Love is in the air at Monash

Email received on 4 August 2008

Very quickly the class has divided up into three factions. One faction being the students who are the backbenches, doing nothing much beyond surviving with 'welfare mentality', studying what they are assigned and not doing much beyond. Thankfully they are a small minority.

The second group are the ones who won't volunteer an answer, but will try when they're called upon, living in a state of constant fear. "Oh no he's looking at me!" they dread.

And then there's the third echelon: the upper echelon; the volunteers. They thrust themselves into the fray. Its not that they are smarter than anyone else, but they have courage. And they'll achieve recognition, teachers will get to know their names, and generally they'll get better grades.

Bedside teaching, Long Case discussions, PBL, Clinical Skills, clinics, etc.. all these form the backbone of modern medical education. No more didactic lectures, no more sets and sets of handouts to memorise, and very specifically we, the teachers are instructed: NO SPOON FEEDING!

Medical students are to have 'Self Directed' learning which is "Research based"; very specifically NONE of the teachers are to reply the answer '2' when asked what is 1+1? Instead teachers are to challenge the students into a dialog as to what 1+1 is, or to get them to research under guidance the answer to 1+1.

And we the modern medical teachers loyally do what we are told and paid to do. That's the BEST approach, the experts in medical education assure us. I have no PhD in education, only membership in some really OLD, old boys club and even teaching nowadays is EVIDENCE based!

So this is how medical school is supposed to work. The future doctors are to have read and learned the material BEFORE the class so that an intelligent discussion can take place. The professors, bless their aging brains, are to teach them to think like real doctors.

A large part of that is not accepting things at face value, but to question things that don't seem right. The student no longer studies Peking Duck style where facts are stuffed down his throat to regurgitate at the exams and vivas. My throat still hurts from all the facts shoved down from days of old, but those very facts were and still are very helpful. In fact, the very questions I ask my students are based on those same facts! But this is the era of self directed learning of Evidence based medicine. That's the magic word.

Dialogical and research based teaching, not the transfer of data from the USB port of the teacher to the USB port of the student. For those who want a clear and specific message, this effectively means lots and lots of Q&A. Loads of reading BEFORE the class.

This is the Best approach so let us both teacher and student do the world a favour and stop whining. We, the teachers will adapt to the new world and will teach as directed, and you the student will read and answer as required. You're no longer a secondary school student but an adult. You will be a future doctor soon so let's make the best of it while we are here. For the rest of your career as a doctor, countless people from patients to colleagues to consultants will be asking you questions. Vivas with no time to research and with ZERO margin of error. If there is a clear and specific message, that's it! So lets start as a medical student when one can still afford errors.

If the student can't survive even the trials and tribulations of a controlled environment where one is ALLOWED to make errors, how is he to survive as a doctor?

Long live the Socratic method and the medical students. We love you all. That's why we are here. And yes, I love the medical teachers too!