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With the beginning of 21st century, the world has seen changes in almost all aspects of life. There are some changes that are gradually on increase. Some other conditions which used to be major burden on human lives are now becoming obsolete, thanks to advancement in science and technology. There were no antibiotics and few standardized vaccines a hundred years back. There were no computers. Human mobility was restricted and the plane was just a neonate. The world is fast growing now and it has seen more number of inventions and discoveries in last 100 years than number of inventions and discoveries in the years since the birth of the universe put together.
Field of medicine cannot remain untouched with those changes and in fact, it is one of those fields that have taken maximum advantage of progress science has made. Time has come with change of a millennium that while utilizing the progress of medicine, we should look towards the coming years and the difficulties and challenges they will put in front of us.
Cure is not as good as prevention and dealing with future problems needs application of this concept the most. To make future doctors aware of possible etiologies of unknown and unsuspected origin and the best possible panacea for it, change in certain aspects of curricula of medical education is a bright option. I am tempted to suggest some of them over here:
Understanding Bioterrorism
Terrorism is going to stay here and possibly will attack us in worse forms than is doing now. Bioterrorism – by use of biologic agents like bacteria, viruses, rickettsia, also possibly by fungi and vegetations and other genetically engineered microbes that we don’t know today – is a Trojan horse. Training of how to deal with possible biological attack, how to treat patients, how to prevent spread of infection and how to save oneself from such an attack, should be introduced in integrated manner in curricula of medical schools at undergraduate level.
Integrated application of communication technology
I prefer the terminology communication technology over information technology. A branch as vibrant and vigorous as medicine needs much more than just information. It needs to communicate and ponder. Use of gray matter is encountered at every stage of medical life. There are no simple algorithms but it has its horizontal extensions which merge with other such algorithms. Acting with swiftness and taking right decisions can be supplemented by use of tools of communication technology. Telemedicine, internet medicine and basic knowledge of how to use a personal computer, a fax machine and PDAs should be taught to medical students.
Trauma psychology
Mental health problems are on rise. They will rise further with individualization and breaking of human bonds due to separate vocations and housing with expanding cultures. Social structure is changing fast. In such a condition, any traumatic experience may lead to upsurge in psychiatric illnesses, the way it was observed by epidemics of post-traumatic stress disorders (PTSD) in India after Kutch earthquake and in USA after 9/11. Integrated training in trauma psychology should begin now at undergraduate level.
Reduce weight
I don’t recommend only adding new things medicos should learn. I m personally feeling there are many things, rudimentary and of no significance that students have to mug up in order to pass or to get good marks. There is a lot of dependence upon Greek-Latin language. Especially in anatomy but also in other disciplines, they are a formidable hindrance to easy understanding and effective comprehension. Orphan drugs which are not prescribed and not available commercially have to be studied in detail in pharmacology. There are those rare clinical signs which a professor of sixty years age claims, ‘I haven’t seen a case in my whole medical carrier.’ These things are of importance but they should best be left to those doing specialty and super-specialty in respective branches.
Conclusion
India doesn’t have good continuing education activities. It is better to design basic courseware with such a fine-tuning and futuristic vision that our fellow medicos should not have to run for understanding new problems in future but can anticipate them well in advance. What I have written here is particularly for India, but I guess situation all-over Asian continent will be more or less similar to this. It is now time for us to work for an update in medical curricula that is practical and comprehensive.
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Maulik Baxi
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