Reality of Medical Training

Let us ask some questions to ourselves, what is the reality of Medical Education? Do we realise about this? Do we know what is the purpose of Medical Education? The purpose of Medical Education is to produce academically competent, skillful and professional doctors to serve the people. The medical school curriculum has been designed to achieve and accomplish these visions. However, some aspects of training may cause unwanted negative impacts on medical students' physical, emotional and mental health that can inhibit these ambitions and values. Studies have revealed that medical students well-being deteriorate after students begin medical training and remains poor throughout the training. At individual level, the distress can contribute to poor academic achievement and personal developments. At professional level, as medical pratitioners, studies have shown that distress students can lead to cynicism and subsequently may affects students' relationships with faculty, patients' care, feeling inadequate and unsatisfied with their career, and ultimately the culture of the medical profession. These are the reality of medical training that we should know and face. Perhaps, we as medical teachers need to think and come out with realistic solutions to reduce complications of medical training on medical students well-being. With that, we leave this topic open to be discussed further.

Knowing our learning styles for effective learning.

What is learning styles? How to identify our learning styles? Why we are so bothered about it? How can its help in improving our learning effectiveness? These are questions commonly asked once we are discussing about learning styles.

Everyone have diferrent learning styles. Learning styles are classified into various ways, but most established and widely used learning styles classification are VARK and Kolb's learning styles. In this article we are going to explore Kolb's Learning Styes. Kolb's (1984) postulated that there are four learning styles exist that combine to form two learning dimensions which are perception continuum and process continuum. It is theorised that everybody use each of the learning style to some extent but has a preffered learning style resulting tendency to learn either through concrete experience (feeling), through abstract conceptualisation (thinking), through reflective observation (watching) or through active experimentation (doing). James Zull (2002) stated that "The art of changging the brain is by enriching learning by exploring the nature of learning". On top of that, Darwin stated that "It is not the strongest of species that survive, not the most intelingence, but the most responsive to the change." Thus, by knowing and understanding our learning style nature we can response and adapt to changes better which can help in enhancing our learning effectivenes.

How to recognise our own learning style preference? In general, according to Kolb, there are four categories of learning style which are called as Diverging, Assimilating, Converging and Accomodating. Each category have their own characteristics and by knowing it we can identify our own learning style in term of the most preferred and the least preffered. Diverging is combination of feeling and watching. Assimilating is combination of watching and thinking. Converging is combination of thinking and doing. Accomodating is combination of doing and feeling.

Individual with diverging learning style see things is various aspects, they have a lot of ideas and sensitive to feeling. they like brainstorming session and gathering information. Usually When they learning they preferred groups discussion in order them to gather information, they like personal feedback and listening with open minded. Individual with assimilating learning style like the ideas and concept rather than practical application, they have ability to understand a broad range of information and they will put it in concise, systematic and logical form, and they tend to use evaluate things based on ideas and theories rather than practical application. When learn, they like lecture, reading, exploring theories and take some times to think through before acting. Individual with converging learning style like to find out the practical uses of teories and concepts, they have ability to solve problems and to make decision towards questions or problems based on finding solutions. When learn, they like to experiment ideas and concept, simulation, laboratory works and practical applications. Individual with accomodating learning style tend to learn primarily based on the experiences during practical session, they do what they was planned, like to try out ideas which are new and challenging, they tend to make their decision based on their feeling rather than logical thinking and they heavily depending on other to find information. When learn, they like working in group to complete assignments, they like field-work, and they like to try out new approaches t0 complete tasks or projects. These are the characteristics of the learning styles. Now reflect on ourselves and gauge where we are. Which is the most fits and describes us? Which is the least fits and describes us? Answer the questions and you will find out your learning nature.

It is hoped that this brief introduction on learning styles can help us in improving our learning effectiveness and preparing us to be a responsive person to changes.

What are stressors for medical students?

Everyone have encountered stressors in their daily life either they do realise or they don't realise about it. Stressors is defined as anything that can cause stress to persons either physically or psychologically. We should realise that stressors are different depending on persons' characteristics, surrounding environment, cultures and beliefs. If that so, then why we are so bothered about stressors? Does it really important to know our stressors? If we know our stressors, what can we do about it? These are some questions that come across in our mind.

Medical students are vulnerable to stress. We know that stress is caused by stressors. By knowing their stressors we can find ways to prevent and overcome it. What are stressors for medical students? Many studies have been conducted to look for medical students' stressors. Most of the studies reported that there are 10 most common stressors in medical students and most of them course-related. The top 5 most common stressors that were reported are time pressure, tests and examinations, getting behind in the work, heavy workload and unclear lectures. Other stressors are commonly cited such as financial problems, relationship problems, getting poor marks, family problems, and conflicting demands. Overall pattern of stressors is the same regardless of curriculum adopted by medical schools, eventhough frequency of some stressors might be significantly different.

Now, we know causes of stress among medical students, therefore what can we do about it? Most of stressors are related to course contents, therefore it is unrealistic and impossible to reduce the contents to overcome this problem because to be a competent doctor those contents are essential and crucial. Therefore, solution for this is medical schools and teachers must teach their students how to manage and cope with stress. Perhaps, during first year orientation program, medical school can arrange so called stress-reduction program such as mini workshops on stress management, coping skills and appropriate learning approaches for effective learning in medical course. By doing this at least medical students aware and alert about possible stressors they will face in the future. Therefore, they will proactivley find ways and strategies to prevent and overcome possible stressors that they will face later on. If such measures can be materialised by medical schools, perhaps it can help in reducing students' stress and indirectly can improve medical students well-being. As a result, medical schools can produce healthy and competent doctors.

What are negative effects of stress on Medical Students?

Studies have shown that the prevalence of stress among medical students is high and in facts, it is higher than normal population prevalence. Eventhough optimal stress can enhance medical students' performance and abilities but over stress can cause a lot of mental and physical health problems. Studies have revealed that over stress can reduce medical students' self-esteem and self-confident, impinge decision making, difficulties in handling conflicts, cynicism, increase anxiety and depression, reduce attention and concentration, having sleeping problems, increase alcohol and drugs consumptions (substances abuse) and to a certain extend they commit suicide. All of these negative effects inhibit medical students' achievement and personal attributes development. As a result, medical students feeling inadequate and unsatisfied with their career as a medical pratitioner in the future. Therefore, early detection and diagnosis of stress in medical students can help in preventing future possible illnesses related to stress.

Do Medical Students Pyschologically Distress?

Medical Education is the most stressful course compare to other courses. Many studies have shown that medical students are at high risk of developing psychological distress. Prevalence of psychological distress among medical students are ranged from 30% to 50%. About 15 % to 25% of them developed depression symptoms and around 5% of them need treatment. The prevalence of distress in medical students is higher than normal population. Distress can cause a lof of negative impacts to medical students. Studies have revealed that medical students in distress are academically underachievement, socially incompetent and a few of them commit suicide. Therefore, medical students distress is not a merely simple issue that can be ingored and neglected without proper attention, medical institutions need to address this issue appropriately and perhaps interventions can be planned to help in preventing and reducing adverse effects of psychological distress to medical students.