For academic career clinician should possess both clinical and research qualifications

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 Medical Education & Research

For academic career clinician should possess
both clinical and research qualifications

Universities should start pure research degrees in the
clinical subjects and eligibility should be FCPS

Life blood of development of any scientific discipline
is infusion of research in medical education

Lt. General Mahmud Ahmad Akhtar1, Major General Muhammad Aslam2

Teaching without research is barren. Research enriches teaching, contributes to learning and by its discoveries, transforms our lives. Educational development depends upon both teaching and research. The research is closely linked with teaching and together determines their intellectual tone. Without research teaching without critical and analytical thinking becomes recall of factual memory learnt by rote. The critical and analytical thinking ability, power of imagination and the originality in teaching can only be inculcated by research activities. A multi-faceted approach of an academician is presently considered to be a balanced combination of teaching, research, publication and medical administration. Without this multidimensional role of a teacher a coherent and integrative approach in medical education cannot be adopted.


LT. GEN. (R) MAHMUD AHMAD AKHTAR

In the current years such an approach in academics is considered to be the real essence of medical education. Regarding publication well known phraseology is ''Publish or Perish''. The progress of nations and universities is assessed by their publications. Publications are only possible through research work, diligence, reasoning, thoroughness and knowledge. These assets show that the teacher has researched in a particular field and therefore has special knowledge in that field. Not only do the students benefit from research but also the patients, where by the heath care system improves too. There is a scope for improvement by research in every doctor's field, even in general practice, by using simple methods. As an example in the UK, general medical practitioners played a vital role in the peptic ulcer research. There are many types of research methodologies like descriptive, retrospective, prospective and manipulative (Clinical trials etc.) which are within the reach of every doctor. Research does not mean working with sophisticated equipment only. In fact research is done in every discipline of knowledge be it languages, art or science and may need only simple facilities. Medical teachers should allocate their time to teaching, patient care, research work and administration in proportion to the requirement of the responsibility they have.

A postgraduate degree is only a gateway to a teacher's career. A research degree however forms a good foundation for acquiring wholesome knowledge so much so that in UK, Germany, Japan and other progressive countries, a research degree is essential for a doctor to have career in academics. Education and training in administration is also required to acquire managerial skills to run the departments, institutions and projects etc., efficiently. Life blood of development of any scientific discipline is infusion of research in medical education.

In the British System, there were university post-graduate degrees in the clinical subjects, in medicine MD/ DM (doctor of medicine) Its equivalent in Surgery, MS (Master of surgery) or DS (Doctor of Surgery). These consisted of two parts part one research thesis (of the standard of PhD/ Dphil etc) and part-11 exams, consisting of three theory papers and three practical’s, basic sciences, general medicine, general surgery, special subjects. The British Royal Colleges produced clinical qualifications like MRCP, FRCS, MRCOG etc, there was no research component.

For services in the armed forces and other organizations. University doctorate (dual clinical cum research), though MD /MS were given equivalent status to the Royal colleges post graduate diploma but had precedence (Regulation of Medical Services in India (RMSI 1929) being placed first followed by Royal college qualifications. Later on most of the British universities made MD, MS pure research qualifications like PHD DPhi etc. In the UK those doctors who seek careers in academics do academic qualifications like doctor of medicine/doctor of philosophy (D Phil) after obtaining the clinical qualification. In this system clinicians are produced by the colleges and research work is produced in the clinical subjects at the universities like other disciplines of knowledge including Basic Medical Sciences.

In Pakistan, the universities continued with the old British MD/MS system. The problem was a very few postgraduates were produced in the clinical subjects because of thesis writing which took a lot of time due to lack of guidance and facilitation. Most of the doctors had to go to UK for higher clinical qualifications later to the USA also, later the facilitation decreased.

As an example only fourteen MDs were produced by the Punjab University from 1914 to 47 and a few ones up to 1960. In order to solve this problem the Pakistan Government established the College of Physicians and Surgeons producing higher clinical qualifications. The universities continued with their system producing only a few postgraduates in the clinical subjects. India continued with the university system of producing MD MS i.e. clinical cum research qualifications which is done in the most countries in the world except the USA which has a system of Boards for the clinical subjects. In the USA enormous research is done in the hospitals affiliated with the Boards.

In Pakistan the research is extremely meager in the clinical subject’s even less than tiny islands like Sri Lanka, Hong Kong, Singapore and other small countries. In order to develop research in the clinical subjects it is suggested that there should be pure research degrees in the clinical subjects at the universities, the eligibility should be those having FCPS in the clinical subjects. For an academic career in the clinical subjects it should be mandatory for the clinician to possess both clinical and research qualifications. In this way teaching will improve as well as research output in the clinical subject. The universities dual qualification may be stopped in the near future for creating a uniformity.

1. Prof. Emeritus Lt. General Mahmud Ahmad Akhtar
    Former Surgeon General Army/ DGMS (IS)
    Former DG Medicine Armed Forces

2. Prof. Major General Muhammad Aslam
    Former V/C University Health Science
    Pro-vice chancellor National University of Medical sciences,
    Rawalpindi - Pakistan.

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