Medic's course country(JPA)

[misspenguin]

I am very confusing in choosing the country for medic course.
Aus,India,Ireland,New Zealand,Republik Czech,Russia,United Kingdom and Poland.
I dun know which country to choose..
Can anyone please give me some advice on this?
Thanks a lot!:)

[Athersin]

Does JPA allow you guys to choose whichever country to go for medic? the answer is NO!

I remember last time when one of my former classmate get JPA Medic in India, but she seems to turn it down..Pity. the country is not within our selection, it is upon JPA who decide. So just relax!

[senksiang90]

I remember last time when one of my former classmate get JPA Medic in India, but she seems to turn it down..Pity. the country is not within our selection, it is upon JPA who decide. So just relax!

Yeah.. My sis got JPA Russia and my bro got JPA India. Actually both of them were given a list of countries of where they want to go at that time(4 years ago) but what the heck. It's all bull****. JPA will arrange to where they want to send u. Now they will send most to Indon or Czech Republic as they will want to mass produce doctors at the cheapest cost now. So, do be prepared to be sent anywhere yea. Good luck!

[eugenetoh91]

if you are really allowed to choose to go to the country of interest, then, this is what i suggest.according to order.
1.united kingdom
2.Australia
3.New Zealand
4.Russia
5.India
6.Poland
7.Czech Republic
8.Ireland

Actually, its sad to say that, JPA doesnt offer medic students to US, actually those US unis are one of the best unis in the world for majoring in Medicine. but since studyin medic in US is not cheap and M'sia has collabaration with those countries. thats why, students are sent to a number of few countries which are not very good.
but since JPA is offering you to study Medic, no matter where they put you, just take it. we can still survive, cant we??
quote from:
http://www.topuniversities.com/worlduniversityrankings/results/2008/subject_rankings/life_sciences_biomedicine/

[Glassylicious]

Actually, its sad to say that, JPA doesnt offer medic students to US, actually those US unis are one of the best unis in the world for majoring in Medicine. but since studyin medic in US is not cheap and M'sia has collabaration with those countries. thats why, students are sent to a number of few countries which are not very good.

They can't, even if they wanted to and had the funds to sponsor. Medicine [as well as Law] in the US is a postgraduate program. You need to have at least a degree before applying for the course. No SPM leavers are eligible to study Medicine and Law there.

[senksiang90]

They can't, even if they wanted to and had the funds to sponsor. Medicine [as well as Law] in the US is a postgraduate program. You need to have at least a degree before applying for the course. No SPM leavers are eligible to study Medicine and Law there.

That's funny. I have a friend taking CAL now and she's under bank negara sponsorship to do medicine in US. Better still, she's being called to Harvard University for interview. One of the lucky few in the world man.

[Glassylicious]

That's funny. I have a friend taking CAL now and she's under bank negara sponsorship to do medicine in US. Better still, she's being called to Harvard University for interview. One of the lucky few in the world man.

Wow, seriously? That's quite unheard of. Congrats to your friend for getting a Harvard interview. Do you know how many years she is being sponsored? Are you certain it's Medicine?

I'm trying to figure out how this is possible [not saying you're lying or anything], and a possible situation is that she's doing a related course like Biomedicine, Biochemistry or something before going on straight to medical school or something. BNM might have agreed to sponsor her up till her medicine program, but we may not be able to assume that she's going to go straight to Medicine right after CAL. Anyway, US universities don't really care about your pre-uni results, they'll actually ask you to fly there before your A levels results are even out [that's what happened for my friend]. What matters is your SPM results. =)

[Miracle_seed]

if you are really allowed to choose to go to the country of interest, then, this is what i suggest.according to order.
1.united kingdom
2.Australia
3.New Zealand
4.Russia
5.India
6.Poland
7.Czech Republic
8.Ireland
Even though nobody gets to choose their country, they might still be asked during interview... By the way, I was wondering why Ireland is placed at the bottom of the list? They have some prestigious medical schools...

[Athersin]

if you are really allowed to choose to go to the country of interest, then, this is what i suggest.according to order.
1.united kingdom
2.Australia
3.New Zealand
4.Russia
5.India
6.Poland
7.Czech Republic
8.Ireland


yea, i was wondering too. Probably Ireland should be an ideal place to study medicine. There is a lots of oppurtunities and u can learn a lot more things which is going to be very useful in ur career as a doctor.
My 2 frens are studying medic in ireland now. Both of them excel pretty well in their study.

