Two weeks ago, Feb 5, 2014, I was invited to a course sponsored by my hospital. The CanMEDS Framework is an initiative by The Royal College which describes seven rules for a competent doctor. The one day course was held in The Novotel Business Center. It was conducted by two physicians from National Guard Hospital, a pediatrician, and an obstetrician. All the residents of the hospital were invited, but fifty only attended including a rotating residents in the hospital.
The Novotel has a good advantage of spacious parkings outside. The lobby is very big, and well lit by the sky light. There’s a coffee shop and the seats are crowded with what looks like a businessmen, in contrary to Sheraton, where the atmosphere is more chitchat and friendly. The meeting room on the ground flood was medium size. It was very irritant and shaken by the ventilation ducts for the AC. The sound system was average. As I suited in the first table, I think people on the back faced difficulties listening and looking. The lunch was good, with wide varieties of food. However, we where assigned to specific tables. For the rest of tables, were for other companies.
The workshop was running too rapid to catch up with the schedule. It was very good of the tutors to start on time. However, the contents were supposed to be covered in two days, at least. They emphasized on some points which were supposed to be directed to fellows, at least, or consultants. They tried to be interactive, involve the participants, or start a small groups discussion. In addition, they used some video clips to demonstrate some points. Again, the time was very limited. For sure, I’ve learnt something new after this workshop. However, are we ready to integrate such changes or improvement in our programs?
First, it’s a very nice gesture of the hospital to invite us. The aim to improve the residents and expand their knowledge, competency, and efficacy is always appreciated from our centers, specially non academical institutes. According to the mentors, another session a day later will be suited for the senior stuff in the hospital. That gives me more hope to be on same page, and have same expectations, with my directors and seniors in the hospital. Specially, with a proposed framework which implements many changes, modification, and nonacademic activities. This, hopefully, may facilitates the process of observing a different approach in teaching residents, as well to involve us in such activities.
After this course, I had an example to compare my current situation to. Indeed, the Canadian model is more advance and richer. So, what’s CanMEDS? A patient centered approach is the most essential pillar in the healthcare. This should be a definite point, as the patient is the primary receiver/costumer for our services. However, dealing with the super inflated ego doctors is a major obstacle to deliver the service. Also, many doctors lack the skills in fields which intersect with the medical knowledge, or clinical skills. In addition, professionalism with patient and colleges is a fundamental aspect for a competent doctor. Throughout the day, we passed through the seven roles in CanMEDS framework. And I have a lot to say.
The roles are: Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar, and Professional. To be a better doctor, a physician should obtain these skill. I discussed few points in the previous paragraph, and I realize the discussion may expand longer to cover such roles. You may reach the website to read more about them. What prevents us from applying such framework in our residency program? A doctor timetable for one day covers most of these rules. You should be expert always. We talk and listen or try to listen to our patients. Honestly, listening is an important skill. I learned to ask patients after conducting my interview if they have any questions. Yet, their lack of knowledge in my field limits their question to the time and length of surgery. We manage the resources; humans and materials around us. We read research papers, we learn, and teach on daily or weekly basis. But all this may pass unnoticed by us or by the director/moderator. Therefore, the course is conducted for seniors and juniors.
The major difficulty is: the perspective of a resident here and in Canada. We can’t partially adopt a model, either we take it all or leave it. The resident is a cheap labor who is expected to work until exhaustion. The situation varies from a center to a center, but in general we only work, mechanical work, like robots. Meanwhile, in the other side of the world, residents don’t take a twenty four hours on call, or more, like what we have here. In many occasions, a research paper which is made by the resident will have a consultant name before him or her. Most of the times, a resident will be limited to work in the clinical setting excluding him or her from being involved in the decision making on the level of a policy, program, or department. Until we become consultant, the consultant thinks of us as immature doctors. Anyway, I don’t want to be pessimistic, many things start to change, and I hope to witness the change.
How to improve the image of the health stuff? This was encountered briefly during the workshop. The answer provided by the mentor was to follow an organization which regulates, protects the stuff like the saudi health commission. Still, the commission isn’t capable of controlling all the doctors under its umbrella. Despite the meticulous process of approving and verifying the doctors credentials, fatal mistakes occur. Beside that, our community is medically illiterate. I would blame mainly the doctors, as they lag behind applying the role of health advocate and promoting medical education.
To sum it up, the fact of arranging the course by the hospital is a promising gesture. The tutors were very thoughtful and helpful. We’re learning something outside the clinical side, this will provide the community with more competent doctors. This way, we may regain the sympathy and trust of our community.
