Temporary

After reading my blog yesterday, don't be mistaken: I never think we should focus on or increase the amount of "science" covered in the medical curriculum.

Yes, our students' plate is quite full already.

But more than that. The real problem is: After (theoretically) well nourished with the science and theory of medicine for five years, what do we ask our graduates to do ?

In the past few years, we have done away with much blood taking by house officers. For legal reasons, they are not allowed to admit patients by their own (without the patient being seen by the medical officer within a finite period of time). Many of the procedures are taken up by more experienced doctors.

In one recent meeting outside the solar system, it was further decided that our house officers would no longer be allowed to enter the code of diagnosis into the hospital computer system - because they are "temporary staff" and may not be able to appreciate a case properly.

Then, what's left for the new comers ? Filling in forms for bureaucratic purposes, ordering test label in the computer, copying drug prescription sheet ...

Come on, let's have a clerk.

PS. Talking about temporary staff, many of our senile colleagues would recollect our previous professor of cardiology began his position in the university as a visiting scholar. In a casual meeting some time later, he was asked about his title in the department. His answer was seminal:

We are all visitors.

Humanistic

I am impressed to learn that our sister faculty over the other side of the harbour decides to put up some 20% of their teaching time for ethics and humanistic matters.

Well, let's leave aside the discussion on whether knowledge or ethics is more important for a good doctor. One major concern is: Does ethics teaching of this kind really improve the humanistic quality of the graduates ?

But, even that is not the most important problem. Let's face it: Most of our medical students are enthusiastic and know just too well what should the heart of a good doctor be. It is the years of examinations and calls and numerous torture (or temptation) in the world of real life that rusts their brains and sores their hearts. It doesn't help by increasing humanistic teaching at the undergraduate level.

Alas, realizing this, those die-hard fans of poultry education would no doubt advocate some kind of program to improve the ethical standard of practising doctors.

Shall we call it Continuous Ethics Education (CEE) ?

Does it mean going to the church every week, or to the Wong Tai Sin temple (or Che Kung temple) yearly ?

What a horror !

PS. The whole thing is not new, because our man from Pluto did have a suggestion of similar kind not long ago. Interested readers may like to go through my blog on 13 September 2008 and thereafter.

Ability

Do you notice I deliberately omitted yesterday the possibility that most of our students are rich ? (I mean they come from affluent families.)

That may well be true.

Unfortunately, that's the even more worrying bit.

Let's consider: Who could get into a medical school ?

Creme de la creme, we hope.

In other words, if capability and intelligence are evenly distributed in a society, we should expect an equal proportion of our students coming from every social class.

But we do not.

Which means:

1. There is a substantial inequally in the chance of having reasonable education between children from different social classes (so that school children from poor families are less likely to obtain a good enough grade in public examination and get entrance to a medical school); or
2. children from rich families are preferentially selected, hopefully via formal rather than some backdoor procedures.

I shouldn't say any more.

Dominate

I might have a flight of idea yesterday and did not make it clear what the worrying bit is.

No, it is not (only) a daddy's kind of concern about overspending children.

Let's come and think of it: Why do our students appear so well off and choose a grandiose place for the graduation dinner ? (I presume it is plain obvious that they do understand they don't need an expensive meal to impress their teachers, as I discussed yesterday.)

There are only two possibilities. Either most of our students are really having a surplus supply of money, or there is a selection bias. The latter is pretty easy to imagine: money is an excellent loudspeaker and, in a group of people from all walks of life, the opinion of the rich often dominates.

But if we see it in an university classroom, that's worrying.

PS. Ironically, poverty is the best loudspeaker in our society. That's another story.

Expensive

You may ask, "What if our students could afford a grandiose place ?"

Quite true. Looking at their clothes and accessories and places they dine, many of our students seem to be very well off.

I tell you: That's the real worrying bit.

***********************
Another usual argument that people put up for choosing an extravagant restaurant for the graduation dinner is that's how our students could best express their gratitude.

Come on, don't be silly. By our age and profession, we've been through many exquisite meals. We are impressed by the character of people, not their makeup.

And, if a teacher needs an expensive restaurant to be satisfied, he does not worth any praise.

Concept

You may argue I am just outdated and the event is never supposed to be a Thank You Dinner (謝師宴) - after all, who wants to thank you ?

In that case soliciting sponsorship from us, the possibly well-to-do seniors (many of us, unfortunately, are not), seems entirely justified. As I mentioned, we have a custom to support events of this kind by the nurses, secretaries, and patients.

But no. Nurses and secretaries work for us. More often than not we just cannot find enough opportunity to thank for their contribution and effort to ease us from numerous troubles.

How about patients ? To an university teaching staff, medical students are no different from patients to the doctors - we are supposed to care and support and encourage their independence. Yes, I donate, most happily, every year to the dinner hosted by the patient support group. However, our patients, and also nurses and secretaries, come mostly from the middle and lower class. They are content and always hold their dinner in local restaurants.

And I would be equally uneasy to write a cheque if they book a table at the Gaddi's or the Petrus.

As JW always says, even if you are a rich dad, you need to cultivate the correct concept of money for your children, rather than allowing them to overspend even before they could earn any.

Otherwise your children would become Americans.

Donation

Receive a thank you letter from the organizing committee of the graduation dinner this year - for my donation to it.

It was in fact a small sum of money and to me it is no different from contributing to the gatherings and parties of our nurses, secretaries, or patient-support groups. Nonetheless there is a sense of uneasiness after I gave out the cheque. (Seriously I had the same feeling for some years - but every time I thought it seemed impolite to spoil the enthusiasm of our students.)

I have that uncomfortable feeling because the dinner is, I suppose, not meant to be a gathering of our graduates - for fun, saying sayonara to fellow classmates, or simply a feast - but to express their gratitude to teachers (if there is any; alas, that's why I never attend).

My goodness, we are not autistic office girls who, without a boyfriend, have to buy rose for ourselves and show off.

PS. By and large this blog is much belayed. I wished to write something about it when I first met the students, but my attention was soon attracted to other matters.