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Learning / Practising Medicine in the Changing World

*Dr.T.V.Rao MD

I still remember memories of my teachers in Medical College in 1960s. They were simple, humble, knowledged and committed to their profession. There were few books available to us and otherwise we were unable to afford or own many books personally. The available books were reputed and written by many authors who contributed few chapters who had a real experience, even same concept continues with many western publications, and India too catching up. India has grown far and wide, we have many authors, plenty of guides, all are edited my one or two authors who have no first-hand experience on many topics, but just good composers of books. I still remember one who studied surgical methods by Dr Das still cannot forget what a flaw less book it is, he who understands little of it can make no basic mistakes. Today we are not able to grade the books with demands in Medical, Nursing colleges. Regulatory authorities specifies number of text book copies to a subject to be available for Inspection, so it has become a thriving place for every inferior quality of books entering into every medical establishment and every library. Many teachers criticise that information available on the WWWInternet is not authentic but to find, it is far more superior to many available books in our libraries. Indian Medical education definitely growing through many crises because many become experts and specialists without practising the fundamentals of Science or Medicine, we are certain to turn out bad Doctors.

Rapid increase in Medical and Nursing Colleges, lack of teachers and lacking of interest to teach is creating havoc in the country. No regulatory body can control these colleges every day, so the students too left to their own choices of learning, which is certainly dangerous trend to future of Indias health sector. Many post graduate degrees are awarded without basic knowledge of a good MBBS student. Many Universities are on their own regulations awarding Degrees which are of doubtful use to the Society. People criticize the Internet that is spoiling the younger generation I wish to ask how many classes a senior teachers is taking and if it is the state, that students have no option than accept the path of least resistance i.e. Internet, and good teachers become indifferent to the system with which they are living. Internet is becoming a source of knowledge for learning and execution of practice, and the Internet is widely used in medical education. Educational courses for doctors and medical students are increasingly offered via the Internet. Despite much research, course developers remain unsure about what (if anything) to offer online and how. Prospective learners lack evidence-based guidance on how to choose between the options on offer. The great questions remain How can Internet-based learning, be effectively implemented? and When should Internet- Based learning is used? Internet has proliferated beyond ones imagination, as the future of Internet-based medicine is to tie together many different entities: clinical services such as reference laboratories, offices, and hospitals, as well as administrative services such as pharmacies and health plans. Unfortunately, it is not easy to implement this convergence, as the different health care elements are not always well organized to begin with. Physicians and students simply log in with a modem from wherever they are. They use their browser to go to a certain Web site that the Institution provides. The institution has a firewall can block unwanted

distracting websites and a certificate server to authenticate precisely who the user is. In addition, it provides a secure locked session with everything encrypted, which is governed by Institutional policy. The use of computers in most spheres of medicine has rendered the use of Internet for medical teaching and research very easy. A survey on Internet use amongst health care professionals found that, many of the educated patients discuss the information found on the net with their health care provider. Several doctors found this to be helpful as it improved communication, with more knowledge, made the patient a better partner in health care, and saved time in explanations. However, few doctors felt that it was not helpful, as there was a risk of patient self-treatment. As we find in clinical practice whenever you diagnose a clinical condition many are browsing through WWW- Internet, on next visit we are in wait for many question from patients which may be unfamiliar to many of us, if you are not an Internet Savvy. However we Medical Teachers, Doctors and Medical Consultant cannot escape from Internet, as the information needs of the medical professionals include medical research, publication of Academic work which can be aided by the use of Internet. Right from the selection of the topic, to organizing review of literature, designing the research, finding the techniques to the discussion of the findings are facilitated by the use of Internet. One of the most common uses of computers continues to be in medicine is for communication by Email and searching for medical information. The other possibilities include e-Commerce that includes - sale & purchase of drugs, equipment, instruments, etc. The Internet offers a vehicle of self-promotion or advertisement for doctors and hospitals, though this may be a controversial ethical issue, which is taking many neo generation rich and ignorant patients into their hands. I sincerely feel all of us must adopt many matters on Medicine and advances in our practice through computers and Internet, as we have few teachers left to dedicate their time to us. It is certain that we are losing human

touch in teaching and practice of Medicine. The regulatory authorities should permit e-learning to be given priority in Medical, Nursing curriculum.