Introduction to the History of Medicine (Part 1)

Dear students,

Welcome to Medical School @USM

The medical program is divided into a number of blocks. The first block is the Bioethics and Social Health Block. One of the lectures in this block is Introduction to the History of Medicine.


INTRODUCTION TO THE HISTORY OF MEDICINE

This is my first lecture to all first-year USM medical and dental students. This lecture is given on the first day of class in the big hall. The purpose of this lecture is to stir the students to think about what the origin of medicine was like long ago in our human history, time immemorial. How did medicine get to be what it is today? What does the future hold for the field of medicine? With those thought-provoking questions, we move on to what we already know about the history of medicine.


WHAT DO WE KNOW ABOUT THE HISTORY OF MEDICINE?

We have some interesting things to share about the history of medicine. I shall list a few things and you can elaborate on each one.

The seat of medical discoveries - Where things began ...
How was medicine discovered? - Approaches and methodologies ...
Era of medical discoveries - When things were discovered ...
Acceptance of medical discoveries - Were things useful and accepted?
How did the medical discoveries expand? - How medicine was transmitted ...
The role of the early medical institutions/universities - What are the ancient institutions ...
World wars that changed the medical landscape - WWI, WWII ...
Modern discoveries in medicine - Nobel Prize ...
Traditional medicine and Homeopathy - The peoples' medicine ...

I think that should do. We can discuss some of the above topics in class.


WHY DO WE STILL NEED TO LEARN MEDICINE?

What is the purpose of learning medicine (maqasid al-tibb)? Why did you choose to study medicine? There are many reasons for us to study medicine. I will just list a few to start you to think about the reasons and you can expand the list.

Materia medica - The core body of medical knowledge needs to be passed on ...
The ill and sick - Patients exist forever ...
Easy to treat - Some conditions can be easily treated ...
Not easy to treat (depression) - Some conditions are not easily to treat ...
Presently untreatable (HIV/AIDS) - The biggest challenge ...


USE, ABUSE AND DANGERS OF MEDICINE

Now that we know something about medicine, what do you think are some of the uses, abuses and dangers of medicine?

Uses - Antibiotics, Antivirals
Abuses - Sleeping pills, Morphine, drug addiction
Dangers - Aspirin, Weapons of Mass Destruction (WMD)

There are many that you can think of in due time. Make your own notes.


SENSITIVE ISSUES IN MEDICINE

Sometimes there are things which are alright to discuss in the clinic or within the medical circle but which can be difficult and often not talked about outside the clinic/medical circle. What are some examples of such situations?

Breaking bad news - How to tell the patient what's wrong ...
Coping - One diagnosis but many responses ...
Death, grieve and mourning - How long to cry and be sad ...


 CHALLENGES OF MEDICINE TODAY

We have made several discoveries and technological advances in medicine. Now that we are equipped with medical gadgets, what do you think are some of the challenges we face today? I will list a few to start you of thinking and you can add to the list.

Epidemic (SARS, H1N1 etc) - So many sick. How to contain and stop ...
Death from disasters (hurricanes, tsunami, floods, earthquakes, volcanic eruptions) - So many bodies. How to ID ...
Challenges and relief aid (MERCY, Medecin Sans Frontiers, etc) - NGO assistance and activities ...

I think that should do.


ACTIVITY: STUDENT SEMINAR

For this session, we have 200 medical students and 60 dental students. We therefore have a total of 260 students, excluding repeaters.

For students' activity, students will be divided into 6 groups. Each group will have approx. 50 students. Students are free to join any group. Students must organise themselves for discussion, preparation of the group PowerPoint and presentation.

Each group can pick a topic to discuss and present. Each group must prepare a 15-minute PowerPoint for presentation.

Student Seminar is on 13 September 2011 (8.30am-10.30am) followed by Feedback (11.00am-1pm).


Thank you.

