Sunday, September 13, 2009

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

13 comments:

Rita said...

အဲဒါေၾကာင့္ engineering စာအုပ္ေတြ ေက်ာင္းၿပီးေတာ့ ကိုယ္ဘာမွ မကိုင္ေတာ့တာေပါ့။ ကိုယ္အားလံုး တတ္ၿပီးသားလို႔ လူေတြ ထင္ေအာင္ :P

" ေဆးကုေသာ ဆရာ၀န္သည္ ေကာင္း၏။
ပညာေပးေသာ ဆရာ၀န္သည္ ပို၍ေကာင္း၏။
သုေတသန လုပ္ေသာ ဆရာ၀န္ကား အေကာင္းဆံုး ျဖစ္၏။ " တဲ့။

ကိုယ္ဖတ္ဖူးတာ ေျပာတာပါ။
ေမာင္သစ္ဆင္းရဲ႕ ၀တၱဳတိုတစ္ခုမွာ...၇ တန္း ၈ တန္းေလာက္က ဖတ္ခဲ့ရတာ။ တကယ္ေတာ့ ဆရာ၀န္ေတြအေၾကာင္း သိပ္မသိပါဘူး။

But I think u was born to be a doctor!

:P said...

ျမန္မာျပည္က ဆရာဝန္ေတြလည္း အနည္းနဲ႔ အမ်ားစာေတြ ဖတ္ေနၾကဆဲပဲလို႔ ထင္တာပဲ...။

ေဆးရံုမွာ တာဝန္မ်ားလို႕၊ လခနဲ႔ မေလာက္လို႔ ေဆးခန္းထိုင္ရလို႔ အိမ္ေထာင့္တာဝန္နဲ႔မို႔အခ်ိန္မေပးႏိုင္လို႔ ဆိုျပီး အနည္းနဲ႕ အမ်ားေတာ့ကြာခ်င္ကြာမွာေပါ့ေနာ္....။
(တို႕ ပတ္ဝန္းက်င္မွာ ဆရာဝန္ရွားပါတယ္ .. အထင္ကိုေျပာတာ)

:P said...

ဟိုက္.... ေကာမန္႔ ေမာ္ဒရိတ္လုပ္ထားပါလား... ေခတ္မီေအာင္လား....ငွင္....

ေျပာလက္စနဲ႕ ဆက္ေျပာလိုက္ဦးမယ္...။
နယ္ျမိဳ႕ကေလးမွာ ေနခဲ့တာ...
ျမိဳ႕သူျမိဳ႔သားေတြက ေနမေကာင္းျဖစ္ရင္ ေဆးအျမဲထိုး၊ ၃ ရက္ေလာက္ခ်ိန္း၊ အေၾကာေဆးမၾကာခဏ သြင္းေပးတဲ့ ေဒါက္တာငယ္ငယ္ေလးဆီမွာ စည္ကားျပီး လိုအပ္မွ ေဆးထိုး၊ ေသာက္ေဆးပဲေပးတဲ့ အျငိမ္းစားေဆးရံုအုပ္ၾကီးဆီမွာေတာ့ေဆးမကုခ်င္ၾကဘူး..
ေဒါက္တာေလး ( အသက္ ၄၀ေလာက္) ကုရင္ ခ်က္ခ်င္းေပ်ာက္လို႔တဲ့ ။

ဆက္မေျပာခ်င္ေတာ့ဘူး... ကိုယ့္ျမိဳ႕အေၾကာင္း မေကာင္းတာေတြ အကုန္ေပၚကုန္မယ္....

ShwunMi- said...

လူေတြအားလံုး က်န္းမာဖို႕ဆို စိတ္အာဟာရလည္း မခ်ိဳ႕တဲ့ဖို႕လိုမယ္..

than win htut @ dvb said...

