Why I think Medical Education is broken

At the University of Melbourne MD student conference this year, a thousand-plus Med students were persuasively exposed to the major health issues of our time.

It was a progressive four days of discussions ranging from domestic violence to indigenous health, from gender inequity to the importance of compassion, from body image issues to the unhealthy treatment of refugees. This was a student run conference, featuring speakers elected by a student committee with little censorship from the university medical faculty. Most students I spoke to were moved and engaged by these ideas, and the passion with which they were conveyed.

And yet, over the course of the first year of the MD, 8 lectures were devoted to these topics. Out of 326.

This isn't an issue limited to the University of Melbourne, who ought to be congratulated for giving students the platform to air & better understand these vital issues.

It's a systemic failure built into the doctrines of medicine. In the pre-clinical education context, patients are considered through the lens of their discrete organs, each discussed in isolation. These organs' discrete pathologies are learnt by rote, most often in befuddled nomenclature. There is rarely a word regarding the impact of disease in life. The complexities of life that we all know and share are dissolved in the face of definitions and linear understandings of disease.

In our clinical years, we use patients - real people getting through hard times - as identity-less mannequins to perform and learn clinical exams. The majority of the content of these clinical examinations is obsolete these days, having been superseded by more accurate tests, but we're still taught to learn them. The suffering patients say they're happy with the exchange because "you've got to learn somehow". After half an hour of being depersonalised, their findings discussed before them in jargon no layperson could be expected to understand, one wonders if they're still happy with their decision.

The medical degree lacks humanity, and many will say this is a sad inevitability given the quantity of scientific information students are expected to retain. But the truth is, so much of each lecture's content is irrelevant to clinical practise - the end goal of the MD - that this argument just doesn't hold water. If the knowledge we were expected to gain was stratified in terms of importance, the quantity of lectures could be drastically reduced, leaving more time to focus on the humanities of medicine. And how else could we comprehend the complex system of disillusionment and despair that leads to and results from domestic violence? How else should we hope to understand that communication with people who only speak Pitjantjatjara often isn't easy for native English speakers, but is fundamental to bridging any gap in health outcomes? How is it more important to know, at a first year level, that hepatocytes infected with Hep B have a "ground glass appearance" on histopathology slides? You might think the big-ticket health issues would come up every few days in a doctor's formal education. Unfortunately, you'd be dead wrong.

Is there a better alternative? One would hope. When the current paradigm promotes de- humanising the patient, and when the current curricula puts linear science before complex social health issues, the question cannot be avoided.

We need humanities-focused medical education to produce doctors who are aware, at every juncture, of how their actions could either avert or contribute to the health issues Australians currently face.