Prof Faridah

Interesting pages:
http://gloriousancient.blogspot.com/2007/06/medical-history_3585.html
http://www.crystalinks.com/ancient.html 
http://khaidirlastone.wordpress.com/2011/06/04/ten-scientists-moslem-change-the-world/ 
http://www.islamset.com/ethics/topics/glimpse.html

Orientation for First-Year Medic 2011/2012

Memo: USM/PPSP/A/11-2/Jld. 1
Tarikh: 23 Ogos 2011
www.medic.usm.my

Ke Majlis
Profesor Faridah Hj Abdul Rashid
Jabatan Patologi Kimia

Tuan/puan,

JEMPUTAN KE (slot) HARI BERSAMA PUSAT PENGAJIAN,
PROGRAM SISWA LESTARI PELAJAR BARU SIDANG AKADEMIK 2011/2012

Dengan hormatnya dimaklumkan bahawa pelajar baru program Doktor Perubatan bagi Sidang Akademik 2011/2012 akan melaporkan diri pada 6 September 2011 dan terus mengikuti Program Siswa Lestari (program suaikenal) sehingga 11 September 2011.

2. Saya bagi pihak Dekan, Pusat Pengajian Sains Perubatan dengan sukacitanya menjemput tuan/puan untuk hadir ke Majlis Taklimat Dekan, dalam slot Hari Bersama Pusat Pengajian, Program Siswa Lestari yang dijadualkan seperti butiran berikut:

Tarikh: 8 September 2011 (Khamis)
Masa: 2.30 petang
Tempat: Dewan Utama, Kampus Kesihatan
Tentatif acara:

i. Aluan pengacara majlis
ii. Taklimat Dekan
iii. Sesi memperkenalkan staf akademik/ Ketua Jabatan/ Ketua Unit Sokongan
iv. Jamuan ringan dan majlis ramah mesra pensyarah dengan pelajar baru

3. Besarlah harapan saya agar tuan/puan sudi melapangkan masa menghadiri program di atas. Kehadiran serta kerjasama tuan/puan amat dihargai dan saya bagi pihak pusat pengajian terlebih dahulu mengucapkan berbanyak terima kasih.

Sekian.

Prof. Madya Dr. Shaiful Bahari Ismail
Timb Dekan (Akademik dan Pembangunan Pelajar)

--
My response: I won't be able to attend as I have a class with the M Path students at the same time.
Prof Faridah

Deputy Dean (Academic and Students Development)

This is the Deputy Dean for academic affairs and students development programs for the School of Medical Sciences at USM:

Associate Professor Dr Shaiful Bahari Ismail <shaibi@kb.usm.my>
Deputy Dean (Academic and Students Development)
School of Medical Sciences
Universiti Sains Malaysia
16150 Kubang Kerian, Kelantan, MALAYSIA
Tel +6097676003
Fax +6097656532
H/phone +60199582828

Why students chose Medicine course?

There was once we did a survey in the 1990s on students' choices as to WHY they chose Medicine. Some of the responses returned gave us a SURPRISE, some gave us a big SHOCK!

A large number of students wrote, they chose Medicine course to become RICH! A number wrote that the MBBS or MD degree would give them PRESTIGE (being a doctor is GREAT)! A few wrote that they wanted to become doctors to ASSIST the sick. A few wrote their parents FORCED them to become doctors.

Whatever the reasons for choosing Medicine, one must be truthful. Being opportunistic later on when one becomes a doctor, depends on intentions, which can be good or bad. Remember, the purpose of us training students to become doctors was never based on money. We are concerned as doctors today become rich and super rich especially in private clinical practice. There is nothing wrong with being involved in private clinical practice. What doctors do and their intentions are what we are concerned about. Doctors are becoming ruthless money spinners!

There are many scenarios where we are doubtful about doctors' intentions and what their priorities are. I have presented 10 cases below for you to reflect on. You decide what happened to the doctors' intentions in each case.

Case 1:
A private doctor can't make enough money to become rich. He decides to leave his private practice to join USM.

Case 2:
A young doctor completed his term in government service and quits to enter into private practice.

Case 3:
A private doctor gives "the best medicines" to keep his clientele (patients) so they come back to him.

Case 4:
A private doctor's clinic is doing well. He decides to take on a locum to replace him while he goes on holiday overseas.

Case 5:
A private doctor has no time for his family. He's too "busy" with his practice as he has many patients to attend to.

Case 6:
A doctor works with USM but he decides to also do private practice through the private arm of USM, i.e., via USAINS.

