MADURAI: Medicine is one of the few academic disciplines that cannot be taught in the distance education mode. Why? It's because clinical skills–which can only be taught practically–are as important as theoretical knowledge.
But, the pandemic has forced administrations and academicians to reconsider these notions. With schools and colleges having to move classes online, medical education could not afford to be left behind.
After years of nurturing dreams of becoming a doctor, 21-year-old Raja (name changed) joined the Theni government medical college in February this year. He cleared NEET in his third attempt, and after the Test was postponed twice due to the pandemic.
Unfortunately, medical education, so far, has not been the way he expected it to be. "I feel my batch is the most unfortunate of all. Online classes are frustrating. It’s like we have been left to fend for ourselves," he says.
Raja’s seniors got one full month of face-to-face foundation classes. For Raja's batch, it became just once a week. "It makes a big difference. The foundation course helps us understand fundamentals of concepts that we will learn over the next five-and-half years," says Raja.
When foundation course is compromised, further education could become difficult, feels Raja. The primary reason for this is the lack of interactivity through the digital medium, a few students believe.
"Most classes turn out to be mere slide presentations. The space for asking and clearing doubts is limited. We watch the slides, and have to prepare the rest ourselves," says Ilamaran (name changed), a second-year student.
The situation is much worse for second-year students, says Ilamaran. It is because they miss out on the clinical skills that can only be acquired through practical, ground training. As per the MBBS course structure, first-year students are taught fundamentals of medicine like anatomy, physiology, biochemical tests, and cadaver dissection.
Second-year students are posted at outpatient clinics of various departments. This is where they learn clinical skills, such as understanding symptoms, presentation of case history, clinical diagnosis, and patient-oriented approach.
In the fourth year, and during the Compulsory Rotatory Residential Internship (CRRI), the focus is much more on developing clinical skills. "The absence of clinical skills training takes the fun out of learning," says Ilamaran.
To compensate for the loss, educators are now trying to teach clinical skills in digital classrooms.
"So, instead of visiting wards, checking patients, and making diagnosis, we are sent case sheet of patients online in PDF format. We have to diagnose their condition based on these PDF documents. We are solely dependent on laboratory findings," says Amudha (name changed), a third-year medical student from Cumbum.
This is insufficient, says Amudha, because in real world diagnosis cannot be based solely on lab reports. "Symptoms exhibited in patients differ from one case to another. It is, hence, important to examine them first-hand, before making the diagnosis," she says. It is that crucial skill that medicos are now missing out.
A professor at Madurai Medical College says the 2020 batch of students, who were enthusiastic when they joined the course, now seem frustrated and bored, thanks to the online learning they have to attend.
"On the bright side, these students get more time to read, a luxury that their previous batches did not get," the professor told The New Indian Express.
Dr Sudha Seshayyan, vice-chancellor of Tamil Nadu Dr MGR Medical University, says clinical training is still provided, but for a shortened duration. "Medical colleges completed theoretical classes online and resumed clinical skills training when colleges reopened in December last year. The competencies that students missed out during online classes were taught in the subsequent 60 days," she claimed.
POSTGRADS HAVE IT WORSE
The situation is worse for postgraduate students in surgical departments, especially those who joined last year. With the suspension of elective surgeries, they did not get enough opportunities to learn surgical skills since the start, unlike their seniors.
"When the pandemic peaked in Chennai last year, I was among those temporarily brought in to handle the crisis," says Vineet (name changed), a resident of Erode who recently completed his postgraduate degree.
"For months, irrespective of the specialities we chose to master, we dealt only with COVID-19 patients. Our exams too got delayed. By the time I sat for the final examinations, I realised I had forgotten several concepts in theory and in clinical applications," he adds.
(Names changed upon request)