Czech republic , though the fess is much cheaper, u will be totally impressed by the pictureque and artistic buildings there.:nuts

[duke23]

Even though nobody gets to choose their country, they might still be asked during interview... By the way, I was wondering why Ireland is placed at the bottom of the list? They have some prestigious medical schools...

irish med schools prestigious?=common misconception among malaysians

Its the dumpster ground for medics from all over the world especially from the middle east.

[caramel_nut]

Wow, seriously? That's quite unheard of. Congrats to your friend for getting a Harvard interview. Do you know how many years she is being sponsored? Are you certain it's Medicine?

I'm trying to figure out how this is possible [not saying you're lying or anything], and a possible situation is that she's doing a related course like Biomedicine, Biochemistry or something before going on straight to medical school or something. BNM might have agreed to sponsor her up till her medicine program, but we may not be able to assume that she's going to go straight to Medicine right after CAL. Anyway, US universities don't really care about your pre-uni results, they'll actually ask you to fly there before your A levels results are even out [that's what happened for my friend]. What matters is your SPM results. =)Glassylicious is right. US colleges do not offer medicine for undergraduate studies. Your friend could be applying to do a bio-related courses/ pre-med but she definitely cannot do medicine as an undergraduate in US, or Harvard in this case. Also, getting into a US medical school is very difficult, even for a domestic US student. Very very few international students have gotten admission in the past into US medical schools.

[eugenetoh91]

irish med schools prestigious?=common misconception among malaysians

Its the dumpster ground for medics from all over the world especially from the middle east.

yea. you are right. Its disheartening to say that Irish and Eastern Europe countries do not have well diversed univerties, and certainly they do not have pretigious universities that are majoring in medics. well, other fields too. the fact that JPA is sending the students to these places is, like i said in the previous post, M'sia has collaboration with those countries, eg Jordan, Czech republic, and Poland. These are some of countries that medic students will be sent to. M'sia collaborated with those countries so that our students are sent to those countries to study in a cheap fee, and on the contrary, many of their students are sent over here too. well of course, if country you choose is due to the picturesque vista and environment, then, any europe country would be the best. anyway, for everyone's infomation, eastern europe has a lowest GDP among the europe countries. there are mainly, Bosnia, CR, Poland, and those small countries that i thk i do not have to mention. that is why, their unis are cheap, and our students are sent to there. and as for ireland, it has been 1 of the poorest countries in europe too. i wouldnt say that the university there is the worst in the world, but compared to India, Ireland is worse. Even though India may give us an impression of very unmodernised and poor. but India has one of the most pretigious univerties in the world can contributed a lot professional in sciences. but since if you are really offered to study medic by JPA, just take it wherever you are asked to go.:))dun worry be happy

[Miracle_seed]

This is the first time I hear some negative remarks about Irish medical schools... Anyway I think there are both good and not-so-good medical schools in every country, right? If we simply categorize by country, it's a little generalized.

[Al-Bert]

irish med schools prestigious?=common misconception among malaysians

Its the dumpster ground for medics from all over the world especially from the middle east.

Are you sure? It's because I found this in http://www.escapeartist.com/studying_abroad/Foreign_Medical_Schools_Europe.html

Royal College of Surgeons in Ireland (RCSI) - Royal College of Surgeons in Ireland (RCSI) - The Medical School dates from the 19th century and various postgraduate faculties were added in the 20th century. More recently the College has become active abroad, in the provision of education, training and hospital management. The Royal College of Surgeons in Ireland is independent, international and progressive - a unique medical institution. - [Highly regarded school - it would be one of the first choices of those seeking an overseas education - EscapeArtist]

I'm confused, isn't Ireland one the countries under United Kingdom?

[luminodreamer89]

Ireland, no...while Northern Ireland, yes.
Correct me if i'm wrong =)

[Glassylicious]

Ireland, no...while Northern Ireland, yes.
Correct me if i'm wrong =)

That's right. UK consists of England, Scotland and Northern Ireland. I'm sure there are some British territories lying around here and there, but those aren't significant.

Credit to Al-Bert: Wales is also included. I forgot about that. Sorry.

