not only expected to provide one-to-one care but also act as administrators to ease the implementation of healthcare benefits. Thus, policymaking is another facet of public health, and it is here that many medical graduates fail.[17] It is indeed essential for them to learn this skill. The establishment of a mock senate within the institution and the promotion of national and international medical student federations can be valuable assets for an ideal medical college.
| Structural Changes Required in Medical Education Itself | | |
The core of the medical institution is formed by imparting commendable medical knowledge. However, some structural changes can be implemented in the academic culture of the institute. These changes in the current establishment of medical colleges can turn them into an ideal medical college, but their certainty can only be proven with time and with accurate feedback. These moderations can include changes in the record-making culture where plagiarism is rampant and does not serve any real purpose. Unnecessary attention to examination culture is another example as agreeably explained by Goodhart's law, 'when a measure becomes a target, it ceases to be a good measure.'
| Tryst With the Techniques of Medical Education | | |
Besides already mentioned structural changes, some changes in classroom teaching can also be instigated in an ideal medical college. It would be redundant to describe the need for competency-based medical education, bedside teaching and the need for teaching professionalism, altruism, empathy, attitude, etc.[18] in medical colleges that are already being employed in many colleges in India and abroad. Their requirement can never be overstressed. Nevertheless, newer methodologies, such as blended learning, have not gained much traction in India, which have become much popular in American universities. Flipped classroom model of learning is a type of blended learning which has become particularly useful and has shown to improve effectiveness.[19] In flipped classrooms, the centre of learning shifts from the group to the individual where individuals consume the lecture materials before class, followed by group decisions and interactive sessions involving the teacher. This method has generally received positive feedback from the students as this method allows them greater flexibility. Even though some concerns are associated with newer methods,[20] the inherent desire for the experiment should be present in an ideal medical college at all times.
| How Will an Ideal Medical College Assess its Students? | | |
Assessment instruments should evaluate the aforementioned skills, such as professionalism and communication skills, along with medical knowledge. Tools to judge knowledge can include extended matching questions, multiple-choice questions and essay and reflective writing assignments. Clinical and practical skills can utilise both computer and manual tools based on real-time simulations, multi-station assessment task examination, objective structured clinical examination, clinical and laboratory skills, etc., There could be a very long list of these instruments; however, an ideal medical college should tailor-made them to meet the needs of their students. The ideal college needs to remember that continuous examinations are a mode to judge the students' fulfilment of the curricula and necessarily not the outline to create a divide. The perception of students towards the assessment method used dictates the effort they put in and, in turn, decides the success of that method.[21] However, sometimes, it is difficult for students to perceive the relevance of the method. This can be effectively tackled with monthly seminars and sensitisation sessions.
| Non-Academic Activity Promotes Academic Productivity | | |
For physicians to become successful in academic activity, burnout, which is not rare among physicians, has to be avoided. Practicing one's hobbies, regardless of expertise, is beneficial.[22] The list of hobbies can never be exhaustive and can include anything from sports to drawing to creative writing. A designated place or a community where medical students, as well as existing physicians, can practice hobbies well within the walls of the institution is one of the characteristics of an ideal medical college. Designing clubs and societies lay the foundation for collaborative efforts and promote participation among people with similar interests. Having a student's activity centre with a sports complex[23] and conference rooms is not an ambitious goal for an ideal medical college, which is ironically trying to achieve continuous and uninterrupted productivity. It is also advantageous in battling monotony and can significantly increase the efficiency in academia so much that notably amongst almost all Nobel Prize-winning scientists an artistic hobby is commonly found.[24]
| Mental Health of Students and Workers in Medical Colleges | | |
For any affair to succeed, the health of every individual is essential. Similarly, for the medical fraternity, the quality of work they do is directly proportional to their health. Mental health is stigmatised[25] as compared to other health-related issues, even though it is quite prevalent and more so among medical professionals. Psychologists, specially tasked to cater to medical students' needs, are non-negotiable entities of an ideal medical college. It is also the job of an ideal medical college to provide an all-inclusive, safe and healthy environment, especially to the people from socio-economically maligned groups[26] and the LGBTQ+ community[27] so that noxious elements do not hamper their growth. A perfect institution teaches students to embrace differences.
| Conclusion | | |
The recipe for an ideal medical college should include the abovementioned ingredients. However, like an ideal biological system is a myth, an ideal medical college is also a myth. In a biological system, continuous feedback and feed-forward systems liaise to maintain homoeostasis. Likewise, the only formula to make an ideal medical college is continuous feedback[28] from all stakeholders and the integration of those signals in the hope of making a great medical college. We can then only fantasise about a college which instead of producing factory workers produce outstanding physicians and surgeons, physician-scientists, physician-entrepreneurs, physician-politicians, physician-analysts, physician-lawyers, etc.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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