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So who's teaching whom?

BMJ 2000; 320 doi: (Published 29 January 2000) Cite this as: BMJ 2000;320:323

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Learning from each other

Editor- In her personal view “ So who’s teaching whom?” (1) Liz
Smith highlights some very pertinent issues. Working in other countries
can enhance knowledge and skills, and broaden one’s perspective

Having begun life in India , I qualified in medicine in the UK , and then
spent several years preparing to return to rural India as an
ophthalmologist. Most regarded this choice as quaint, but there were
colleagues who showed genuine interest.

I worked for five years as an ophthalmologist in a Leprosy hospital
(providing eye services for the general population also) in Eastern India.
These have been the most challenging, interesting, (and exhausting !)
years of my career. There were times of feeling ill-equipped, ill-
informed, and totally inadequate for my responsibilities. I quickly had
to learn how to budget, to buy equipment, to write project proposals, to
train and manage staff, and to organise and teach on training courses and
workshops. My training in the UK had not afforded me these skills.

Clinically, I did my best to put into practice what I had learned in the
UK, and to give equivalent standards of care, despite caring for more
patients having less equipment , and there being no senior colleagues on
hand to give advice.

I am now back working as a specialist registrar in the UK, and enjoying
it. I have plenty of colleagues around to discuss topics of interest with,
plentiful equipment for every procedure and a wide range of treatments
available to prescribe. When I am on call, it is for ophthalmology alone.
I don’t have to set up drips on dehydrated infants, perform lumbar
punctures , manage pancreatitis, or deliver babies!

Is such experience in India and elsewhere, valued appropriately? I have
worked with scores of dedicated Indian colleagues who practise as I did,
with access to a tiny fraction of the budget we have here. Few have
European or American post-graduate training, but most have a wide range
of skills and abilities, and a comprehensive “world view” rarely found in
developed countries.

My experience has shown me that my UK training alone (albeit something I
appreciate) has given me a fraction of the knowledge and skills that I
regard as valuable, wherever I am working . Work opportunities in
developing countries broaden the mind and make one realise how much we
can learn from each other.

Kirsteen J Thompson ,

Specialist Registrar,

Tennent Institute of Ophthalmology,
Gartnavel General Hospital,
1053 Great Western Road,

1. Liz Smith. So who’s teaching whom? BMJ 2000;320:323.(29

Competing interests: No competing interests

11 February 2000
Kirsteen J Thompson