Correspondence Address:
Shyam K Parashar
Department of Surgery, College of Medicine, University of Dammam, P.O. Box 2208, Al-Khobar 31952
Kingdom of Saudi Arabia

Full Text

It is our firm belief that medical education in general should not be compartmentalized in undergraduate curriculum, internship training and postgraduate training programs. It should be one continuous process and provide at the end multiple options for the graduates as they proceed forward in the programs. A good foundation can be laid in undergraduate years for excellent trainees in postgraduate years. Similarly, shortcomings in undergraduate teaching will definitely have adverse impact on postgraduate training.

It has been our experience that the internship year is taken by many graduates as an interlude, a year to relax, especially when the required supervision is lacking. There is need to have a renewed look at the training program and its strict implementation during this mandatory year.

Most of those who complete the internship training settle down in various types of general practice in geographic areas of their interest. Even though most of them may aspire for further training in specialties and obtain higher degrees, logistics like the availability of training slots and the need of community for specialists limits the number of those whose aspirations for higher training are fulfilled.

While Saudi council should continue providing professional degrees for clinicians, universities in the kingdom must assume the role of producing the "teachers, trainers, and researchers" for the future. They must create training program for special certificates for which motivated trainees can enroll after their Saudi council fellowships.

These programs should provide exposure to teaching and evaluation techniques like problem-based and e-learning, virtual learning, preparing and evaluating MCQ and OSCE examinations, assessment techniques, biostatistics, research methodology, manuscript writing, etc.

A research-based thesis should be the mandatory component for such certificates.

At present, demonstrators who are in training programs, and are also destined to be future faculty, wait for 3 years after their clinical fellowship for faculty appointment. This period can be suitably utilized by them to obtain their special certificates. These should be a prerequisite for promotion to a faculty rank.

A group of professionals can work on the details. If this concept is accepted, employment and appointment requirements for the faculties will have to be suitably modified, making university PhD degree or its equivalent and post fellowship certificates from the university in teaching methodology as the prerequisite for promotions or appointments as faculty. Fellowship certificate only should not be enough.

In view of their additional qualifications and responsibilities, the facilities and the salary structure of university faculties should be upgraded, consistent with the functions they perform.

In summary, after an experience of quarter of a century in medical education and training in the Kingdom, it is time for the providers of teaching and training, such as the universities, to reflect and have a fresh look at the future needs of the country, i.e., for community-oriented medical professionals as well as professional teachers, trainers, and researchers who will fill the competitive faculty posts. This eventually will also decrease dependence on expatriate faculty.

Universities owe the responsibility of creating a cadre of "academia," intellectuals who put science before service, who are research oriented and are prepared to make necessary sacrifices required of any scientist in the world.

Universities should fulfill this responsibility in the field of medicine also by producing "medical academia" by offering appropriate postgraduate programs.

Duplication of fellowships by the universities will be a waste of necessary resources. Instead, universities should concentrate on Masters and Doctorate programs.

Whole medical education should be looked at as one continuous spectrum and all concerned should come together to prepare a blueprint that provides ample opportunities and options for medical aspirants according to their convictions and capabilities. In the days of increasing strength of students and trainees, and the shrinking resources, especially the clinical material in sufficient quantity and quality, every resource will have to be conserved and maximally utilized.