Finishing two years of basic sciences and really looking forward to the clinical years now I am thinking as many a time I did in the past, whether the basic sciences course taught us in Nepal are not updated as per the need of now.
What I am saying is that the information we learn now should be learned either to make a base for learning and understanding the clinical medicine or knowledge that can be utilized in the clinical side.
Let me give you an example:
Why do we have to learn “all” the names of enzymes and memorize the steps of a biochemical pathway? I am saying “all” because some steps are there where the pathology lies(deficiency or overactivation) or the site for drug action and these are crucial to understanding to learn about the disease and the treatment but some steps are there without any significance in clinical application( they may have importance in research but we are learning medicine not researching about everything) . And our syllabus expects us to remember those rather than concepts that are vital.
It may sound like a cry of a lazy student but I say lets put the same time and effort to learn other concepts and applicable things. I am not undermining the importance of the basic science subjects or the curriculum but I feel that if the students are taught from the very beginning to be clinically oriented they will retain the information better and be a better doctor.
If students know that they need to learn the path of this tract in CNS because it signifies the appearance of clinical signs and symptoms according to the site of damage then they will want to know and will understand it better then just learning the path.
Best of all will be integrating the basic science subjects’ concept to give their clinical application. For example, knowing about the location of the pancreas(anatomy) gives me the idea that carcinoma of the head of the pancreas(pathology) can block the hepato-pancreatic duct thus obstructing the bile flow. Knowing about the formation and function of bile(biochemistry and physiology) I can know what will happen in the obstruction vs infection(microbiology). I admit all the times the subjects can’t be integrated but I feel more integration is needed.
Latest approach by Kathmandu University to introduce more clinical insight to the basic sciences is done by the inclusion of a subject named Introduction to Clinical Medicine(ICM) and it is very appreciable and fruitful for the students. It integrates the knowledge of the basic sciences to explain signs and symptoms and management. But one subject is not enough.
I hope that in the next revision of the curriculum the integration and clinical use will be given more importance than just facts and numbers that won’t be clinically applicable.