[Al-Bert]

My parents taught me that UK is consisted of 4 countries - England, Scotland, Wales and Ireland but they never mentioned to me that it's actually Northern Ireland...

Thanks for clarifying!

[Glassylicious]

Oh yeah! How could I have forgotten about Wales. T_T

[misspenguin]

oh yea~thanks for all of the replies!
Ya..I just want to prepare for interview as they may ask why do you choose for that country~
^^

[windhoe2]

yea. you are right. Its disheartening to say that Irish and Eastern Europe countries do not have well diversed univerties, and certainly they do not have pretigious universities that are majoring in medics. well, other fields too. the fact that JPA is sending the students to these places is, like i said in the previous post, M'sia has collaboration with those countries, eg Jordan, Czech republic, and Poland. These are some of countries that medic students will be sent to. M'sia collaborated with those countries so that our students are sent to those countries to study in a cheap fee, and on the contrary, many of their students are sent over here too. well of course, if country you choose is due to the picturesque vista and environment, then, any europe country would be the best. anyway, for everyone's infomation, eastern europe has a lowest GDP among the europe countries. there are mainly, Bosnia, CR, Poland, and those small countries that i thk i do not have to mention. that is why, their unis are cheap, and our students are sent to there. and as for ireland, it has been 1 of the poorest countries in europe too. i wouldnt say that the university there is the worst in the world, but compared to India, Ireland is worse. Even though India may give us an impression of very unmodernised and poor. but India has one of the most pretigious univerties in the world can contributed a lot professional in sciences. but since if you are really offered to study medic by JPA, just take it wherever you are asked to go.:))dun worry be happy

I am 4th year JPA-sponsored medical student currently studying Trinity College Dublin. It is quite disheartening and shocked to know the some of the view on Irish medical schools. I am totally agree that each country has their own best and bad unis.

Dump site for medics? I have been hearing this before I came here, it is because most of the students (not Irish ) decide to study here when they cant get offer from UK.
However, many middle east will choose the ONLY one private medical schools in Ireland which has relatively lower prerequisite for entry but it doesnt mean you will get through easily, many drop out and repeats occur among students there.

However, I am not here to compare or praise any medical schools. From my point of view, what really matter is the THING between our ears and I cant deny that proper and good-quality teaching does make some difference but it is all about our own initiation and motivation.

On final note, I shall suggest that everyone will be grateful to whatever they have been offered since this is the golden chance in lifetime to experience different learning (especially for not-so-affluent students)

All the best and good luck to all potential applicants.

[Vaan]

I still think if you want to be expert on application and theory in the medical field. You should go for Australia. As Australia universities emphasize heavily on application of the facts you have learn from your textbooks. Not just exams, exams, and exams....Plus, Australia is also a country with well-established universities offering medicine degree.

[CCY_to_the_top]

hei, i applied for medic..erm, can u tel me the different between MBBS and MD?? MD need a degree rite?? so it take a longer time to finish ur medical studies rite??

[Al-Bert]

MD in America is equivalent to MBBS if I'm not mistaken. Both are bachelor's degree for medicine.

In other countries, MD should be postgraduate academic degree for medicine.

[Miracle_seed]

MD in America is equivalent to MBBS if I'm not mistaken. Both are bachelor's degree for medicine.

In other countries, MD should be postgraduate academic degree for medicine.Yes, you are right. MD is from America while MBBS originates from UK. For example, some universities in Malaysia offer MD while some offer MBBS, but both are of the same. Some countries adopt MBBS, while some MD. By the way I think some countries have another MD as a post graduate degree...

[youngyew]

MD in US is a post graduate degree.

[CCY_to_the_top]

does Malaysia, i mean JPA send u for MD ?? i heard msia oni recognized MBBS...correct me...

[Al-Bert]

MD in US is a post graduate degree.

I got that information from a clinic doctor.

This would the reference to back up my claim:
The Bachelor of Medicine and Bachelor of Surgery degrees (MB BS or MB ChB, and several variants) are equivalent to the North American MD degree.

In my opinion, some people tend to regard MD in US as post graduate degree because one is obliged to undergo 2 years pre-med before proceeding to MD course in US...

The doctor and wikipedia could be wrong (10~20%) nevertheless...

