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What ails medical education today?

Rote learning and quality of education has killed the essence of medical education. Students must be told not to fear failure as a learning process

Rote learning has killed the essence of education. To get near-100% marks in entrance examinations, students are encouraged to memorise facts. The whole education process is constructed to check the recall capacity of students. Thus, trained and tutored students become memorising masters. Memorised facts, of course, slowly disappear from the association area of the brain within a couple of months, unless you keep memorising them daily.

This method of study could be detrimental in medical education where students should be able to understand and logically reconstruct the facts to get to the root of the real issue in disease management. The bad habits learnt in school persist through life. In medical education, students need to ask six important questions: who, why, where, what, when and how. Unless the student (especially if s/he becomes a teacher later) listens to these six questions and learns everything that way, it will be dangerous for patients.

The rote method of study also makes students subservient to what is being taught or written in the textbooks. They will never be given an opportunity to question any of the tenets being taught. Now, we also know that textbooks in medical college are mostly ghost-written by drug and instrumentation companies that want to brainwash young minds in medicine with their philosophy of do-it-fix-it strategy. Catch them young is their plan of action. What doctors do not get to study in medical school is much more profound than what they do get to study.

A simple example will illustrate this point. Physics teachers teach students that laminar flow of fluids cannot exert any lateral pressure on the flowing pipe. If they exerted any lateral pressure, the flow cannot go on! Students memorise this and get into the medical school only to find that blood pressure is the lateral pressure exerted on the vessel wall by the flowing blood. What is taught at school and at medical school are opposed to each other. However, students and teachers never ever get to realise this contradiction. They never think that everything in this universe flows by whirling and how the blood flow inside a closed blood vessel system flow is laminar. This blood flow eventually opens into a huge lake of capillary network of nearly 500,000 kilometres of capillaries where even a red blood cell cannot move freely as the capillary lumen is smaller than the diameter of a red cell! Nature has made the red cell into a dumbbell to facilitate movement through capillaries!

Since logical thinking is not what our educational system imparts, we do not realise that if the blood flows by whirling, how could our reductionist chemicals reduce the blood pressure for the good of the organism? An audit of 17 blood pressure lowering clinical trials reported in the six best medical journals of the world by Professor Uff Ravneskov and colleagues showed no significant difference between drug-treated hypertensives and those who followed lifestyle changes and dietary adjustment. This study did not audit the adverse drug reactions in patients who were on life-long treatment with chemical drugs. It could have been a prohibitively high incidence.

Medical students are made to believe that circulation of blood is solely due to muscle contractions of the heart. Of course, by the time they reach this stage of learning, students would have forgotten what they learnt in embryology—that we did not have any heart until the 20th week of gestation in the mother’s womb. Who pumped blood and circulated blood in the foetus until then? This is the ghost of memorising learning that was taught to our students in school. The earlier we change that, the better for mankind. The rot in the teaching-learning process is crying out for change.

The most dangerous omission in medical, nay, any education is the lack of ethical and moral content. We must teach students not to lie to their conscience. They must also be told that it is better to fail than to cheat. How else could one tolerate senior professors spreading white lies to make enormous amounts of money from drug companies, by creating new (non-existent) illnesses to facilitate drug companies to sell their drugs?

Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.



Awadhesh Vaish

3 years ago

an eye-opener.. and explaine din such a simple and easy to understand way.

Pulse Beat

Medical developments from around the world

Popularity of Treadmill Work Stations
For some years now, studies have revealed that sitting for a long time is bad for health and leads to obesity, diabetes, high blood pressure and heart disease. Health conscious companies, in the United States, now provide their workers standing facilities to work; they are building workstations with treadmills so that people can keep working while walking on the treadmill. This has cut down their health insurance spending. Interestingly, sitting jobs damage health, even if the person has been exercising regularly otherwise.

Female Sex Hormone Is Important for Males Also
Nature works wonders and scientists have not understood the whole thing even now. A study published in the 12th September issue of New England Journal of Medicine shows how reduction in oestrogen levels, and not testosterone, results in diminished sex drive and middle level spread of fat in men. Drug companies should take note that selling testosterone alone might not be of much use in male menopause.

Dying with Dignity
In 1968, a letter titled “Not Allowed To Die” was sent to the British Medical Journal describing the ordeal of a retired 68-year-old doctor, who had metastatic stomach cancer. Reporting on it, the New York Times stated: “After much of his stomach was surgically removed and a blood clot cleared from his lung, he asked that ‘no further steps be taken to prolong his life, for the pain of his cancer was now more than he would needlessly continue to endure.’ Two weeks later, the unfortunate doctor had a heart attack in the hospital. His heart was shocked and restarted five times in a single night; morning found him in a persistent vegetative state. His body remained alive for another three weeks. That hellish situation, rare in the rest of the world, is all too common in the USA, and now in India, a copy cat of US medicine. That has only become worse over the years from 1968. Although most of us claim a desire to die with dignity, as Katy Butler reminds us in the book Knocking on Heaven’s Door, a fifth of American deaths now take place in intensive care, where 10 days of futile flailing can cost as much as $323,000, as it did for one California man.”

I am told that 90% of the profits of American hospitals come from keeping dying people in intensive care units for the last 10 days! A very good business indeed!

What Has Food Colour Got To Do With Health?
Darker colours of fruits and vegetables contain a higher level of anti-oxidants. It is a good habit to include many coloured foods in your diet for good health. According to, a study published in the Journal of Medicinal Food showed the protective anti-tumour activity of tomatoes. The website said, “When mice were given either isolated lycopene or tomato paste for three days, the researchers found the tomato paste had much stronger antimutagenic activity compared to corresponding doses of pure lycopene.” The research paper said, "Results indicate that lycopene has antimutagenic effects, although the effects are lower than that of tomato puree, which contains a complex mixture of bioactive phytochemicals. The antimutagenic effect is connected with the chemo protective role of lycopene, tomatoes, and tomato products in the prevention of carcinogenesis.”


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