Oleh : Puteri Nurull Sanim Syahamah, Tahun 5 Fakulti Perubatan, Universiti Al-Azhar Kaherah
Rumour has it that by the year 2015, all overseas medical student graduates will need to sit for the Medical Qualification Examination (MQE). Though all hope goes towards this staying as a rumour, this examination has already been taken by some overseas medical students whose universities are not recognized by the Malaysian government. The Principal aim of MQE is to assess whether an individual has the necessary basic knowledge and clinical skills to practice safe medicine.
Recalling back to the 90s, the number of interns were no more than 5 people per department and these same people are the ones who had to monitor everything. This covers from clerking patients to ordering drugs.
Contrary to the current time, this number had increased to over 30 interns per department, hence the reason why the Malaysian Medical Council (MMC) criticises this number load as a major factor for the decline in the training quality amongst interns.
So, what is in store for us, fellow medical graduates from the Middle East, particularly from Egypt? I do not intend to frighten anyone on the matters mentioned in the previous paragraph.
However, I believe that the concern regarding our quality as physicians needs to be elicited or at the very least, rise up our pulse rate. If not, we are far from being good and competent medical practitioners.
On top of this, it was reported that overseas medical student are facing credibility and competency issues especially those who study in countries with totally different language. Therefore, I would like to share some advices. Plus the ones I have gathered from a number of senior doctors and consultants together with some advices on the issues related to our circumstances in Egypt.
The first thing that struck my mind was the language barrier. Of course one would think that we only have six years in Egypt so why bother right? Eventually, we will end up working in health centres, in our homeland where we speak our native language.
True, no doubt about it. But wait! There’s a catch. In most of the medical clinical book that I have read and stumbled upon, I would find this quotation; “A good history taking makes a good doctor”. In short, how can we obtain a good history without mastering the patient’s language? Therefore, we need to learn the spoken Arabic fluently in order to obtain a good diagnosis.
Second is clinical skill. Looking at the deficient practices and the theory- oriented education in Egypt, we have to admit that there are some weaknesses in our practical course. Therefore, to compensate this matter, I would recommend all of us to do elective postings in Malaysia during our summer holidays.
In my opinion, it is important to do so in terms of adapting one’s self to the local hospital environment and system, bio-medical machinery and also prevalence of a disease. If you really use this opportunity and are interested to learn, you will find the hours in the hospital to be worthwhile and discover that the nurses and Medical Assistant are good teachers to learn from.
Next, I would like to discuss about the education system in the Egyptian universities. It is obviously different from the Malaysian universities especially the universities in Egypt with conventional programme.
For instance, in local universities, the students are allowed to go to hospitals as early as in first year. Plus, they could do basic skills such as taking history from the patients and even teach patients on things like how to use spirometer.
Here in Egypt, we start going to hospitals in our fourth year. I’ll give you another comparison. Internal Medicine is being taught for three years in Malaysia whilst in our faculty here, we learnt Internal Medicine for an average of one and a half year. Moreover, during this course, we are not required to fill in any logbooks such as those provided in Malaysia.
Briefly, it means we do not have a reliable assessment system. Of course, this will make studying medicine easier. Once we finish studying a particular subject, at the end of the year, we tend to forget it. This make our system to be year- oriented.
In addition to elective posting in Malaysia, I think doing ward rounds in our hospital universities here in Egypt will be helpful in improving our language and clinical skills. In Malaysia, this activity is a key to being a good doctor.
Therefore it is about time that we too include this in our study schedules. Equip ourselves with the correct tools and have a checklist and goals of our own on what cases or skills we want to learn for that particular round.
Ward rounds does not take long, but frequency matters since every day, new admission and cases come. Most importantly, do plan before visiting hospitals.
Next, I would suggest active case discussion with peers. The cases discussed may include diseases that are common in Malaysia. Do not forget to refer updated medical websites, for example; Medscape, and journals such as Oxford journal to make the discussion more updated and based on real life patient. Another issue in hand is the lack of interest and the lost identity of a medical student.
In Egypt, it has been a phenomenon for students to take extra classes other than medicine. This is undeniably good. However, many tend to lose interest in medicine after a while. Therefore, time management and balance is very crucial. It is never wrong to gain extra knowledge but as a medical student, we need to make medicine as our priority and we have to master the medical knowledge heartily.
Lastly, I would like to remind all of us to think back on why we wanted to pursue medicine. In reality, medicine is tough both during studying and working time. Though medicine is a noble profession, it demands sacrifice and lot of patience that one would describe as insurmountable.
Regarding the intern load issue, I am hostile to the idea that intern load is a liability to our health sector. Since specialist are still in demand in our country and remote geographical area such as East Malaysia is still unreachable by medical health personal, obviously there are still vacancies to be filled in this field.
Last but not least, let us strive for success for the sake of our community, country and Deen.
