Patients-not just Images
Devoted to Education and Practice in Patient-centered Radiology
Chairman's Corner
Chairman's Corner
The Lull
The Lull
Ravi Ramakantan
Ravi Ramakantan
There has been quite a lull in the department these past few days.
There has been quite a lull in the department these past few days.
You do not see residents scurrying around, reading scans, supervising technical staff or talking to patients or just out in broad and long corridors of our department.
You do not see residents scurrying around, reading scans, supervising technical staff or talking to patients or just out in broad and long corridors of our department.
The teaching room is bereft of activities and the faculty are bitterly agonizing over all the gaddha majoori (donkey work) they have to do - .. the residents have been truant on “exam leave”.
The teaching room is bereft of activities and the faculty are bitterly agonizing over all the gaddha majoori (donkey work) they have to do - .. the residents have been truant on “exam leave”.
Those that are familiar with teaching departments in our country will be aware of what I am talking about - a tradition I loathe from the bottom of my heart – having been a post graduate teacher in Radiology or close to 40 years.
Those that are familiar with teaching departments in our country will be aware of what I am talking about - a tradition I loathe from the bottom of my heart – having been a post graduate teacher in Radiology or close to 40 years.
What I am I talking about?
What I am I talking about?
There is a practice in postgraduate teaching departments in our country that postgraduate students - invariably resident doctors - are allowed to avail of “exam leave” for up to three months in the last term of their three year post graduate course.
There is a practice in postgraduate teaching departments in our country that postgraduate students - invariably resident doctors - are allowed to avail of “exam leave” for up to three months in the last term of their three year post graduate course.
This is like the ‘study leave’ system we have in many schools.
This is like the ‘study leave’ system we have in many schools.
Why do I hate this tradition?
Why do I hate this tradition?
In any postgraduate course, it is impossible read all that needs to be learnt - in 3 months .. in 3 years .. not in 30 .. not in a lifetime.
In any postgraduate course, it is impossible read all that needs to be learnt - in 3 months .. in 3 years .. not in 30 .. not in a lifetime.
Ask me, I should know.
Ask me, I should know.
Why do students take this leave?
Why do students take this leave?
This is what I often hear...
This is what I often hear...
“Sir, it gives us confidence in facing the exam”.. Sir, all other departments give leave, we are the only unlucky ones.. it makes us very nervous seeing all others studying so hard.. Sir,.. please .. please”
“Sir, it gives us confidence in facing the exam”.. Sir, all other departments give leave, we are the only unlucky ones.. it makes us very nervous seeing all others studying so hard.. Sir,.. please .. please”
Finally - “What if I fail?” they ask.
Finally - “What if I fail?” they ask.
The world doesn't end..
The world doesn't end..
Ask me - I should know.
Ask me - I should know.
As chief, through the years, I have gotten smart. I no longer handle these .. “please. please” stuff. I let the chief resident and the academic coordinator sort this.
As chief, through the years, I have gotten smart. I no longer handle these .. “please. please” stuff. I let the chief resident and the academic coordinator sort this.
This ‘toxic’ environment is the cause of much anguish all around.
This ‘toxic’ environment is the cause of much anguish all around.
The truth is lost in the flames of these toxins of ‘complete the syllabus”
The truth is lost in the flames of these toxins of ‘complete the syllabus”
In reality though, completing the syllabus in any part of medical education is an impossibility.
In reality though, completing the syllabus in any part of medical education is an impossibility.
In Radiology for example, you learn over a period of a 1000 days.
In Radiology for example, you learn over a period of a 1000 days.
From cases you see - from the very common to the zebras..
From cases you see - from the very common to the zebras..
You learn by reading on the job - reviewing cases as you go along day after day.
You learn by reading on the job - reviewing cases as you go along day after day.
You learn from the ‘on call’ nights, as you miss the perforation in an inflamed appendix or a SH type 1 fracture of the humerus.
You learn from the ‘on call’ nights, as you miss the perforation in an inflamed appendix or a SH type 1 fracture of the humerus.
You learn attending case discussions, interdepartmental meetings and periodically browsing journals in the library or the teaching files.
You learn attending case discussions, interdepartmental meetings and periodically browsing journals in the library or the teaching files.
And most important of all, you learn by following up your patients…knowing when you were right or wrong.
And most important of all, you learn by following up your patients…knowing when you were right or wrong.
Finally, you learn from the procedures you performed, the ease with which they could be performed, the complications you may have had and how you handled the patient’s questions before and after the procedures.
Finally, you learn from the procedures you performed, the ease with which they could be performed, the complications you may have had and how you handled the patient’s questions before and after the procedures.
Medicine is learnt from patients day after day and not during the leave that you availed of for your theory and even before the practical exams.
Medicine is learnt from patients day after day and not during the leave that you availed of for your theory and even before the practical exams.
Most times, what you answer in the exam is based on what you learn in 30 months and little from what you studied in 30 days.
Most times, what you answer in the exam is based on what you learn in 30 months and little from what you studied in 30 days.
In the words of William Osler
In the words of William Osler
“To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all”
“To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all”
How I wish I could wield a magic wand and make this tradition a thing of the past and hope residents learn through three years- from what they see and hear and not from books alone…
How I wish I could wield a magic wand and make this tradition a thing of the past and hope residents learn through three years- from what they see and hear and not from books alone…
I hope there will be no more lulls - though in my heart of heart, I know that next year too, this time of the year, there will be a lull and much heartburn from those left holding the sack.
I hope there will be no more lulls - though in my heart of heart, I know that next year too, this time of the year, there will be a lull and much heartburn from those left holding the sack.
Lots of bhashan..you say ? What did I do for my MD examination?
Lots of bhashan..you say ? What did I do for my MD examination?
Go ask my contemporaries; you will understand why I get this right to preach to you.
Go ask my contemporaries; you will understand why I get this right to preach to you.
There may be a lull in the department these days; but, it is only a superficial layer. Beneath it, is the lava of frayed tempers, daytime yawns, hushed expletives…more..
There may be a lull in the department these days; but, it is only a superficial layer. Beneath it, is the lava of frayed tempers, daytime yawns, hushed expletives…more..
It does not have to be this way.
It does not have to be this way.
April 2019
April 2019