Dr. Avinash Supe Dean, KEM Hospital, Parel, and Professor of Surgical Gastroenterology, Seth G. S. Medical College, Parel, tells Shraddha Kamdar
It has been a while since I interacted with a medical professional, especially one who has headed two prestigious institutions in the city and has oodles of experience is training students and tackling their problems from their point of view. Early one weekday morning, I went up to his office at KEM hospital so that he could devote some uninterrupted time to answer my questions. Which he enthusiastically did. Only when I left his office I realised at what cost he did it, since there was already a long line of visitors waiting patiently for their turn with him. This week, Knowledge presents a few thoughts and ideas of Dr. Avinash Supe – Dean, KEM Hospital, Parel; Professor of Surgical Gastroenterology, Seth G. S. Medical College, Parel and Ex-Dean – Sion Hospital, Sion. Excerpts:
How do the students learn life skills one they enter first year MBBS, because by the time they start with the programme, they have devoted most of their time only to studying.
KEM is a place where the focus is on practical training in the true sense. Students from all over the state, and even the country come study here, and they see all kinds of human stress, among their peers, among the patients and otherwise. Over 60% of our patients are from outside the city, and students see all kinds of emotions and situations – those who have hope, those who have no money, those who have no understanding of their medical condition. Our students treat these patients and develop human to human interaction skills among many others. They develop an attitude towards being a medial practitioner, which is extremely essential for this profession.
They also learn managerial skills during the programme, and become complete human beings during the MBBS programme. They undergo a variety of experiences both personally and professionally and they will always cherish what this institute has taught them.
How important is it for a medical student to develop compassion?
Of course it is, and they do learn it during the course of the programme. It is the duty of the seniors and the peers to bring in this compassion among students. Say for instance when they see a case of amputation for a young person, or a case of paraplegia, they would think about how society would react to such a condition, and what effect some of these diseases would have on the patients and their families, and also on their occupations.
Often, since the students are witnessing such cases day in and day out, a sort of compassion fatigue sets in. That’s when they become more focused on knowledge. But over a period of time the teachers strive to work towards this feeling. Students are also trained to not bring their emotions or compassion into the dining room. That’s a small way in which their survival instincts come handy. They need to attempt everything, and yet not get too involved. In case the worst happens, and they lose a patient, they should learn from it for the next patient. The teachers and mentors are constantly helping them realise this.
How to they deal with the stress?
In a study we did a while ago, we studied the whole concept of stress. It showed that stress factors were academic, emotional and logistic. For medical students, academic stress is the most important. All the students who come for MBBS here are toppers in their own way, and they are used to putting in the hard work and effort to achieve their goals. They want more. So instead, we look at the relieving factors. We have cultural, literary, music and sports activities where they get involved and enjoy themselves.
Students at KEM have a good peer network and support system. Thus, stressful factors are caught early on and dealt with well. There are ways to deal with the stress, but we cannot take away the stress. Previously there was a suicide trend, but that has been dealt with and overcome.
What if a particular student cannot cope?
Dropouts are quite less, and mostly it is due to the fact that the student made a wrong choice. The problem at admission is that only marks are considered. Actually we also need to factor in that we need to create service oriented doctors, not money oriented doctors. We have had a few cases in the past where after passing MBBS students have gone to handle their family businesses. Some have even gone to become police inspectors. That’s a waste of seats. But such cases do exist.
How do students react when they see a cadaver for the first time?
Well, there are cases where students get scared, and some even vomit. But in recent times, colleges are putting in tremendous effort to orient them with net simulations and slides, especially to inculcate respect towards the cadaver. In fact, they are now physically brought in contact with a cadaver in a graded fashion. That said, we also need to understand that the anatomy lab will still have the formaldehyde smell. That is something the students have to get over.
Some institutions also do a formal ‘pooja’ at the beginning and a thanksgiving at the end of the term so as to respect the cadaver. Thus, attitudes are cultivated to make the student experience much better.
How has the MBBS programme evolved over the years to keep up with the research as well as new developments in disease as well as medication?
Many revisions have take place over the years, and the last one was in 2012. Sometimes I feel that new knowledge is readily being incorporated in the curriculum, but the old is not done away with. I feel that some amount of flexibility should be incorporated based on local needs. They need to be oriented and early clinical exposure, according to world standards and needs of society.
The most important factor is that we have to try to make a competent physician. With new changes which are likely to be implemented soon, that should happen. The attempts are being made and they should have a lot of impact.
How can those students who may not have adequate exposure or infrastructure improve their knowledge?
Initially, they may struggle, but then they learn. Once computer- and internet friendliness sets in, these students may even surpass city students with their capabilities. They have to work hard though, especially those who are not from the English medium. But they are ready for the challenge. Years ago, not many of us had that benefit of English, but we survived and rose up to wherever we are. So will these students.
