It throws me each and every time I pick up a report highlighting the "tradition" of rote learning in India, such as this article, "It's plain murder, by rote", which appeared in a 2012 edition of Outlook. The report brought to light certain startling facts that are no less than an indictment of the state of education in general.
Our obsession with descriptive questions and answers as the prime tool for assessing medical students is something that stifles our medical education.
I, personally, have never been a defender of the notion that the problems of Indian education are all about rote learning. There isn't any denying that it does permeate nearly every stratum of schooling, but I see several other factors that are also as damaging -- for example, low budgetary allocations, the traditional attitudes of our men and so on. But the term "rote learning" leads me today to a very conspicuous handicap that plagues our medical education, something that needs to be addressed for it to be able to become a modern, dynamic one. And it has to do with our love for long, descriptive texts and paragraphs.
Our obsession with descriptive questions and answers as the prime tool for assessing medical students is something that stifles our medical education. In an age which centres on the soundness of applied knowledge, in nearly every field, it is astounding to find that we haven't yet switched to the more rational, application-oriented examination and training system that should have seen light decades ago. We have kept on with our descriptive long- and short answer questions beyond the point where they lose their efficiency. We have blindfolded ourselves of the importance and might of application/concept-testing exam systems – which actually test our understanding of facts and concepts.
The ramifications of this stretch far and long, as I've outlined in my article on theory exams. A theory-centred system makes the curriculum more cumbersome and voluminous, siphons off fruitful time, and promotes redundant, superfluous practices and activities. It kills the attitude to explore beyond the confines of the textbook, promotes practices like rote-learning and cramming, while being a relatively inefficient method of testing concepts. The most menacing influence is the one it has in shrivelling up the attention given to practical classes.
Practical teaching and evaluation is sloppy and dubious in a number of institutions across the nation.
On the other hand, we have made a travesty of practical training by keeping it largely to history taking, physical examination and clinics that end in theoretical cul-de-sacs. Despite the fact that a number of medical institutions epitomize and set the standard for excellence in practical education, practical teaching and evaluation is sloppy and dubious in a number of institutions across the nation. We can do so much towards building a strong practical approach by enforcing hospital/patient care exposure as a prominent part of the MBBS curriculum. The benefits of including activities like ward rounds and exposing students to actual diagnostic and management protocols are multifold, as I've outlined in my article on practical education.
Our medical education has been the target of a number of studies and reports, emanating from multiple areas of healthcare, which aim to explain its wretched facets, and we've often thought of having recourse to filters like exit tests to set things right. We need to understand that no measure to vitalize the shoot can bear fruit in the presence of the rot that has affected the root. It's time to open our eyes to the fact that modernization is more than just computers and telemedicine, and that it entails looking beyond redundant practices that thwart a better tomorrow.
This article was first published on the blog The Free-Thinking Medic