No 28 - Which country trains the best doctors?

Last week I was chatting with some senior registrars, fellows and consultants, while having a coffee and the discussion turned to why there seemed to be so few medical students on the wards at the moment.

The Asian trained and African trained doctors were surprised by how little interest most of our students showed in attending the word and reviewing the patients. They commented that students where they had trained were expected to do long hours in the hospitals, reviewing all of the patients, visiting the patients with signs and really dedicating themselves to the practical study of medicine. They also suggested that UK students and doctors did not practice clinical skills enough to have as wide a range of skills as those trained in other countries.

Which got me thinking, are they right?

Are UK medical students and junior doctors too focussed on learning comm skills or MCQ trivia? Are we neglecting the study of patients in hospitals? Are we not learning enough skills?

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We’ve all heard about South African doctors who need to be able to do emergency C-sections, open appendicectomies, intubation and chest drains before they can graduate and work in the rural hospitals. We’ve all seen fantastic Indian Subcontinent doctors lay their hands on a patient, examine them carefully and then come up with a fantastically niche list of differential diagnosis that are often correct. Most of us have met a Bulgarian doctor who can stick a cannula into anyone.

Many of us have had the pleasure to work with a Filipino nurse, that we loved, because they could do everything and would do it competently and with a smile. So, I’m happy to claim, with a small n number, that they are the best nurses in the world.

So, my question is this, which country produces the best doctors?

Which country should we all be learning from?

Or is it not that simple? Does it depend on speciality? Does it even depend on which particular medical school?

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An obvious counterpoint is that the most motivated doctors in other countries decide to emigrate to the UK or America to find a better quality of life and so, who we meet at work in the UK are actually the over-achievers?

We Brits, I think, like to think of ourselves as some of the best clinicians in the world, working in one of the best healthcare systems in the world. But this might just be because we don’t work abroad very much. Again, I’ve heard many people suggest that Brits are better generalists with a more holistic knowledge than our American colleagues. We take pride in the fact that many other countries use our Royal Colleges as their post-grad examiners. We think we must make better doctors because UK trained doctors tend to score more highly in UK based post-graduate examinations, on average. But are we being complacent? Could we make our medical training better?

Or, am I being too harsh on UK doctors? Should we actually rank ourselves as No 1 best trained doctors in the world?

If you would like to take part in this informal survey then please leave a comment and I will tally them up. If you think this post has been interesting then please do share it with your colleagues. I look forward to hearing your thoughts.