Neel Sharma: The dark side of medical education

As a trainee and keen medical educationalist I have witnessed the rapid rise of movement in medical education. At a time where there was minimal change it seems now that we are in constant flux with new headlines appearing frequently on how best we should teach and assess doctors in training.

As a recent attendee at a medical education conference I observed a top down approach where senior often non clinician educators battled among themselves to reach consensus on appropriate training methods. Often their personal opinions clashed and heavy bias was noted. I immediately thought two things: Firstly, where were all the trainees? Why were they not asked to speak about their concerns? Surely we should hear from those on the shop floor regarding the current issues and then ask our expert educators to solve them. However, from what I witnessed this was far from reality. Rather overt bias filled the room with no true evidence of what works and what doesn’t. The second concern I had was the significant overcrowding of several educational based consultancy groups, often backed by the same educationalists providing their opinions and offering upcoming workshops on either assessment or teaching strategies. And at a phenomenal expense. Surely this is morally unjust and significantly unethical. How can it be justified to allow often non practising educationalists to present their viewpoints in medical education and then allow the same representatives to function as members of consultancy groups offering courses on educational practice.

In scientific conferences we see numerous drug companies advertising their latest therapeutics. But we have also witnessed the UK hindering the previous on goings of pharmaceutical sponsored dinners and travel. Scientific journals require any drug or diagnostic company sponsored research to be declared as a conflict of interest. However, we rarely see such occurrences in medical education. Surely we need to apply the exact same moral compass in medical education. After all biased opinions of how to train doctors ultimately impacts on how patients will be treated. And the continued consensus route and lack of evidence is concerning.

Neel Sharma graduated from the University of Manchester and did his internal medicine training at The Royal London Hospital and Guy’s and St Thomas’ NHS Foundation Trust. Currently he is a gastroenterology trainee based in Singapore.

Competing interests: None declared.

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