Changing Scenario in Medical Teaching

Vol 3 | Issue 1 | Jan – Jun 2017 | page: 2 | Girish Bakhshi

Author: Dr. Girish Bakhshi

Associate Professor & Unit Head, Department of Surgery,
Grant Govt Medical College & Sir J.J.Group of Hospitals,
Mumbai-400008, Maharashtra, India.
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Changing Scenario in Medical Teaching

It gives me great pleasure to write an editorial for international Journal of Surgical Case Reports. Being a teacher in a medical college & tertiary hospital, gives us an opportunity to work closely with medical students, interns & post graduate residents. I am sharing my observation of changing trends in medical learning over a period of two decades. Twenty five years back as a medical student, I used to find everyone with their clinical manual in the wards early morning taking history & doing clinical examination of the patients. We were taught that more the time we spend with patients in the wards, the better we understand medicine. Our teachers used to take bedside clinics helping us understand clinical medicine. Illiciting a clinical sign on a patient was like getting a gold medal. The art of diagnosing a pathology clinically used to give mental satisfaction which cannot be described in words.
As a resident, we used to learn from our teachers the art of illiciting history & its correlation with clinical findings to arrive at a diagnosis. Investigations were advised based on the clinical diagnosis.

However, over a period of two decades, the trend of learning medicine has changed from clinical examination to investigation based. A medical graduate goes through the investigations of a patient followed by clinical examination. Hence mind is getting trained that clinical examination is done to justify the results of investigations rather than investigations being done to confirm clinical diagnosis. This may affect slowly the art of differential diagnosis. Even the clinical rounds presented by the surgical registrar begins with brief history followed by investigation rather than detailed history followed by clinical examination & lastly the results of investigation.

The reason for this change could be ease of availability of investigations, or perhaps we as teachers are not able to impart the art of clinical examination & its significance to our students or is it that because of consumer protection act we are forced to do investigations? This is a question which will be bothering every medical teacher in present era.
I feel Change is the only thing that is universal. However this change has to be channelised so that it is fruitful for the society. Investigations form an important part of arriving at a diagnosis, but Clinical examination should always preceed them in making a clinical diagnosis. We as doctors should be always promoting this fact in our clinical practice as well as while teaching our students.

Lord grant me the serenity to accept the things I cannot change,
the courage to change the things I can
and the wisdom to know the difference.
Saint Francis of Assissi

How to Cite this Article: Bakshi G. Changing Scenario in Medical Teaching. International Journal of Surgical Cases 2017 Jan-June;3(1): 2.         

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