What MBBS Doesn’t Teach You!
Bachelor of Medicine, Bachelor of Surgery: noun. Origin – Latin: Medicinae Baccalaureus, Baccalaureus Chirurgiae: A noble degree that encompasses the entire human body and experience. From trivial rashes to life-threatening brain bleeds, reading people to reading MRIs, keeping the relatives calm to keeping our cool during unprecedented complications – A doctor needs to know it all!
We slog through five years with an average of 18-20 subjects before proceeding to another five to specialize in one aspect. But is it enough? Is it sufficient to know the mystery of diseases and the pharmacology to solve them? Would we be ready to face the big bad world with our Harrisons under our arms? Can Bailey bail us out of our legal crises? Could Parson shine a light on us during our financial upheavals?
There is more to the world than medicine. Words that provide a distinctive meaning to different people. Words I remind myself when I start twirling around the four walls of the hospital. Words I retrieved from interviews with four doctors – who have given their lives, effort, and time to this field for the past decade.
Precision and Patience
“Knitting, crocheting, baking – help you inculcate the practical skills necessary for a doctor in a fun way.”, says Dr Himani Murdeshwar, Senior House Officer, General Surgery, Barts Health NHS Trust, “Not only does it improve hand-eye coordination but also impresses the importance of precision and patience.”
Along with home improvement activities, playing an instrument also promotes the same values. Several doctors and surgeons are natural musicians. The discipline, patience, and practice it takes to steadily learn the chords to a guitar, matching the meter of the drum, the simultaneous flow of the fingers on the piano, all subconsciously add new neuronal connections in our ever-developing brain.
Communication is Key
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Dr Murdeshwar continues, “Soft skills like communication and empathy must also be taught at medical schools.” This was backed up by Dr Ashish K Joy, Assistant Professor, Department of Biochemistry, Travancore Medical College, Kollam, Kerala, who went on to say, “Though it’s not emphasized much, communication skills are of prime importance to Medical students and hence should be included in the curriculum.”
We are dealing with live human beings, people with feelings, with lives outside the disease they were just diagnosed with, with a family to take care of or fall back on. We must be kind, sympathetic and soft. Though we theoretically have a few lessons on “How to break bad news” and “How to declare death”, does that prepare us for the reality of the emergency room with the mob of a family wailing and angry, ready to blame the doctor standing by the patient’s bed? Do those classroom lessons teach us to deal with the understandable responses of the patient and their families to news as dire as cancer? While USMLE and other international exams have a section testing our soft skills, can a checklist replace a human touch? An automated machine could do a checklist!
Empathy. Understanding where the patient stands and how the family feels isn’t something that can be taught, but it must be spoken about. We learn from what we see. It pains me at times to see experienced doctors be impatient and rude. Everyone stepping into the hospital has an ailment that they are unable to solve themselves and have come to ask for help. It is a difficult task – asking for help. Understand that they are in pain and need your expertise. Give them hope or a shoulder when hope is dim. Behave as we would want to be treated if we were on the other side of the table, not just for us but for the young eyes watching our every move as well.
Financial and Legal Independence
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Dr Joy adds, “The second subject which should be included in not just Medical undergraduate course but an undergraduate course in finance management. Personal as well as institutional.”
This was one of the most significant subjects the doctors I spoke to wanted to be incorporated into the curriculum. Finances. How is Income Tax filed? Tax return? Shares and stocks? Should I be investing? SIP or MF? How much can I leave as liquid cash? Loans? Debts? Malpractice insurance? Health Insurance?
“A doctor’s life revolves around its patients. So much so that they lose track of what is happening to the money they are earning. Doctors are the students who took Bioscience in school and escaped studying Mathematics (a big relief for 90% of the population). Hence, calculations are never their strong suit. So, when it comes to keeping tabs on their income, they are lost.”, Dr Swadip Mishra, Interventional Pulmonologist, Sir Ganga Ram Hospital, points out. “Financial management is an extremely important aspect that all doctors should learn. And this learning needs to be inculcated when the young minds are still malleable to learning something other than their curriculum. Financial independence, investments, returns – these are terms we hear very late in our lives.”
“To survive outside, you need the knowledge of a lot of practical subjects – Accounts, Taxes and Business studies- which would help you live your life easier, more independent, and more informed.”, says Surgeon Lieutenant Dr Devansh Goel, Indian Navy, “Apart from that, I would say, land laws, how leasing, notarized paper making, getting a tenant and the legal procedures involved in it and another minor day to day legal situations and parlances that you might encounter should be brushed on.”
Several doctors go on to have private practices of their own. That not only comes with the baggage of managing our finances but the legalities of the practice as well. We would be responsible for running the business aspect and be legally responsible for all our employees. We should be adequately trained on the Indian Law & Penal system pertaining to our field and otherwise.
Career Counselling
One of the most interesting perspectives I received from the interviews was the need for proper career counselling. Like most children of the ’90s, we had two choices – Medicine or Engineering. After M.B.B.S., the fork became Medicine or Surgery. The other paths were never firmly etched out.
Surgeon Lieutenant Dr Goel continues, “Most of us aspiring or under-trainee doctors have a pinhole vision of what our prospects are after M.B.B.S. The curriculum designed to accommodate all these little starter courses, injecting young doctors into society as citizens first and a service person later – would benefit from increasing its scope to inject them into the far reaches of the society. For those sections of the society and those jobs will benefit just as much from having them, as they would benefit from finding the right fit of a workplace and work type for them. For how the world is full of permutations and possibilities, it’s never a one size fits all solution.”
Each of us is built differently. Sure, a cardiologist saves failing hearts, a neurosurgeon has the glory, an obstetrician brings life into the world – but is that line of work the right fit for you? A billion people run the hospital. It is built by everyone from the sweepers to the heads of departments. How would it run without the pathologist or the forensic specialist? Do you think your labs would magically appear without the microbiologist running those stains and sections? With the growing need for mental health care, what would the world be without psychiatrists or counsellors? Who would help us find new cures for drug-resistant bugs, if not the research assistants in the department of pharmacology?
We should be shown all the cards on the deck, describing each career path as it is – pros and cons, not just the glory and a career counsellor to help us find our niche. Not a system based on one written exam to decide our fate but an aptitude test to find the best fit for our personality, skills, and futures.
A special shout out to the doctors who contributed to the article. Each of us had similar beginnings with different branches, witnessing various hardships and gorgeous glories on the way. It is this cumulative perspective that helps us grow. While medicine is extensive and never-ending, we must be prepared for everything the world has in store for us. From being financially independent to planning a career that is a perfect fit for our personalities, we can hope that our undergraduate courses can prepare us for the future.