Pre-Clinical Postings of Medical Students

A new idea – Pre-Clinical Postings of Medical Students

Pakistan is a poor country.  The quality and conditions of almost all its public facilities and utilities demonstrate the fact that there are never enough funds or resources to bring them at par with those of even other developing nations.  With the prevailing economic situation, people should think outside the box, to seek improvements that do not need lots of funds. 

One such sector that badly needs funds, reforms and improvements is the healthcare sector, specifically the publicly funded and operated hospitals and clinics.  Anyone of us who may have visited any of the government run hospitals in Pakistan knows that, though they may be providing great healthcare services for the funds and resources available to them, there is a whole lot to be improved.  Sometimes minor improvements may add a lot of value if someone thinks about the same.

It is a well-established fact that in addition to the actual medical treatment, a good hospital environment also makes a positive impact on the recovery and well being of the patients.   In this text the writer is proposing a new idea of “Pre-Clinical postings of the medical students” that can utilize the energy, excitement, drive, initiative, enthusiasm and creativity of young medical students to make some easy but badly needed improvements in the healthcare facilities and environment.  It will also provide good practical exposure and learning opportunities to the medical students about their future work environment. 

The idea is to seek help from medical students for identifying, planning, and implementing process and facilities improvements activities during their first two years of studies at the medical colleges (the pre-clinical years). 

This is how the draft idea works:

In Pakistan, duration of medical studies (MBBS) is 5 years which is followed by at least one year of house job. 

The first two years of studies are called pre-clinical years.  These years are purely academics during which time the students attend classrooms and labs and just study. 

The last three years of studies are called Clinical years.  During these years, in addition to attending classes and labs, the students are required to attend wards and interact with medical staff and patients under the strict guidance of their professors.  During the clinical years the students not only get acclimatized with the high-pressured working environment of a health care facility but also learn policies, procedures, and practices of various supporting medical staff.  The students are assigned certain responsibilities, are provided access to all patients’ conditions and medical information/records and are expected to make their assessments and suggestions.  Though students are required to discuss their assessments and suggestions about medical treatment of group of patients assigned to them with their professors, they are not allowed to make any decisions.

During the period of house jobs, medical graduates perform actual medical treatment activities, however, under guidance from a senior and more experienced doctor.

The idea is that exactly on the same grounds and pattern of their clinical years, the medical students get assigned to certain wards during their pre-clinical years as well.  The difference, though, would be that during pre-clinical years instead of assigning responsibilities related to patient care, the responsibilities assigned are related to facilities care and maintenance.  Also, instead of reporting to a professor they report to related facilities managers. 

We know a well-established and time-tested process is already in place at the medical colleges following which medical students are assigned their roles, responsibilities, wards, and reporting structures for their clinical years.  The same process can be utilized, with little tweaks, for the pre-clinical years as well to assign roles, responsibilities, wards/departments, and reporting structures to the medical students.   All groupings, assignments are wards/departments and times etc,

During these pre-clinical postings, the students are required to:

• Learn and study the environment and working of the wards/departments they have been assigned to
• Document gaps in the human/physical resources needs and availability.
• Identify improvement opportunities in the processes and/or physical facilities.
• Develop improvement plans/projects for addressing the above
• Make presentations and seek approvals for the improvement plans/projects.
• Implement improvements, if possible, after seeking necessary departmental approvals
• Temporarily fill up human resources gaps as helping hands, if possible, but only after due approvals

Depending on the initiatives and drive of the students the areas of improvements may be:

• Hygiene/Cleaning
• Painting
• Lighting
• Curtains
• Ventilation
• Organizing
• Numbering/naming
• Filing/record keeping
• Broken things
• Overall aesthetic look and presentation
• Plantation
• Etc.

Students should try to make as many improvements as possible.  A healthy competition can be held between different teams/wards/departments each year and the best teams can be acknowledged and rewarded.

With the passage of time the whole pre-clinical posting process will improve itself and can add more and more value to the healthcare facilities without costing tons of funds that are already scarce.

The above program will not only improve the hospital environment for patients, visitors, and staff alike, the students who actively participate in the program will also get valuable experience, hone important skills, and help them have a better appreciation of the healthcare facilities, environments, and it’s working.  This practical experience equips them for their next clinical rotations and fosters in them the sense of accountability and compassion that will serve as the cornerstones of their future medical professions.

Specifically, they learn:

Sense of ownership:  Students are given the responsibility of finding and implementing improvements in their designated ward, which encourages them to take ownership of their work.

They are aware that their efforts have a direct bearing on how the hospital runs and how its patients are treated. The highest standards of care are ensured because of the students’ motivation to go above and beyond in their tasks.

Understanding of patient care:  The training program also improves students’ understanding of patient care and empathy. Students gain a higher level of empathy by interacting with patients and seeing their experiences in the hospital setting. Students help patients feel more at ease by improving areas like lighting, ventilation, and cleanliness. This helps patients feel better overall and speed up their recuperation.

Networking and professional development:  The pre-clinical postings program also offers networking and professional development possibilities to the students with the paramedical and administrative staff, in addition to doctors and nurses.  These contacts foster their professional development and expose them to real-world situations faced in medical practice.  This program also provides mentorship, direction, and networking possibilities.

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Babar Saeed

bsaeed@yahoo.com

July 05, 2023