Case 7:
A seasoned doctor knows the major complaint in his private practice is URTI (Upper Respiratory Tract Infection). He knows that such infections are either due to bacterial or viral causes. If he knows that the cause is viral, for which there is no known drug so far, but he decides to treat anyway. He then charges his patients for his prescribed "medicines" (whereas he knows there are no medicines against viruses). Is he a good doctor?

Case 8:
There is no age limit in private clinical practice. A doctor works till he drops dead!

Case 9:
Medical/clinical inventions and development are continuous. Medical/clinical knowledge keeps expanding as new discoveries are made. Old medical/clinical knowledge either supports present knowledge or becomes obsolete and is replaced. Which doctors will have present updated knowledge on medicine/clinical practice, young or old doctors? Is it safe for old doctors to continue medical/clinical practice? Do patients trust their old doctors? Why?

Case 10:
There is no such thing as a "poor doctor" in private clinical practice. How much money do doctors "rip off" from their sick/ill patients? Is it ethical? Doctors are supposed to be caring, supportive and assist their patients. Why then did they become "rich" whilst most patients never dreamed of themselves becoming "that rich"? How do doctors in private clinical practice become rich? Do doctors over-charge their patients? How would patients know they are being ripped off?

Option: Islam

From my Facebook, 21 August 2011:

For Orientasi Pelajar Tahun 1 Medic/Dental/PPSK 2011: I would like to suggest that the secretariats involved, do Solat Tasbih berjemaah rather than do ragging etc. Then get the students to register for Quran classes every weekend (Saturday early morning, 1 hr) so that by the time they graduate, they also have completed Quran reading. Also organise Solat Maghrib & Isya' berjemaah every Thursday and do Zikir. Try that.

Prof Faridah

About Blindness

Just heard on TV yesterday or day before. Was very hesitant to even write it here but I must as there are babies born blind. There are infants, children and adults who are blind. This was what I heard on TV:

"If a man looks at his wife's private parts (pp), and then they copulate, the child that is born, will be born blind! Similarly if the wife looks at the husband's pp, she will give birth to a blind child!"

OMG! Please don't argue with me. I will take this up in another blog when I have more info - go to Lifelong Learning on Islam.

American University of Antigua

This is an American university operating in Antigua in the Carribean. The environment looks very good. If you like Captain Cook and Long John Silver stories, then this is the place to study I guess. The facilities look first class. A visit to see the place would be good. Don't know if the medical program and degree conferred are recognised/not recognised by Malaysia. Have to check with JPA first.

American University of Antigua

India: Entrance exam in Medicine

This is the Aakash Institute in India that conducts entrance exams for Indian citizens for entry into medical schools in India. The children look very young.

Aakash Institute

MedLibrary.md: All what you need to study medicine

You may want to take a look at this forum. Looks interesting. May need registration to post messages. Otherwise viewing should suffice.


MedLibrary.md

Cases Beyond Doctors' Reach

There are several cases where doctors are challenged by difficult cases which need a lot of patience, expertise, teamwork, in order to treat patients. I want you to watch some videos which will make you think twice about whether you are indeed fit to be a doctor.

Treeman - papilloma virus infection resulting in skin disease (numerous warts)

Elephant Man - diagnosed with neurofibromatosis at age 4.

Heart beats outside the body in an infant

Crystals in the eye of a girl

Little girl with additional limbs

Harlequin ichthyosis in an infant - thickening of the fetal skin

Viral myocarditis

Digital natives in education and work (Part 4)

Malaysian Qualifications Agency (MQA)

The Malaysian Qualifications Agency or MQA is a statutory body in Malaysia set up to accredit academic programs provided by educational institutions providing post secondary or higher education and facilitate the recognition and articulation of qualifications.

Our contact person for MQA in MOHE is Associate Professor Dr Zarida Hambali (seconded from UPM Medical School).

Student-Centred Learning (SCL)

For medical school programs to be accredited, they must meet strict MQA requirements. Today, since teaching has moved from being teacher-centred teaching to student-centred learning (SCL), the way lecturers teach and students learn have changed considerably. We have moved from didactic lectures to self-regulated learning. Essentially students are supposed to manage their own learning. They must know how to study. They can choose how to study and when & where to learn. Lecturers are still available but students have to approach them rather than lecturers approach the students to help them. Lazy and shy students will be left behind. Overcoming shyness doesn't mean students should be rude.

