Educating tomorrow’s doctorsBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e3689 (Published 29 May 2012) Cite this as: BMJ 2012;344:e3689
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On behalf of the World Young Doctors' Organization (WYDO) we would like to mention our appreciation for the efforts BMJ and StudentBMJ have made for many years to involve medical students and young doctors in medical science and for facilitating the sharing of opinions and ideas regarding issues that are important for medical students and young doctors. In response to your article we would like to mention three issues that we think are currently of much interest to young doctors.
While acknowledging that education and teaching methods have received greater attention over the past years, we do share the concerns which students and junior doctors raised in your poll regarding the quality of teaching (1). Individual supervision and teaching on the job -whether in clinical medicine, research or in public health- are important skills, which too often are assumed to come naturally when graduating from medical school. It is our impression that young doctors would like to be better equipped with tools and skills as they become teachers themselves.
Secondly, the working conditions of medical doctors, their payment and opportunities for further education are of much concern in many countries of the world, often causing young doctors to leave their countries. This is not because young doctors do not want to be part of the development of their countries, but simply because they do not see another way to develop their careers and/or to take care of their families. Ironically, some countries simultaneously criticize brain drain yet provide incentives for foreign doctors to immigrate, rather than support the improvement of working conditions in the countries these doctors are coming from. Although brain drain is a well-known problem and BMJ has also highlighted the issue through several articles over the past years (2-6), leading to numerous passionate responses, the situation does not seem to be improving.
As WYDO we see a recent development in which young doctors are joining together. It is interesting to note how many national organizations were set up in 2010 and 2011 with a focus on improving working conditions and career opportunities for young doctors, for example in Nepal, Burkina Faso, Bulgaria, Spain and Papua New Guinea. Young doctors will need to work together to point out problems and possible solutions and hold policy makers accountable. We see a role for WYDO in bringing young doctors' organizations together and support them in this endeavour.
The last issue that we would like to mention is the current financial crisis and the consequences this has on healthcare. Most countries in the world are drastically cutting their budgets, including for healthcare. In Europe this is probably most dramatically seen in Greece, Spain and Italy. Many developing countries are also feeling the consequences of the financial crisis as international donors decide to reduce or stop their support. Both in developed and developing countries this undoubtedly has consequences for the quality of care, the availability of treatment options, the maintenance of public health programmes and the out-of-pocket costs that patients will need to pay. Sergio Minué-Lorenzo et al. recently described how they fear the deterioration of Spain's healthcare system under the budget cuts (7). WYDO is currently preparing an initiative to assess the extent of these consequences from the perspective of young doctors and to raise awareness for this healthcare crisis.
We think that young doctors should play a role in identifying challenges and solutions in all aspects of healthcare. An interesting example of how this could be done was captured in the seven key recommendations for how junior doctors and managers can collaborate to improve quality (8). We encourage young doctors to work together in raising issues and achieving practical solutions. We also support BMJ's efforts to address these issues.
1. Chanchlani N, Godlee F. Educating tomorrow’s doctors BMJ 2012;344:e3689
2. Loefler I. How to halt the brain drain. BMJ 2006;332:921.1
3. McColl K. Fighting the brain drain. BMJ 2008;337:a1496
4. Brain drain. mp3:bmj-podcast. http://www.bmj.com/podcast/2011/12/13/brain-drain
5. Gaál P, Szigeti S, Panteli D, Gaskins M, van Ginneken E. Major challenges ahead for Hungarian healthcare. BMJ 2011;343:d7657
6. Mills EJ, Kanters S, Hagopian A, Bansback N, Nachega J, Alberton M, Au-Yeung CG, Mtambo A, Bourgeault IL, Luboga S, Hogg RS, Ford N. The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis. BMJ 2011;343:d7031
7. Beginning of the end for Spain’s national health system. BMJ 2012;344:e3213
8. Seven key recommendations for how junior doctors and managers can collaborate to improve quality http://blogs.bmj.com/agentsforchange/2011/04/06/seven-key-recommendation...
Competing interests: No competing interests
Very interesting and informative article. As a recent graduate I found pre-prepared case base discussions a very effective way to learn. The practicalities on the ward of finding a patient with a educational ABG, finding that patient's notes, digesting their history, finding a log on to look at their X-ray and finding a doctor with the time and enthusiasium to teach you about it were often difficult and time consuming; having all that information to hand in a pre-prepared environment no doubt makes for very efficient learning. However, I am sure some of the old school would emphasis the importance of patient contact and time on the wards at this point, which, although it may not help you pass the exams as much, will definitely pay off in your junior years.
Competing interests: No competing interests