[Miracle_seed]

does Malaysia, i mean JPA send u for MD ?? i heard msia oni recognized MBBS...correct me...This is definitely not correct. Some European countries, for example Czech republic offer MD instead of MBBS, still JPA send students there. Furthermore, even in Malaysia, many public universities such as UKM, USM also offer MD. In these cases, MD is first medical degree, regardless of the name. You can read more here (http://en.wikipedia.org/wiki/M.D.)

[CCY_to_the_top]

so studying MBBS is a better choice or studying MD?? can u show me some of the pros and cons of both of them?? im quite ignorant about this 2 courses..i heard people prefer MBBS since it is faster ( lesser by 2 years )..thx..

[youngyew]

It really depends on what you mean by "better". Melbourne University's MBBS is probably better than what some Malaysian universities call MD due to its research effort and long teaching experience, for example. Faster is not necessarily better; in fact the contrary tends to be true. You need time to study medicine.

So my point is, what it is called DOESN'T matter. The institution, the course structure and the teaching staff are more relevant in the context of a medical school's quality.

[Miracle_seed]

so studying MBBS is a better choice or studying MD?? can u show me some of the pros and cons of both of them?? im quite ignorant about this 2 courses..i heard people prefer MBBS since it is faster ( lesser by 2 years )..thx..I've never heard that MBBS is faster than MD, unless you're referring to US MD degree, as it's a postgraduate degree, so you'll need a first degree to enter, of course it would take a longer time. Rather, the duration of degree depends on the university, not the name of degree offered. MBBS is not any superior to MD and vice versa, and as youngyew said, it depends on the university/course structure, that you would say whether it is better.

[youngyew]

Yup, whether it's MBBS or MD, all medical students study pretty much the same thing.

So to summarise it:
MD - In US it's a post-graduate course; but it can be an undergraduate course e.g. UNIMAS. If it's a post-graduate course then it will take longer to become a doctor because you need an undergraduate degree before you enter the medical school.

MBBS - It's ALWAYS an undergraduate degree. But it doesn't mean that you learn more / less than MD. Same thing.

[CCY_to_the_top]

thx Mr Seed...i think i get the idea..so MBBS and MD are just almost equivalent rite? just that if you want to do your MD in US, u need to have a first degeree which normally cost you another 1 or 2 years depending on the uni rite?

so MBBS and MD in other countries outside US is almost the same..i mean in term of duration..they are the same rite?...btw, there should be some different between MBBS and MD, isit just because they are from different origin which make them different?? or the stuff you learn is different??

thx Mr Seed...i think i get the idea..so MBBS and MD are just almost equivalent rite? just that if you want to do your MD in US, u need to have a first degeree which normally cost you another 1 or 2 years depending on the uni rite?

so MBBS and MD in other countries outside US is almost the same..i mean in term of duration..they are the same rite?...btw, there should be some different between MBBS and MD, isit just because they are from different origin which make them different?? or the stuff you learn is different??

[youngyew]

Eeer CCY, did you read my previous message? :P

[music_freak28]

I think almost any medical scholarship is good. It does not really matter which medical university you graduated from, as long last it is recognized by the Malaysian Medical Council. It really largely depends on yourself to work hard and your mindset and how focused you are to become a doctor. Yea, I do admit the surroundings and the facilities of medical schools does play a part but rather a very small part.

Even if you were sent to the best medical school in the world, with the wrong mindset and without the passion for this job, you most likely won't go far. So, just accept any medical scholarship given to you especially when it is a heavy burden on your parents to support your medical fee.

Plus, at bad economic times like these, it isn't exactly wise to reject a medical scholarship. If you didn't get your first choice of country, just go with a positive mind and an open heart. If you did get an offer from JPA, try not to reject it. Think about the people that a vying for it.

Good luck in obtaining JPA scholarship.=)

[Miracle_seed]

Yup, whether it's MBBS or MD, all medical students study pretty much the same thing.

So to summarise it:
MD - In US it's a post-graduate course; but it can be an undergraduate course e.g. UNIMAS. If it's a post-graduate course then it will take longer to become a doctor because you need an undergraduate degree before you enter the medical school.

MBBS - It's ALWAYS an undergraduate degree. But it doesn't mean that you learn more / less than MD. Same thing.This explanation is clear. By the way, I've a question here, my friend studying in Australia told me that medical degree in many universities in Australia, including Melbourne University is going to change from undergraduate to postgraduate, is it true?

