By: Dr. Jeremy Lim, Editorial Board Member, SMA News
I am angry, and worried. The negativities around the transformation of our medical specialisation programmes have caused not just bitterness but also, I fear, much learned helplessness. Faculty and residents alike grumble and bemoan the many things that cannot be done now, because the AccreditationCouncil for Graduate Medical Education (ACGME) does not permit this, or explicitly disallows that. So what?
Let’s look back at what used to happen. I remember London Lucien Ooi taking us for mock vivas informally onSaturday afternoons in the build-up to the membership exams. Kenneth Mak who was then in National University Hospital also faithfully tutored us in exam techniques every single week after office hours. And the list of committed teachers goes on and on. Enterprising “trainees” (as we were called in those days) would boldly ask senior doctors for tutorials and generously invite everyone else who was also preparing for exams. Logged? No. Official? No. Did we learn? YES! And we learnt not just the technical craft and knowledge that would define our futures but also the values and ethos of being a doctor.
What can we do today as seniors in the medical profession? I would suggest at least three avenues. Firstly, teach. Who cares whether it is accredited or not? Who cares about the restriction on hours? This is not about whether our juniors and our institutions meet the ACGME requirements; it is about future generations of doctors and our commitment to their learning. It is about passing on the torch of knowledge, the same torch that was passed on to us from the luminaries of the past, the Balachandrans and the Seah Cheng Siangs.
Secondly, create opportunities for our young doctorsto learn. Duke-NUS Graduate Medical School has a modest Doctors for Doctors Fund which supports students attending conferences, enjoying an overseas stint, and the like which complete their medical education. Such potentially life changing experiences are vital to our young brethren, and do help them find and define themselves as members of our noble profession. Finally, set the example. As Dr Albert Schweitzer, Nobel Peace Prize winner remarked, “Example is not the main thing in influencing others. It is the only thing.” Reading the list of donors to the SMA Medical Students’ Assistance Fund is heartwarming, because large numbers of doctors in both the private and public sectors are donating to support our students, and just as importantly, leading by example. Duke-NUS has initiated a graduating cohort class gift, starting young doctors on the right path right from day one, reminding the graduates of their responsibilities to “pay it forward”. I was one of many who taught this pioneering cohort and I am so proud that every single one in the class contributed to the class gift, despite many of them having very modest means themselves.
So, is the future of medical education bleak? Are ourdoctors in training doomed to a weary existence of inadequate instruction and poor preparation for a life in Medicine? There is an ancient tale of a wise man reputedly able to answer any question. A brash young boy seeking to trick him brought a bird in his hand, and asked, “Is the bird in my hand dead or alive?” The boy thought he could crush the bird if the wise man said the bird was alive, and open his hand to free the bird if the wise man said the bird was dead. The wise man’s response is also the answer for us: “The bird is in your hand.”
Note
1. Dr Lim donated the honoraria from his three years of being a faculty member in Duke-NUS to the Doctors for Doctors Fund.
The Duke-NUS Class of 2012 will be graduating on 26 May 2012. Let’s cheer them on in “paying it forward” through their Class Gift 2012 fund. This fund will providefinancial assistance to talented Duke-NUS students who follow behind. Online donations to both the Duke-NUS Doctors for Doctors Fund and Class Gift 2012 can be made at http://www.duke-nus.edu.sg/giving.
Dr Jeremy Lim is the CEO of Fortis Healthcare Singapore. This commentary is contributed in his personal capacity. He can be reached at jlim@jhsph.edu.
Extracted from SMA News April 2012