I am serious: medical graduates in the future would not be allowed to practice independently.
You see, the whole world is moving towards that direction. In the old days, an MBBS or MBChB would give you permission to do intubation, perform endoscopy, repair hernia, and deliver a baby by your own. I must say most graduates in those days were fully capable of doing all these. A favorite story that I tell my students is that a now professor in chemical pathology - also a classmate of mine - used to repair perforated peptic ulcer by himself when he was a surgical house officer !
No, not in the future. You need a specialist in general surgery to supervise. (This is not all bad a policy. Quality of care could be ensured. After all, the complexity of procedure has increased over the years - for example, you need to repair the same perforation laparoscopically nowadays.)
Yes, this is not new. We have already moved a long way. Many areas of medical practice are now restricted to specialists: eye, ENT, gynecology, and so forth. Surgery and internal medicine are doing so by having sub-specialities - leaving very little for general surgery and medicine (mostly the part that is suitable for protocol-driven practice or, alas, for trainees). The only remaining subject that is not well specialised - at least in Hong Kong - is general practice, but I am sure we will eventually follow the footsteps of the States, Britian, and Australia.
Do you see the implications here ?
You see, the whole world is moving towards that direction. In the old days, an MBBS or MBChB would give you permission to do intubation, perform endoscopy, repair hernia, and deliver a baby by your own. I must say most graduates in those days were fully capable of doing all these. A favorite story that I tell my students is that a now professor in chemical pathology - also a classmate of mine - used to repair perforated peptic ulcer by himself when he was a surgical house officer !
No, not in the future. You need a specialist in general surgery to supervise. (This is not all bad a policy. Quality of care could be ensured. After all, the complexity of procedure has increased over the years - for example, you need to repair the same perforation laparoscopically nowadays.)
Yes, this is not new. We have already moved a long way. Many areas of medical practice are now restricted to specialists: eye, ENT, gynecology, and so forth. Surgery and internal medicine are doing so by having sub-specialities - leaving very little for general surgery and medicine (mostly the part that is suitable for protocol-driven practice or, alas, for trainees). The only remaining subject that is not well specialised - at least in Hong Kong - is general practice, but I am sure we will eventually follow the footsteps of the States, Britian, and Australia.
Do you see the implications here ?
1 comment:
I would like to congratulate the chemistry professor, who must have saved so many lives from PPU back in those days. I have no doubt if the surgery was left to be performed by the real surgeon, it would have resulted in disaster (like the grandpa that i never get to meet).
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