Teachers should be trained how to identify the problems & they must talk to students affectionately- Waqar Azeem


 The Psych Lounge during Prescription for Wellness Conference
Teachers should be trained how to identify
the problems & they must talk to students
affectionately- Waqar Azeem
We teach them good medical knowledge but we need to
ke them better human beings which will make
them better doctors
Students should be member of the Academic Councils;
they should asses the teachers though at present it
is being opposed by senior teachers- Dr. Ali Hashmi

By Shaukat Ali Jawaid

LAHORE: One of the most important sessions during the recently concluded International Psychiatric Conference on “Prescription for Wellness” was the Psyche Lounge. This session was chaired by Prof. Waqar Azeem a renowned Child Psychiatrist along with Dr. Amina Ahmed a medical educationist, Dr. Saida Saleem, Dr. Tazvin Ijaz, Dr. Durre Shahwar, Dr.Ali Hashmi and Dr. Nazish Imran. This session was moderated by two brilliant medical students Mr. Salar Haider and Suchna Meeral Khan and the way they conducted the session was very heartening and it also showed that the future of psychiatry is very bright in Pakistan. During the whole deliberations some exceptional contributions were made to the discussion by Dr. Ali Hashmi, Dr. Amina Ahmed and Prof. Waqar Azeem, Dr. Tazvin Ijaz not to forget the other panelists and experts who also enriched the discussion with the valuable comments.

Some of the important questions raised in the beginning of the session were the reasons and major stressors for growing mental health problems among the students in our colleges, the stigma, what are the barriers to reaching out and seeking help and how does one identifies the red flag in one’s self and others and how do we seek help besides how mental illnesses are treated and what was the role of medications? These are all very important questions indeed. It was pointed out that it was extremely important to identify the mental health issues as early as possible. However, people start neglecting it. We must know what interventions these people need and must also keep in mind the stigma in public and among the healthcare professionals as well. The role of faith healers also figured up during the discussion. It was highlighted that when something unusual is happening, we get offended. We need to accept the problem exists, only then one will seek treatment. At times it is late. Sometimes the patients do not have good experience with the doctors. We need to help patients to overcome all this as early intervention ensures better and good outcome. It is also important that services should be available and we must pick up these patients with mental disorders as early as possible. We have scarce resources, very few qualified trained psychiatrists, and hence these services are not easily available all over the country. There are numerous barriers to seeking help. Psychiatrists are not available in small cities and towns hence it is essential that mental health resources are made available.

Prof. Waqar Azeem alongwith other panelists chairing the session on The Psyche Lounge.
Photograph from (L to R) shows Dr.Amina Ahmed, Dr. Nazish Imran, Dr. Ali Hashmi,
Dr. Tazvin Ijaz, Prof. Waqar Azeem and Sadia Saleem.

While discussing the role of medications, it was stated we must discuss is it enough? This, some of the panelists opined, was a unique session during the conference and your wellbeing is important but primary prevention is all the more important. For any intervention, scientific evidence should be there regarding its safety and efficacy. Anxiety and depression are most common in medical students. It is more common during the first two years particularly among those who live in hostels. These disorders are also more common in female students. Since we have less time we think medication is the solution although social factors are more important than biological. We need supportive teachers, medication is the last. Psychological interventions should be preferred and medication is only needed when all functions are severally affected. Dr. Nazish Imran stated that student’s health centers should be set up at all medical institutions. There are institutions which have three to four full time counselors on the campus. These health centers should look after health of the students including mental health. They should be doing better. At times there is reluctance to see psychiatrists hence it is better that these health centers are located in the university rather than in the hospital which will be an added barrier.

There are students, teacher’s dilemma due to communication gap. It is essential that the teachers should come down to the level of students. It is the teachers who should take the lead and open communication channels with the students. They should encourage the students to open up and discuss their problems and talk about their issues. The teachers should not be judgmental. They must come to the same level. Dr. Ali Hashmi opined that we teachers also learn from the students. At times some students are treated unfairly. Dr. Ali Hashmi highlighted the importance of accountability of the teachers and felt that the students should assess their teachers. The King Edward Medical University, he further stated, has such an assessment Form on its website. He encouraged the students to give their feedback about the teachers. It is not only the undergraduates but postgraduates as well who should give us the feedback. Teaching modality should be changed. It was pointed out that the confidentiality of those who assess the teachers and give their feedback should be ensured. It was important to change the institutional culture to get honest feedback. Dr. Nazish Imran stated that all teaches should be assessed. The university authorities, administration can also post some people to assess the teachers. There is a generation gap between the students and teachers which affects the relationship between them. Prof. Waqar Azeem was of the view that the teachers should be trained how to identify the problems. They must talk to the students affectionately. Teachers should be considerate, accommodating and supportive. They should help students to cope with mental health issues. Teachers, he further stated, are part of the system and we need to fix the system. Lectures are good and bad and we need to find out why they are so. We do teach the students good medical knowledge but social, personal leadership skills are neglected. We need to make them good human beings which will make them better doctors. Students will follow the teachers. Teachers, Dr.Ali Hashmi stated, must be able to say we do not know the answer. Say sorry if something is wrong. They need to fill up the gaps between parents and friends. They should help and guide the students. Recreate things with more light; ensure help by students and teachers. We need to improve the curriculum to attract students. Students are not interested in lectures but they need more discussions.

