Education, Medical, a process by which individuals acquire and maintain the skills necessary for the effective practice of medicine.
To train as a conventional doctor in the Western world a person needs to have achieved a good level of understanding in the sciences (for example, physics, chemistry, biology), either at senior (high) school or at college. Medical schools are usually part of a university (although not all universities have medical schools) and they offer only a limited number of training places in any one year. This results in fierce competition for places, with only the best students being admitted.
Most medical schools offer a training course of between three and six years in duration. The curriculum is traditionally divided into two parts: a preclinical course in which the basic science of how the human body works is studied; and a clinical course in which the student is introduced to actual patient care in a hospital. The former is usually taught in science departments at the university and the latter at a hospital affiliated with the university.
The preclinical course involves such areas of study as the gross and microscopic appearance and connections of the human body (anatomy), the organization and basic functions of different types of human cell (cell biology), the function and underlying biochemical processes of parts of human cells (biochemistry), the integrated functions of tissues, organs, and body fluids (physiology), the principal actions, distribution, and elimination of drugs in the body (pharmacology), the general principles underlying disease processes and such disease-related micro-organisms as viruses, bacteria, and parasites (pathology), the defence mechanisms of the body (immunology), and the structure and function of genetic material in living and infected cells (genetics).
The clinical part of the course involves medical students working with experienced doctors in general practice and hospitals to learn family practice and general medicine, and such specialized areas of health care as surgery (removal, reconnection, or transplantation of parts of the body), obstetrics (pregnancy and childbirth), paediatrics (diagnosis and treatment of childhood complaints), gynaecology (diagnosis and treatment of ailments of the reproductive system), geriatrics (diagnosis and treatment of ailments suffered by elderly people), and psychiatry (diagnosis and treatment of mental ill-health). During this time, medical students observe and learn from doctors working with patients on the wards and in specialist clinics, and gradually, under their supervision, become involved directly in the provision of health care (for example, diagnosis and administration of therapy).
Students have to pass examinations in all of these different aspects of the course, which take to form of written, practical, and oral tests. Upon graduating, they received a Doctor of Medicine (MD), Bachelor of Medicine (BM), or an equivalent degree. New doctors swear the Hippocratic Oath (or an equivalent professional statement) to adhere at all times to high standards of medical practice and ethics, and to protect the right of every patient to life, dignity, and confidentiality.
It is usual for “junior” doctors to serve at least one year as an “intern” or “house officer” and to have responsibility for both diagnosing and treating patients in the hospital. At this point, they choose to move away to a new hospital. Such a post, however, is considered to be an extension of their training with overall responsibility for their work resting with the senior colleagues supervising their work. In most countries, “junior” doctors often complain that they work excessively long hours for relatively poor pay (that is, relative to other professionals after several years of training).
During his or her time as a junior doctor, an individual must decide whether to work in general or in a specialist branch of medicine. If the latter, the doctor applies to work with a particular specialist and his or her team and once accepted embarks upon a training course which lasts for several years; the training being obtained largely by the experience of working with other more experienced doctors in the group. During this time, he or she is called “registrar” or “intern” and the training culminates in both written and oral exams set by an official body on that subject (for example, the Royal College of Pathologists or the Royal College of Surgery in the United Kingdom, both of which decide whether a doctor is sufficiently knowledgeable and able to practise as a specialist in that particular area of medicine). If successful, the doctor is awarded “membership” of the college.
It is important that doctors keep up with medical progress (the results of medical research concerning new forms of diagnosis and treatment). Most often this takes the form of reading medical journals and books, attending conferences, and discussing medical matters with other specialists in the same or different fields. More recently, doctors have been able to communicate with one another and receive the latest medical information using the Internet (often referred to as the “information superhighway”), which can link computers used by doctors in different hospitals and/or general practices around the world.
Some doctors, especially those in general practice, choose to incorporate such unorthodox medical techniques as acupuncture or reflexology (see Complementary Medicine) into their medical practice and offer these to their patients, where appropriate, usually in parallel with more conventional treatments; these are seldom offered as an alternative to conventional Western medicine. So popular are some of these unorthodox methods that some medical schools are now offering training courses on these topics for both trainee and postgraduate (that is, experienced, practicing) doctors.
Claire Elizabeth Lewis