The current fashion in teaching doctors, which allows medical students to decide what they want to learn and how to go about it, is strongly criticised in a paper published in the British Medical Journal this week (10th July 2004).
The authors argue that the new ideology may damage medical training in this country, and that there is now a risk that gaps in basic knowledge could actually interfere with a doctor’s ability to diagnose and treat illnesses.
Both authors are at the University of Bristol. Professor Gareth Williams is Dean of the Medical School and Alice Lau is a fourth-year medical student. Although Lau will enter the medical profession almost thirty years after Williams, both are passionate supporters of a balanced medical training in which clinical experience is properly integrated with a sound understanding of the scientific basis of medicine – traditionally regarded as the essential foundation for becoming a doctor.
Currently gaining popularity in the UK is an approach that rejects the systematic and in-depth teaching of subjects like anatomy, pathology (the study of disease), and pharmacology (the study of drugs and their effects), in favour of ‘problem-based learning’ (PBL) which is directed by the students themselves. PBL is being promoted by enthusiasts as liberating students from the drudgery of learning facts, and improving their problem-solving skills. Lau and Williams argue that while PBL may be a more ‘humane’ teaching alternative, it deprives students of contact with inspirational teachers, and that cutting back on basic medical knowledge is a false economy.