Prof. Javed Akram VC UHS presenting a memento to Mr.Shaukat Ali Jawaid Chief Editor
of Pulse International at the concluding session of Int. Conference on Prescription for
Wellness held at Lahore recently. Also seen in the center is Dr. Nazish Imran the
organizing secretary of the conference.

The issue of mandatory attendance also came up under discussion and it was pointed out that it is the requirement of the regulatory bodies; hence we have to maintain it. Though we know at times students mark attendance for others not present in the class as well. Dr. Amina Ahmad remarked that teachers should be engaging. According to the principles of adult learning, students will pay more attention if the teaches are more passionate about teaching. Particularly in basic sciences people do not come by choice. It was also pointed out small group teaching is much better and more effective but in large group of students this does not work. We need much more resources, faculty and other teaching training facilities for small group interactive discussions. One does not become a teacher just after getting some postgraduate degrees. Some degree or diploma in teaching is essential. It is good that now the PM&DC has made it mandatory that all faculty members must have at least attended a Certificate Course in Teaching, which has been started by many medical universities and other medical institutions. Dr. Tazvin Ijaz pointed out that at Government College, they have student’s health center at the institution and they have full time counselors. We look at the students problems. We need qualified people to work as counselors, she further stated. Dr. Amina Ahmed opined that intervention in the home institution is the good option. Now research has assumed much more importance and students are encouraged to undertake research and they get due credit and points for this when they apply for jobs or Residency in UK, USA, if they have done some research before graduation. Self-directed learning is immensely important.

One of the participants referred to high suicide rates among medical students in one of the studies. Responding to this Dr. Ali Hashmi said that there has been no such study on this as far as he knows in Pakistan. Role of good mentors was also highlighted. It was also stated that some medical teachers are in the medical institutions for other reasons but they have no passion for teaching. Every institutions, it was said, should have an internship and research programme. At this one of the participants complained about the red tape in getting hospital data for her research topic from various hospitals. Dr. Amina Ahmed responded by saying that there are some ethical issues involved and these restrictions are in place even in UK and USA. Some identity and information has to be protected but as regards the fear that the topic of your research will be leaked out to others, it is the duty of the hospital to keep all the documents submitted by the researchers confidential.

Mr. Salar Haider and Suchna Meeral Khan the two medical students from KEMU
conducting the session on The Psyche Lounge during the International
Conference on Prescription for Wellness recently held at Lahore.

Dr. Amina Ahmed further stated that we also need to modify our examination system. Assessment should be valid and reliable. It is important to know how the attitudes are being taught. What quality assurance measures are put in place? Curriculum and examination system needs major overhaul. It is said that the First and the Final professional examinations are the killers. Assessment should be done during the whole year. One can have just Pass and Fail and not bother about the Grades. We must inculcate the concept of thinking in the students. We need to do problem solving. Questions should force the students to Think. Students should be represented in the Academic Councils though at present it is being resented and opposed by some senior teachers. Dr. Amina Ahmad remarked that in the recent PM&DC regulations the students are supposed to be in every committee. Dr.Ali Hashmi opined that in the past representatives of students unions used to perform this duty. We need to get back to that minus the politics in which students unions used to indulge. These students’ representatives in different committees should be selected by the students themselves.

During the discussion it was also stated that the Third and Fourth year students can help and guide the First and Second year students. Many professors have a paternalistic attitude and approach as in our society, it is the parents which most often decide what is good for their children, including their choice for further studies, professional career and even when and where they will get married. Dr. Ali Hashmi was of the view that the children should be given the choice to explore their own passions. There are instances where parents force their children to become doctors. Passionate students will be much better doctors than those who opted this profession under compulsion. Government College Lahore it was stated has qualified people as counselors and mentors. These counselors should also be held accountable as to what they are doing for the students. Dr.Ali Hashmi suggested that before getting admission to medical colleges, the students must go through medical, physician, mental and surgical checkup.

Summing up the discussion Prof. Waqar Azeem commended the panelists as well as the participant for their excellent thoughts, suggestions. He particularly commended the students who had moderated the session saying that he has never seen such a good session at any international psychiatric conference. Credit for all this of course also goes to the organizers Prof. Imran Ijaz Haider and Dr. Nazish Imran for having thought of such innovative ideas and introduced many innovative things at the conference.

Two NGOs set up by the medical students i.e. AWAZ and ZAINHAQ which are active in creating awareness about mental disorders and providing counselor services also collaborated in organizing this session.

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