[ayja]

This explanation is clear. By the way, I've a question here, my friend studying in Australia told me that medical degree in many universities in Australia, including Melbourne University is going to change from undergraduate to postgraduate, is it true?

If I'm not mistaken, yes. The MelbU rep told us that starting last year, they won't accept undergrad students studying medicine. It will be only allowed for postgrad students. I guess it's something like the US system, whereby you need a basic degree before entering into medicine? Not sure though.

[youngyew]

Yup that's correct, Melbourne will turn into a full post-graduate course in two years, and they have already stopped accepting undergraduate since last year I think. The official reason for this change is to promote "academic excellence"; though most people regard the change as being inspired by higher tuition fees in the postgraduate structure (people need to study even longer to get the MD now)

[eve88]

Just an aside : since we're talking about MD and MBBS..

New Zealand uses MBChB - which i think came from latin - its one of the more obsure ones.

But yeah, med students pretty much study the same thing.

[youngyew]

EDIT: Sorry after a proper reading I find that the following may not be very relevant after all. Just skip it; but I decided to leave it here for those who are interested to know what this is about.

While we are at the topic of undergraduate medicine vs postgraduate medicine, I thought I should share this journal article (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2898%2902290-9/fulltext?_eventId=login) from The Lancet which is very relevant:

Why graduate medical schools make sense Richard Hortona (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0ff660ca3cd122e5ed2336bf6fec764f#aff1)
aThe Lancet, 42 Bedford Square, London WC1B 3SL (R Horton FRCP)


“… we do not begin to learn the multiplication tables because it suddenly dawns upon us that we do not know the sum of nine 8s, nor the dates of the Kings of England because we know we do not know when Edward I came to the throne: we learn these things at school because we are told to learn them.”Michael Oakeshott
Universities make students sorrowfully pursue dull courses.* (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#fn1) Probably true. This phrase was also a tiresome way to learn the relations of the abdominal aorta on its left side.1 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib1) I still recall the dreadful task of memorising the foot muscles that conspire to align themselves into four inexplicable layers. When I now turn to Gray's Anatomy—aversion therapy—it is not much consolation to discover that “the ‘layers’ can be overemphasised …”.2 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib2) Tell that to anatomy demonstrators.


What do doctors think of their days at medical school? Thomas Sherwood3 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib3) has described the experiences of over 1000 students from the Cambridge clinical school, representing 15 years of entry. Why should this retrospective survey signal any special attention? Because Sherwood sets out the views of those passing through the UK's newest graduate clinical course.


The Cambridge curriculum involves 2 years of standard preclinical teaching and a third research-oriented degree year. Graduate students then embark on their clinical course for 2 1/4 years. They are joined by 25 graduate students—selected by interview—from other UK medical schools. At the time of Sherwood's 1997 questionnaire, 16% of Cambridge medical graduates were in “established senior or junior academic work”.



Gratifyingly, more than 90% said they would choose Cambridge again. There seemed a healthy balance between damnation (“humiliation is not training”) and eulogy (“the best possible clinical education”). But the Cambridge experience revealed an interesting dissociation between a generally much enjoyed time at medical school and the sometimes displeasurable reality of working as a doctor in the modern UK National Health Service (NHS).


Sherwood is too modest to conclude that the Cambridge graduate clinical school has been a success, but he does point out that “we do not take enough care to brief bright, enthusiastic young men and women, queuing up to be medical students, about what is facing them beyond qualification”. What is facing them? And might the lessons from Cambridge be drawn together to set out some new objectives for educating doctors to be?


Predicting medicine's future is to enter a hive of competing possibilities: super-specialisation, molecular medicine, technical advances in diagnosis and treatment, evidence-based everything. But for many clinical specialties, the most radical change is likely to be in the doctor-patient relationship. Patients rightly expect more from their doctors than ever before. They often seek a dialogue with their physician as much as a diagnosis. They want to know something about their illness. And they want to take part in discussions about their care. This newly inquiring patient poses fierce challenges that are difficult for the current generation of doctors to meet.