Communication

Students who fail to communicate well will also shy away and fall behind in their studies. It is therefore, very important that parents as well as students, pay attention to communication and that students acquire sufficient communication skills or an adequate level of proficiency before they come to medical school. English is used to teach Medicine throughout the five years. Knowing how to speak in the English language is a skill. Being proficient is a bonus and is therefore desirous. Students can listen in on English news on local TV or ASTRO channels. A good period to pick up good communication skills is roughly about 3-6 months of intensive listening and practising. Don't waste time doing nothing about English communication skills.

Please take note that there is a great difference between speaking the Malaysian English accent, KL English accent or the Singapore English accent and British English (or Queen's English as it is called) or US English. Most of the lecturers in Malaysian medical schools are trained overseas and most speak either British English, Australian English, New Zealand English or US English. Students therefore may want to learn to speak these foreign English accents and try to move away from the accents of Manglish/KLish or Singalish which sound more Chinese than English. English courses are taught by Unit Bahasa and the "Sound of English" is an interesting subject to learn proper pronunciation and accent.

Language Gadgets

There are quite a number of gadgets that can help teach the English language. Of course having a live teacher plus a few gadgets help. Where do we begin? We begin with Poldy!

PTPTN

What is PTPTN?
PTPTN = Perbadanan Tabung Pendidikan Tinggi Nasional

From Wikipedia:
Better known as PTPTN (English: National Higher Education Fund Corporation), this agency provides education loans as a form of financial assistance to students with financial needs in order to aid them in pursuing a higher education. PTPTN also manages a students savings scheme for higher education purposes.

My input:
You don't need PTPTN to study Medicine in Malaysia or overseas. Students get Jabatan Perkhidmatan Awam (JPA) Scholarship some time late in their first year Medicine. So most students are on Pa-Ma $ for the first few months until they get the scholarship and the hard cash. However, parents should be reminded that students often use the $ to purchase handphones first before they decide to buy medical textbooks. Teach students to save their scholarship for rainy days. Who knows, savings may come in handy some day. My reminder to new students, keep your old handphones if you already have them. Use your scholarship money to buy textbooks or practice books for revision.

Digital natives in education and work (Part 3)

I will list some of the useful digital resources used in medicine today. My focus is mainly videos and medical illustrations which are useful for first year medicine. This list is not exhaustive and additional useful resources will be found in due time and added on here. Check back here often.

It should be noted here that medical illustrations and multimedia resources fall into three main types - public access, commercial packages (some are available free of charge/FOC or with subscription) and institutional repositories (usually FOC). Some institutions also have repositories but which do not allow outside access.

Most medical schools also have medical libraries that subscribe to some of the medical illustrations and multimedia databases or repositories (repositories is the buzz word today). Please enquire from the respective library at your university. For our USM Medical School, the medical library subscribes to many such repositories. However, the use of such resources is minimal, if any as students are unaware or don't know or don't find out. It does take time to find these resources and to familiarise how to navigate them in order to see their worth.

It should also be noted that some illustrations are too simple for first year medicine. They are meant mainly for insight. Students must try to obtain good illustrations from the various resources, especially those with a lot of details and with good layout that is not confusing.


Public Access

YouTube medical videos

 - Stanford University - Vascular Disorders of the Central Nervous System

- Human Body - Nervous System

- 3D medical animation by Nucleus Medical Art -- demo reel of animations (in Spanish)

- Patient Education Reference Library (PERL) - Orthopedics -- Knee surgery
-- Normal Anatomy of the Upper Cervical Spine -- Regions of the Spine (female) -- Regions of the Spine (male) -- Anatomy of the Knee Joint -- Vertebral Column -- Cervical Spine and Intervertebral Disc Anatomy (male) -- Cervical Spine and Intervertebral Disc Anatomy (female)

- Nucleus Medical Media - Spontaneous Vaginal Delivery (SVD) -- Cesarean (C-section) --


Commercial (demo/subscription)

A.D.A.M. Images

McGraw-Hill AccessMedicine

Elsevier medical images

Nucleus Medical Art -- Anatomy of the Skull  -- Menstruation



Institutional

NWTC Medical Illustration Library