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Medical qualification consensus

I have been concerned for some time by the appropriate time lapse needed for the formation and qualification of physicians. It is always quite long but how long should it be? In parallel to this question another not less important view arises about a standard “medical qualification consensus”. The latter view proposes that there should not be a difference in the medical knowledge and training skills among all doctors. I remember the “difficult” time I had in my medical courses when there were a lot of things to understand, memorize, and interpret and to fear from.

I did not by that time know that there could be a problem in the learning process and what it could be except that I was always tired and life could just lose its delight; I am a future doctor! The door is thus open for each one, medical student, to build and adopt personal idea and trace an “emergency exit” for such apparent medical career crisis. Some sought a solution in simply memorize to preserve a respected position as a university staff member as best thing among all bad options. Some others diverted to international certificates for both recognition and enhancement. The third group made every possible effort to escape the GP label to a specialist or assistant specialist title. In many of those examples the solution was almost superficial and cosmetic. The outcomes of the medical service provided by many medical colleagues are, therefore, almost random and the learning curves are quite flat too. The typical query: doctors are guilty or victims?

The proposal for an efficient and working medical formation may find its success in a well designed medical qualification consensus. There could be no more need to read whole books or to sprain your mind to memorize “a line” within the covers of several hundred pages book just because it may come in a question. The consensus should be laid down and agreed upon by notable and experienced scholars and practicing physicians such that a whole subject, e.g. physiology, may not exceed 50 pages in its neatest and leanest form. A subject like anatomy, e.g., should not be such frustrating for a green student mind with all details in one menu, but rather served in pieces that are totally clinically and research-wise relevant. In this regards building models and simulations and encouraging learning maps and subjective imagination should be also very helpful.

Pharmacorhythmics

The study of drugs as for their chemical nature and therapeutic applications is included in the subject ‘pharmacology’. In typical medical courses the drugs are presented in relation to the body system for which they are usually used; e.g. drugs of digestive system, drugs of the eye and so on. In such way many students do not like the subject as it would overstrain their memorization capacity. In another apparently not better working style the drugs are ordered in alphabetical manner regardless their uses or forms. If this would be the case, medical teachers and students should find some compromise in learning pharmacology with more appreciation for its importance for the medical practitioner.

Indeed, in pharmacology we find interesting information about drugs as regard their metabolism in the body (pharmacokinetics), effect (pharmacodynamics) and relation to genetic factors (pharmacogenomics). In the latter theme the individual response to some drug is handled so that the drug type, form and dose would be appropriately tailored to suit a given type of patient. This would rely on the fact that there could be differences among different persons in their tolerance and response to some drug depending on differences in metabolic machinery (e.g. enzymes) which in turn have to do with the genetic makeup. Given the sophistication and high expenditure of those tests for individualized drug tailoring their applications would considerably differ by time and place. However, the keen appreciation of such differences can prove crucial for wise and prudent use of medically important drugs.

In this topic I may point to an interesting aspect of studying drugs concerning the frequency or mode of its taking. For examples: how often a dose should be given? Should it follow some diurnal rhythm (morning, day or night)? should the dose be always the same in some application context? How should be then its pattern in case it might be changing? ‘Pharmacorhythmics’ would consider an individualized drug dose, pattern and frequency to best suit a given patient in a given medical context. Needless to emphasize that such drug “iterations” need good knowledge of drugs and their particular therapeutic contexts.