Doctors are brought up to accept—if not always to respect—a hierarchical teaching environment: lecturers from academic faculty standing before packed rooms of drowsy students, or a senior physician imparting a distillation from a career's experience. Nothing is wrong with either of these approaches, in their place. But they need to be matched by attention to an individual student's progress, concerns, and weaknesses. Such a culture of mentorship with an inspiring teacher is not a formal part of many medical curricula (though it is in Cambridge). These encounters could include discussion of the meaning of language used in taking a case history (the use of names not diseases, presenting concerns not complaints, a patient's own words not the doctor's medical rewording, separating the illness from the disease, and discovering patients' views about their condition4 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib4)) and how this language may help to build a strong and trusting relationship between doctor and patient. These personal skills are being neglected. Pfeiffer and colleagues5 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib5) have described a decline in the ability among medical graduates to gather information about social history. These researchers concluded that “the overall culture of medicine may serve to encourage the voice of medicine rather than the voice of the lifeworld”. How can this culture be changed?


The graduate medical school offers one answer. To produce doctors who are able to respond well to these changing relationships invites a different way of thinking. Each student must not only develop excellent technical skills but also be able to adapt to a setting that increasingly respects other health professionals, such as nurse practitioners, who are brought up to be more responsive to the anxieties of their patients. To achieve this aim demands an unusual mix of interests, from the immediacy of laboratory science to the perspective of medical history, from the precision of quantitative epidemiology to the interpretive depth of reading literature, from local clinical experience to time spent overseas. We are likely to be asking a great deal more of students in the future.


Graduate medical schools might be especially well placed to draw out these skills. They could emerge from several moulds. First, the Cambridge system introduces a third research year in a (pre) clinical science. But a second approach might allow a third year to be devoted to any subject, not necessarily a medical discipline. In either case, a further 3 clinical years would follow (2 1/4 in Cambridge, perhaps a target other medical schools could aim for). Lastly, a fully fledged graduate medical school would require a degree in any subject before embarking on an additional four years of preclinical and clinical training at medical school. This model is the norm in the USA.


These possibilities are a radical departure from current methods. Can we meddle with our traditional forms of medical training without jeopardising their quality? This question begs another. What does it mean to go to university to study medicine? This is a sensitive issue. Clinical academics often regard their teaching roles with barely concealed disdain. In his evidence to the UK House of Lords Select Committee on Clinical Academic Careers, Keith Peters argued that,
“it is worth pointing out that people do clinical academic medicine primarily, in my view, to do research … the people who are the leaders of the profession originally get into the academic track to do research, and of course they are now being asked to do many other things as well”.6 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib6)Such as the chore of teaching. These views are not confined to the senior academic elite. John Savill, an academic nephrologist, has put the matter even more starkly. “The really critical issue at the moment for clinical science is what are medical schools for, and what can medical schools support”.7 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib7) Why should this be an urgent matter? The NHS “expects those academics to pull their weight in service, and pull their weight in teaching. There is not much around to protect a bright young researcher at the start of a university career”.7 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib7) Protect the academic physician from what? When the very best of our clinical researchers portray themselves in this harshly selfish light—“my research comes before patients and students”, he seems to be saying—one begins to envisage a future for academic medicine isolated in the stillness of a laboratory, protected from the daily irritations of care and teaching. Some future.


Not all intellectual disciplines place teaching second to research. George Steiner, not a scientist but a professor of comparative literature, has argued that “… major scholarship … can arise out of the business of teaching. I am persuaded that should”.8 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib8) He too saw a division between research and teaching but his vision was more bleak.
“I suspect that the future will bring about a widening gap between certain privileged centres of research and postdoctoral training and those colleges and universities devoted more explicitly to teaching. This may indeed prove unavoidable; but both enterprises will be losers.”The same observation might apply to medicine. Charles Sanders Peirce,9 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib9) the inventor of randomisation in medical research, writing a century ago certainly thought so. In universities he believed that “instructors and pupils here compose a company who are all occupied in studying together”. Not only should we be seeking a deeper and broader academic background for clinical students but also we must seek medical leaders who place teaching on an equal footing with research, and not regard it as an unwelcome intrusion.


Michael Oakeshott, who was professor of political science at the London School of Economics until his retirement in 1969, developed this idea still further. In his essay on the place of politics in the university curriculum,10 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib10) he begins by considering what it means to talk of an education. School education is “without specific orientation” and “we are, quite properly, not permitted to follow our own inclinations”. A vocational education (medicine, for instance) involves “acquiring a specific body of knowledge and being able to move about within it with ease and confidence and to use it”. It is about fitting someone “to satisfy the current demand”, concerned mainly with “a strictly circumscribed body of knowledge which does not significantly look outside itself”.