ကိုု စတီဗ္ ေရးတာျမင္ရေတာ့ ငယ္သူငယ္ခ်င္း ဆရာ၀န္ေတြ ျငည္းၾကတာေတြကိုု ျပန္သတိရပါတယ္။
အျမဲေလ့လာေနရတာကေတာ့ က်ေနာ္မ်ား မာလ္တီ မီဒီယာသမားေတြလည္း ဒီလိုပါပဲ။ နည္းပညာ လက္တံေတြက ဆန္႔ထြက္လာတာျမန္လြန္းလိုု႔။ ကိုု အျမဲစိမ္း စတီဗ္ တေယာက္
ျမန္မာလုုိ ေရးတာေလးမ်ား ရွိရင္လည္း ဖတ္ခ်င္ပါတယ္။

Rita said...

I meant I think u r a born doctor.

ksanchaung said...

အသုဘ႐ႈရ၊ ေဆးက်မ္းဖတ္ရ၊ အြန္လိုင္းေပၚတက္ရ၊ ေကာင္မေလးေတြနဲ႔ႏႈတ္ဆက္ရ၊ ဟင္းေျပးခ်က္ရနဲ႔ အန္ကယ္လည္း အေတာ္ပင္ပန္းရွာတယ္။

ဝက္ဝံေလး said...

Thanks for your birthday wish Steve

bye take care

Rebel said...

ျမန္မာေတြ ဘာေၾကာင္႔ ေအာက္က်ေနရလဲ (၁)

Rebel said...

ျမန္မာေတြ ဘာေၾကာင္႔ ေအာက္က်ေနရလဲ (၁)

Unknown said...

ကြ်န္ေတာ္ထင္တာ မွတ္ထားတာကေတာ့ ဆရာ၀န္က latest guidelines ေတြကုိအျမဲတမ္းဖတ္ရွာေဖြျပီး ကုေနရမယ္လုိ႕ထင္တယ္ေနာ္ ဘာလုိ႕လဲဆုိေတာ့ guidelines ေတြဆုိတာ က အစဥ္အျမဲ evidence based ေတြပဲေလ ျပီးေတာ့ေနာက္တစ္ခုက အျမဲတမ္း conference ေတြနဲ႕အဆက္မျပတ္ထိေတြ႕ေနရမယ္ ဒါမွ ဖလွယ္ယူႏုိင္မယ္ ေမးခြန္းေတြထုတ္ေမးျပီးလက္ခံႏုိင္မယ္ continuous medical education က အသက္မေသခင္အထိ ( ေဆးပညာကုိစိတ္၀င္စားေသးရင္ေပ့ါ ေလ) တသက္လုံးလုပ္ကုိလုပ္ရမယ္လုိ႕ထင္ပါတယ္ (ကြ်န္ေတာ္(honour) က အငယ္မုိ႕မွားရင္ေတာ့ခြင့္လြတ္ပါ ကုိ Steve)

Unknown said...

ကြ်န္ေတာ္ထင္တာ မွတ္ထားတာကေတာ့ ဆရာ၀န္က latest guidelines ေတြကုိအျမဲတမ္းဖတ္ရွာေဖြျပီး ကုေနရမယ္လုိ႕ထင္တယ္ေနာ္ ဘာလုိ႕လဲဆုိေတာ့ guidelines ေတြဆုိတာ က အစဥ္အျမဲ evidence based ေတြပဲေလ ျပီးေတာ့ေနာက္တစ္ခုက အျမဲတမ္း conference ေတြနဲ႕အဆက္မျပတ္ထိေတြ႕ေနရမယ္ ဒါမွ ဖလွယ္ယူႏုိင္မယ္ ေမးခြန္းေတြထုတ္ေမးျပီးလက္ခံႏုိင္မယ္ continuous medical education က အသက္မေသခင္အထိ ( ေဆးပညာကုိစိတ္၀င္စားေသးရင္ေပ့ါ ေလ) တသက္လုံးလုပ္ကုိလုပ္ရမယ္လုိ႕ထင္ပါတယ္ (ကြ်န္ေတာ္(honour) က အငယ္မုိ႕မွားရင္ေတာ့ခြင့္လြတ္ပါ ကုိ Steve)

Steve Evergreen said...

you are right, honour, that is what I was trying to say.