Online medical education won’t work in the Philippines

I beg to disagree with the suggestions of Dr. Leonardo Leonidas on medical education in the Philippines. To start with, I would not like to be examined and treated by a doctor who spent only two years of clinical experience in a medical school.

To start third year and fourth year high school students in learning medicine by “shadowing” practitioners is not practical for the following reasons: 1) those kids from ages 15-17 may not be sure whether medicine is for them or not; 2) they have extracurricular activities on weekends; 3) patients may not like the idea that these teenagers are “shadowing” their own doctors since they themselves would not like to be “practiced” on by these young people; 4) even if the practitioner himself/herself will not be doing the actual teaching, the residents may do little or no teaching at all since residency is also a hard job (reports, conferences, research, etc.) and who pays for these extra tasks to the practitioners?; 5) unless these kids are 101 percent sure to be a medical doctor, they may suffer from burnout even during premed; and 6) these plans are supposed to be for rural areas but as of today and probably even in the near future, internet service in the Philippines especially in the provinces is very spotty.

Medicine is both an art and a science. The science can be learned online except for some parts where laboratory work is mandatory. The first two years in traditional medical education are mainly in basic sciences but some curriculum includes clinical sciences even in first year but mostly in second year. Clinical science is physical diagnosis and treatment where for the first time, young medical students can practice what they learned in anatomy, physiology, biochemistry, microbiology/parasitology, etc., which can be learned online to some extent. Physical diagnosis can be learned online through video, Skype, but the internet cannot teach you how to feel an enlarged liver, spleen, lymph nodes, breast masses, or even tenderness on the abdomen. To learn more about it, you have to learn how to “palpate,” i.e., feel and “laying of the hands,” i.e., touching.

If Leonidas wants to cut the number of years in medicine, some schools like the UP College of Medicine and those in the US have “intermed” which is just seven years; but the formal teaching of medicine in a traditional medical school is still four to five years. Making the students take classes online is not a guarantee that the tuition will be lesser.

Leonidas’ suggestion to attend four years of premed courses online and two years online medical school then enroll in a traditional medical school for two years will not improve the quality of medical education and, therefore, the graduates. We need interaction with other people and that is found in campuses and workplaces. My doctor may know all the different diseases and syndromes but being less exposed to people, his/her interpersonal relationship with me may be zero.

Although my doctor might not have graduated with honors from medical school, I will still prefer a medical doctor who went to a traditional medical school who knows his medicine but not through internet, Skype, or Zoom, but by “palpating,” feeling and touching, and “auscultating” or listening to my heart, lungs, abdomen, and, most important, listening to my complaints.

IDA M. TIONGCO
Visiting Consultant in Dermatology
Ospital ng Maynila
[email protected]