Concerns over Medical Graduates from Russia

“This is old news! Do we have to go thru this all over again?!”.

 

If you don’t want to get through this, you may leave. What I shall bring you here are the quotes from doctors in Malaysia who have valid concerns about our competence. It’s not just about us; it’s also about them and about Malaysian healthcare system.

 

Since they are not in our shoes, they can be wrong big time. These doctors in Malaysia are in dire need of information/opinions about graduates from Russia. Since they couldn’t get official reports, they have to depend totally on what they heard; either from their peers who have one or two Russian graduates as their underlings, or if one is dumb enough – from one or two rumors. Thus they generalize graduates from Russia according to “one or two” stuffs they heard.

 

Some people really defend and look up to the medical education system here. I totally respect that. However, from the views of concerned Malaysian doctors, these lame med students in Russia are simply convincing themselves that they are currently in the right system, that our whole 6-year education here is perfect.

 

These doctors only trust the harsh critics to our medical education. Funny, the critics mostly come from people who have never been to Russia or understand its structure of medical education. Funnier, some of the critics are from people who have nothing to do with medicine.

 

Thus I believe that an opinion is best heard from the critique within the system itself.

 

Here, I bring you different quotes from different texts from the concerned O&G doctor. I shall give more weight to the bolded parts of the texts.

 

HOs (Housemen @ House Officers) usually work like robots without using their brains. Even that, the robots have to be programmed with correct and up to date software. Many of these HOs came without any basic knowledge such as calculating EDD, Partogram, simple history taking, recognizing risk factors or diagnose some important disorder such as hypertensive disorder in pregnancy and gestational diabetes. They came with lack of these knowledge which they should have learn in their medical school. This reflect the quality of their medical school (or their dubious standard of selecting the medical students).

 

Imagine that you have to teach these HOs again and again, 5 or 6 time per year the same topics just to learn the basic. The housemanship in each posting is only 4 months, they should gain clinical management experience during this period. They should not come and trying to learn O&G as though they are fresh medical student. When you are in my position, I own my patients the responsibility of providing the patient quality care.

 

I totally agree that HOs (interns) have very limited time to think when they are at work. This is due to their exhaustion of overworking, running here and there seeing different patients with different problems. So they need to work like robots programmed with compatible software.

 

In my humble opinion, the Russian medical education does not provide “software” compatible to Malaysian healthcare system. The software needed is basic clinical knowledge and clinical skills. Unfortunately, our students here do not have correct study materials for certain subjects. We have to rely 100% on teachers’ substandard lecture materials because they are better oriented towards passing the  substandard exams. I call them substandard not because I am better at giving lectures than they do, it’s because some information is missing, not updated with the latest medical developments and their English simply sucks with simple annoying spelling/grammatical errors.

 

It’s not like we learn nothing. We really learn something; but only for 3-4 hours each day including more than half hour break in a two-week clinical rotation. What we learn here are mostly theories with very little clinical cases or integrated problem-based learning.

 

The homework we receive daily is to read and memorize a particular topic – and speak out what we read and memorized the next day in class. This homework is not easy, but what I resent is that this kind of homework only emphasizes on the ability to answer orally without any emphasis on “written medicine” (the best term I can come up with). The importance of “written medicine” is totally underestimated here. Apart from case reports, we practically have no other serious tasks for our coursework. Thus, the students here seem to have so much free time (like me, blogging nonsense). They simply read, then they play. The more serious ones will try to memorize – they are the rare breeds of our system.

 

It is very untrue that we do not learn basic knowledge. All of us here learn basic knowledge, but the basic knowledge is given only very little emphasis due to the very short duration of rotation and many topics to cover. In the end, it looks as if we did not learn a single basic knowledge.

 

I am sure there are fine Russian medical schools but the concern is the overall quality of the training Malaysian students coming from the region. It may be suspect if the students are weak and somehow get into medical school despite poor grades. On top of that the weak students have to master a foreign language so I can’t imagine how such weak students can even get through medical school.

 

The next issue is about admission into med schools. It is very true that to be admitted into Russian med school is very easy. Only one pillar is needed – money. Lately, the administration has decided to make the admission a little bit tighter with some new policies that I am not familiar with, but I bet that would not make any difference because the conditions of admission is not standardized by any exam. For example, to be admitted in med school in US, one has to ace MCAT along with several coursework in college years.

 

This is a worrisome trend. If students do not fight hard enough to get in, they will not fight hard enough to ace in studies and secure their medical education seats. They simply laze around thinking their futures are secured. Most of their time here is everything but medicine.

 

But somehow, thanks to the previous primary and secondary educations Malaysian students received, some of our students really struggle for greatness achieving greater heights in our medical education. They are those people worthy of getting this noble seat in the first place.

 

The weaker ones like myself are total losers in the system. We lag behind the bright students and are always demoralized for not catching up with the education system. We have no discipline, we have no motivation, we entertain ourselves a lot more than we study.

They only clerk average ONE patient in RUSSIAN in their posting in O&G. They spend most of their time studying their books in class room and their room (even though they are in clinical years). They have no written exam except viva.

 

In my entry Obstetric Rotation, I mentioned that I never saw any patient this semester. Our groups spent most of the time studying in classrooms. This is also very worrying since that we are already in our clinical years.

 

But I’d like to focus on how the exams are conducted here. While med students in Malaysia sit for uniform written exams, we med students here sit for non-uniform oral exam (viva). What does that mean? In Malaysia, a batch of students sit for the exam at the same time with the same questions. They write on papers and send those papers to examiners. Then they await exam results.

 

In Russia, our timing of exam is different according to groups. However, that is the least of the problems. The bigger ones are that we study like hell only to receive 2-4 little questions. And those questions differ for each individual  students. Still, those are minor problems. The much bigger one is that there’s no official written exam. What they assess is our presentation of answers. The lucky students read very little and received very easy questions. Unlucky ones – they read a lot, but  questions are damn difficult. That is the non-uniformity of examination assessment students here feared most.

 

Students prefer more lenient examiners to answer to. The varying English levels of examiners and students pose quite a problem. Sometimes the students answer just fine, but some English terms are unheard of to that examiner, making the assessment highly biased and unfair. Sometimes, if students answer something wrongly, the examiner would not explain where they went wrong. The worse thing is that if we ever forget something during the oral answer session in front of the examiner, most students will have panic attack and forget everything. If the exam is in writing like in Malaysia, the forgotten answer can simply be retrieved later.

 

Most Malaysian students who never had this kind of panic attack during exams before have developed fear of exams – because the exam is viva and students need to answer face-to-face with the stern examiner. But the good thing is, the exam result is received right after the finish of viva exam session.

 

The students never practice history taking because all patients speak Russian. They do nothing throughout the medical course till the graduation and be expected to perform as houseman in Malaysia.

 

This claim is false. We learn Russian language (medical and social). We see patients and practice history taking. But sadly, we don’t see enough patients. Thus explaining the inferior clinical skills. Although the supervision here is quite  decent and medico-legal aspects are not as tight as in developed countries, but somehow this fertile ground for med students to develop superb clinical skills gone wasted and unutilized. I can not fathom the reason.

 

What I wrote above are just the problems. I offered no solution. That makes me a bad guy, isn’t it? Think what you want to think, I really have no idea how to clean our very messy backyard. But if any one of my readers can offer brilliant solutions, your ideas will be respected for generations of Malaysian students studying in Russia.

 

I am sorry I have to say this but this is what I saw at the ground level. Those Russian medical students and HOs are the worst products that I ever seen. I do not blame them and they are not stupid, they just went to the wrong school.

 

For the time being, let’s just prove the above quote wrong!