Friday, September 23, 2011

The Singapore Medical Council Physician's Pledge - respect for teachers

Upon graduation, all newly minted doctors in Singapore have to take the SMC Physician's Pledge. The pledge is our local adaptation of the Hippocratic Oath and the similarities are obvious if you lay them out side by side.

In the original Hippocratic Oath, the very first para addresses the issue of respecting your teachers. It reads :

"TO RECHON him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look up his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according the law of medicine, but to none others."

I guess it was something very important to Hippocrates, or at least to the Hippocratic School.

Our SMC Physician's Pledge more succinctly states "give due respect and gratitude to my teachers". That it is placed second only to "dedicate my life to service of humanity" but before all the other practice related oaths also indicates the relative importance of such a value.

Unfortunately though, as undergraduate medical teachers, few of us observe the expression of this in the hallowed halls of learning. In fact a common refrain among medical teachers is that medical student behaviour is arguably the worst among the undergraduate population. They come late for class, talk, send text messages, surf the net, and play with their smart phones during lectures. And generally are somewhat lacking with respect to respecting their teachers. I do have to qualify that the above probably applies to only a section, and perhaps only a very visible minority of the medical student population. Yet it is a significant enough segment to create the impression that there is very little respect in the class for the teacher who is in front of them trying to start a lecture.

I have always wondered why this is so. Perhaps it is because the students have not yet been exposed to these noble values as articulated in the Physician's Pledge. It does seem a bit late to take an oath to respect your teachers only after you have graduated, and after having spent 5 years abusing your teachers. Perhaps the medical students ought to take a earlier version of the Physician's Pledge, a Physician's Pledge Lite, for example, that might encourage them to consider value systems they need to cultivate and express during their undergraduate years.

Some shrug their shoulders, capitulating to the idea that this bad behaviour is really just our local manifestion of the global modern 'Gen Z plus' university student phenotype. But I disagree. I have been to universities in Japan, Korea and even Taiwan where University and Medical School teachers are held in high respect and where students are appropriately deferential to their seniors and their professors. And it seems like the non-medical student classes in the NUS are somewhat better behaved.

Please do not get me wrong. I am not arguing here for blind submissiveness. I am all for a fiercely independantly thinking medical students. Students who can be clear minded and innovative enough to challenge traditional professional paradigms. But our students need to be taught that the development of independent and creative thinking does not mean a jettisoning of responsibility and respect for others.... especially their teachers.

So Minister Heng Swee Keat, please have a look at our universities and medical schools as well.

The new educational focus on values and character - a long overdue initiative

It was certainly refreshing to read of the new Education Minister Heng Swee Keat's take on the future strategic educational mission. Apparently the new mission will focus on values and character.

Great stuff! I hope this is not one of those empty promises that serve no other purpose than to look good in annual reports and glossy brochures.

For too long our educational system had fostered this mindless ultracompetitiveness to excel academically. It seemed like all that mattered was getting those As and distinctions. Those that couldn't fell by the wayside, as did the noble values of respect, integrity, discipline and selflessness. We have seen this precipitous moral erosion among the undergraduate and medical student population. It seemed clear to many that this decline in values among the university student population was largely due values and behaviours inculcated during the preceding 12 years of schooling. Many have been dismayed by the apparent lack of concern shown by the school and ministry leaders,many of whom were clearly motivated by chasing after those elusive academic KPIs.

Fancy pedagological approaches such as 'student centred learning' and 'the student as the customer' became cliched excuses for spoiling students and fostering negative student attitudes and behaviour.

So Minister Heng's position is to be applauded. Not only is it timely, but in my opinion, long overdue. But it is a difficult task and there will be many who will resist him. I certainly wish him and his Ministry well, and will certainly go all out to support his initiatives. We have too much to lose if he does not succeed.