Friday, 20 April 2012

Picking out talents in children

There is a lot to learn from children. From the time they were born, growing up years, till they can make it on their own, all parents WORRY about their children. I've always observed how parents raised their children. They basically fall into 3 types - the very caring, the not so caring, and the couldn't care less. The outcomes of the 3 groups vary greatly and there are a lot of modifiers which affect outcome when it comes to children. 

When children are asked what they wish to be when they grow up, the first answer is always they want to be a doctor, then lawyer and then engineer. Why do they choose such high-sounding professions when they don't even understand the professions? Sometimes I wonder, whether parents are to blame for pushing their children. Sometimes, we may go overboard and expect too much from our children. Sometimes, we think we make the right decisions for our children and all their choices and opinions don't count. Sometimes children refuse to listen to parents and they want to try something of their own wants, only to find later that nothing works right for them - and then parents come in to blame and criticise and make the children feel unfit.

I have seen and I have listened to many such instances where parents are unhappy with their children's decisions, and vice versa. Many a time, nothing seems to work right for anyone. Why?

For children to choose to study medicine, the choice is one of the most difficult. The course itself is 5-6 years. For students who have the right background, life at medical school should work out fine. But for some who don't have the optimum background, then life at medical school can be a difficult trial. I have worked 29 years (come 28 June 2012) and I have seen children come to study at our medical school. Some make it great in the end, some never graduate, and most just about made it.

Where do we strike a balance and make studying medicine a wonderful experience?

As I penned the 43 biographies of our early Malay doctors, I noticed that most of these doctors came from poor Malay families and made it great as doctors. They had interesting lives as children which I enjoyed hearing about and wrote in their biographies. They had hopes and dreams, and every child was different. But they all turned out to be very good doctors and served the society well. They did not forget their roots and their society. Almost all doctors returned to serve at home.

Today, we have many medical schools and different medical curricula. Most are sound curricula and are constantly reviewed for many things. One that I particularly pay attention to is whether students really enjoyed learning and will the learning experience help to direct them to be more open and resourceful persons. Will they only serve as doctors or can they take on other responsibilities that their society requires from time to time. 

I am most open to suggestions for human resource development for the medical school, not only students but lecturers too. I am probably #3 oldest in age rank in my medical school. Most of my seniors have retired and gone elsewhere, mostly to make extra money after retirement.

I am not concerned about retirement and what it pays. But I am concerned about the quality of doctors that medical schools produce today. I am concerned about hospitals not having enough nurses and the hospital operational budget cannot afford to hire extra hands. I am concerned about a good hospital being poorly managed. I am worried about patients seeking help at hospital and not getting the help they need. I am worried that we are sweeping a lot of our problems under the carpet.

I think it pays to study little problems and try to see what can be done. It pays to walk around at peak hour to find out what are patients' problems are and overcome that. It pays to know how much trouble patients have trying to come to hospital. It pays to have a friendly hospital service that reaches out to patients rather than wait upon them to turn up, if they do.

I still don't understand why we have so many patients waiting in overcrowded corridors even in our modern hospital clinics. I don't understand the clinics are unmanned at peak hour when the patients fill the corridors and they smell of sweat even with air-conditioning. What is happening?

Where should doctors be? Where do you expect to find doctors in a teaching hospital? Where do you expect to find doctors in a medical school?

I still feel doctors are nowhere to be found. Where are they?

In the modern working environment today, teaching does not count. Only Key Performance Index (KPI) matters. Even teaching in a medical school has low priority. Lecturers don't know how to strike a balance and thus 3 strands arise - the research doctor, the lecturer doctor, and the plain doctor who does no research and no lectures.

Doctors have a choice where they wish to be and what they want to be. Many prefer the high posts, better status, better pay and no hands-on in the clinic (ie, no clinic). We all know doctors are paid 3 things - a basic salary, a clinical allowance (if they do clinic)/a critical allowance (if they don't do clinic) and a teaching allowance. Clever doctors what what path to take.

This is not the point I'm writing this post. The point is, why are we taking so much trouble to graduate a doctor, only to find that in less than 5-10 years, the doctor does not want to be a doctor in practice? The doctor does not want to do clinic. The doctor has no interest in petty things like patients. The doctor now has a business mind and has become a businessman! I still find it hard to come to terms that doctors want to be enterprising when initially we teach them to be doctors and expect them to function just as doctors and never leave bedside practice and clinic practice.

Many doctors are in administration and not in clinics or clinic practice. This is the root of the problem in the medical industry. They don't want to be medical lecturers because the pay is small (despite it being hte highest pay in the teaching professon) nor do they want to stay put in the clinics. Why did they choose to be doctors then? Did they lie at medical school interviews? I don't know but it worries me. I don't want to teach a medical student who upon graduation only wants to fill his pockets. If I had my way, I would shoo him/her out of my class, for having the wrong attitude towards a wonderful profession.

I have a workshop on medical school interview on 24 April 2012. I hope this matter is stressed when we look for potential medical students. It is not worth spending half a million Ringgit a student, and expecting him/her to become a doctor, when the student only wishes to become a businessman/administrator upon graduation. I would rather accept a student who would want to spend 20 years in clinical work/practice and then go on to become a businessman.