Sunday August 12, 2012
Making it in medicine
BY PRIYA KULASAGARAN
To stem the brain drain, a foreign medical university hopes to encourage students to study locally.
WITH the increasing numbers of young professionals leaving the country, the Malaysian brain drain is a familiar lament.
In the field of medicine, there is a further localised sort of brain drain in terms of the distribution of doctors across the country.
“There are more doctors per square metre in Kuala Lumpur than just about anywhere else on the planet,” quips Newcastle University Medicine Malaysia (NUMed) provost and chief executive officer Prof Reginald Jordan.
He shares the story of a student applying to the university, who had been sailing through the interview process up to a particular question.
“We asked him if had spent any time with doctors, or talked to doctors about what a medical career is like - and he just dried up.
“He finally said, ‘I have to tell you, I never saw a doctor till I was about 16-years-old’,” says Prof Jordan
Having lived in a remote village that required a two-day boat ride to get to, the student dreamt of being a doctor so he could go back and serve in the area.
In this regard, Prof Jordan believes that a way of stemming the brain drain is to encourage students to study locally.
“Our experience is that if you recruit students from where they live, they tend to stay — they build their professional networks where they are trained,” he says.
He adds that NUMed is “trying to reverse the brain drain” by bringing international specialists into the country.
“These specialists are employed by us to teach our students, but they also treat patients within the (government) hospitals.
“You do get the sharing (of knowledge and skills) among equals (local and foreign specialists) ... it’s about sharing good practice — we’re not coming here to tell people how to do things,” says Prof Jordan.
A fully-owned international branch campus of Newcastle University in the United Kingdom, NUMed has been operating from its campus at EduCity@Iskandar in Nusajaya, Johor from last year.
Having offered its five-year Bachelor of Medicine/ Bachelor of Surgery (MBBS) degree programme since 2009, the institution also plans to introduce a Bio-Medical Science honours degree course in 2013.
Prof Jordan points out that the way we train our young doctors today will have a far reaching impact.
“The students who enter our medical school in 2012 will still be practising medicine in 2050; the average professional life of a doctor is about 40 years.
“That’s quite frightening when you think about it ... you’re not only teaching medicine as it is now ... it’s about learning to learn,” he says.
He adds that there are essentially three basic skills of medicine — fundamental clinical skills, communication, and professionalism.
“The human race may have evolved, but basically your heart is still where your heart was 1,000 years ago —so the basic (clinical) competencies will always be there,” he says.
“Sixty percent to 70% of (patient) diagnoses are made by what the patient tells you, so doctors have to learn to listen.
“The third element is the professionalism of the doctors, they must have high ethical standards.”
While many aspiring doctors would say they want to study medicine to “help people”, NUMed aims to give its students first-hand lessons in empathy.
By way of example, Prof Jordan explains a curious process students have to go through in their third year.
“We’ll take a perfectly healthy student and put them in plaster from ankle to hip, give them a pair of crutches, and say ‘now you live that way for a week’,” he says.
Meanwhile, another student may end up with both his legs plastered and relegated to a wheelchair — yet another student would be tasked with pushing that wheelchair around for a week.
“This is really putting yourself in the place of the patient, and (understanding) what it’s like to be a career,” adds Prof Jordan.
So what does NUMed look for in a medical student?
“What we’re interested in is whether they have an understanding of what a medical career is, and what it demands of you — it’s not Grey’s Anatomy (the popular TV series) for a start,” says Prof Jordan wryly.
He adds that stamina, perseverance and time management skills are needed to survive medical school.
“Among the reasons people drop out of medical school, on top of the list is that they were pushed into it by parents,” he says.
“Another reason, believe it or not, is lack of intellectual challenge.
“Undergraduate medicine is about knowing a little about an enormous range of different things — it’s not actually knowing a lot about anything.
This is why the institution offers an “intercalation option” for able students to step away from the five-year medical programme to take on another degree, be it an undergraduate biomedical sciences degree, or a Master of Research (MRes) in Medical and Biomolecular Science.
Prof Jordan explains that the NUMed programme is also “fully integrated”, meaning that students are exposed to real-life practice as part of their academic study.
“Our students meet their first patient in the second week (of the programme); a mother who is about to deliver a baby.
“Students, in pairs, sort of ‘stay’ with that family throughout their first year,” he says.
He adds that as the families are volunteers from different levels of society, students are exposed to the social dimension of medical care as well.
In this regard, the programme also seeks to ease the students’ transition from academia to medical practice through gradual exposure to the realities of being a doctor.
“We can give study guides while you’re in medical school, but there are no study guides when you are a houseman,” adds Prof Jordan.