By contrast, a university education is quite different. University study is about analysing the “intellectual capital”, old and new, of a subject, “a cooperative enterprise, in which different minds, critical of one another, are engaged”. Through this endeavour, a way of thinking develops that is peculiar to that discipline. A mind evolves—one that is nourished by being a spectator at a table at which conversations between teachers using different ways of thinking take place. Steiner's words are “contamination” leading to an “afterglow” of excellence. In sum, Oakeshott concludes that “what university has to offer is not information but practice in thinking”. Can we put our hand on our heart and say that this is one of the chief concerns of those running medical schools today?


Medical education is under pressure. New evidence points to the continuing decline in clinical skills among medical students.11 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib11) This trend is deep and long term; it has now been observed over a 10-year interval. Also, the broader abilities and empathies needed by future doctors (more, not less, patient led12 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib12)) will demand a different emphasis, one requiring a distinctly reflective practice. Why? Because a more patient-driven practice is likely to undermine some of the authority and certainty that doctors have enjoyed. Doctors will have to be more questioning and analytical about their own clinical work; to be more willing to acknowledge the limitations of the care they give; to reflect explicitly about how their past experiences influence their current practice; to assess bad as well as good aspects of a consultation, what was omitted as well as included, and why; to study specific non-scientific literatures that might help them understand the feelings and anxieties of patients with particular illnesses; and, finally, to fit all these things into an already busy clinical schedule.


Two themes emerge from these arguments. First, there is a need to boost the lifeworld of medicine with a substantial infusion of humanities subjects either before or during medical school. This proposition has been supported in medical journals13 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib13) and by the UK's General Medical Council. Medical schools have been slow to take up these promptings. The Lancet's interest in the humanities has several origins, but perhaps the most important one, for me at least, is that reading encourages quiet contemplation about the words and ideas flowing from another person's mind.14 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib14) Thought of in this way, reading complements and encourages listening, perhaps the most under-rated of all clinical skills.


Second, there is a growing interest in how an individual's personal awareness may be an important means to understand how we react to patients. If doctors have explored their own behaviour (eg, their response to bereavement) they are likely to be freer to understand why a patient is reacting in a particular way and to adjust their own actions to the prevailing circumstances. Novack et al15 (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bib15) have reviewed their experience of introducing a programme for promoting a physician's personal awareness. They conclude that,


“Too often, physicians learn difficult lessons in solitary reflections or by chance discussions in hallways or cafeterias. More unfortunately, they can also learn difficult lessons through professional censure or malpractice litigation. If medical educators respond to the challenge of instituting and evaluating activities that promote personal awareness, it could have important consequences for physicians and patients”.


It is these reflective skills that would be acquired by a university undergraduate education before the medical course. Once these analytical skills have been learned, the business of developing clinical skills can begin apace. The truly graduate clinical school would have required students to develop abilities before entry that are not easily found in current undergraduate medical courses since the pressure to learn quantities of fact displaces any other learning imperative. A pilot of the truly graduate medical school in the UK seems worth considering.


* (http://www.sciencedirect.com.ezp.lib.unimelb.edu.au/science?_ob=ArticleURL&_udi=B6T1B-3SVRXJC-1K&_user=559483&_coverDate=03%2F14%2F1998&_rdoc=1&_fmt=full&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_acct=C000028178&_version=1&_urlVersion=0&_userid=559483&md5=bfd2e1e91d987ce98ecb3483118f919a#bfn1) Left [I]ureter; inferior mesenteric vein; sympathetic trunk; small intestine; peritoneum; duodenum; left crus.

[CCY_to_the_top]

so will JPA send students to Australia???

[Miracle_seed]

so will JPA send students to Australia???If you check the JPA list, Australia is still in for medicine this year. However, sometimes things might change that if they no longer want to send students to a particular country, they might change it to another country after your preparatory course, though this doesn't happen often.

[runninghorse]

so will JPA send students to Australia???

Yes. Not all universities in Australia change the medic course into graduate entry.

There are still many options like Adelaide, Western Australia, Queensland, Sydney . . .

[vseehua]

Thread closed because of redundancy. Please continue your discussions here (http://www.recom.org/forum/showthread.php?t=8485)