Continuing medical education

A couple of years ago, my relative from Burma was visiting Britain, staying at home for a month. He noticed I was reading medical books and journals as my hobby or my task or whatever it was described.

"Work hard, Steve. Study harder to get a higher level"

His expression made me surprised. I was not preparing for any exam. I was doing a routine thing as a doctor. But in his eyes, I had to keep reading books because I still needed to learn a lot. He treated me as a student, patronising me a lot. I did not explain too much why I had to read books while working at hospital in Britain. I felt it was not worth doing so. He was just a visitor going back to Burma in a few weeks.

Basically, it is compulsory in Britain that all levels of doctors, from first year medics to consultants and professors, to do "continuing medical education" while practising. We need to keep updated with recent developments and advances in medicine while refreshing existing knowledge and skills. That is part of the duty of a good doctor. We are entitled with study days and leaves for that purpose. We need to attend education meetings and conferences .

I am wondering how a consultant physician from Burma seeing patients till late evening after working from 8Am to 4PM at hospital, would have a chance to update his or her knowledge. At the same time, I believe if patients and their families in Burma found out that their doctor keeps reading medical books, they would not trust him/her any more with the thought that our doctor had not got enough knowledge yet , but still studying. They might move to new doctors.

I still remember my early career when I ran a private clinic in Insein, northern part of former capital city, Yangon. I treated minor illness with pills and I did not request too much laboratory tests. There was a specialist clinic nearby. At that point, a funny thing was going on. The local people had been spreading words, saying that the specialist doctor from that clinic had no idea how to treat without blood tests and claiming that that young doctor, it was me, was much better. Every evening, there had been a long queue in my clinic.

Next, it is disappointing that there is a poor referral system in Burma. The doctors want to keep their patients with them for some reason, regardless of the conditions. My aunt has a sleeping difficulty and anxiety , and a cardiologist has been treating her with sleeping pill for many years, instead of referring to a psychiatrist or counselling service. Again, from the patient point of view, if they are advised to see other doctor for a different problem , they may think the referring doctor is not efficient. I heard several similar stories before. So we can't blame doctors' way of practice in Burma. But I believe general people would need to be educated. At the same time, the authorities concerned need to make sure the referral system in Burma running smoothly and effectively for the sake of our patients. Reinforcement may be required.



Friday afternoon Library at the hospital I am working


Evidence based Medicine corner


Reading a medical journal