Senior house surgency

Of late, doctors when  they complete their under graduate training, choose one of the three options for their future. Apply and get selected for post-gradaute training; join an entrance coaching programme and try for post graduate admission; appear for qualifying examinations to go overseas.

The majority seems to choose one of the first two options. In fact, if the rough estimate is correct, there are thirty five thousand doctors who are undergoing entrance coaching through out the country currently. There will be an equal number who would compete with them for getting a seat for post graduate training in 2013. Only one out of 8 would secure a seat for training as of now.

During my time of training in the early seventies, the post graduate admission was based on the marks obtained in the final examinations. But it was compulsory to have completed one year of senior house sergeancy, out of which six months  in the speciality, one was seeking for post graduate training, before applying for the admission. 

How did the senior house surgency help a doctor in preparing for post graduate training! 

First, it is one occasion after the compulsory rotating internship, when a junior doctor has a chance to  have hands on experience to develop competency in decision making, taking care of patients, being part of a treating team, exercise skills in communication, breaking the news and counselling, acquire clinical observation and examination skills, etc. A senior house surgeon is the first care provider, whose judgement and critical approach determine the treatment outcome. He or she would normally develop managerial skills as he or she is often in charge of one ward of about thirty five patients. It is the house surgeon who presents patients to the consultants on the ward rounds, which would hone his or her skills in clinical communication and self confidence. At the end of one year of my senior house sergeancy, I had done most of the clinical and therapeutic procedures needed in my specialty. Therefore I had the advantage of beginning my post graduate training with an advantage of clinical familiarity.

What a pity that all these are foreign to a junior doctor who gets into post graduate training without this one year of experience! One year post internship clinical training is seminal for completing the undergraduate training soundly. It is during this one year, one becomes a competent primary clinician. 

Let me suggest that all those who would like to have a better completion of their undergraduate training, choose one year of post internship clinical training as a house surgeon. It is even better than one year of training in an entrance coaching centre, in the long run.

If that one year can be spent in a general hospital in a rural area, having good clinical load and reputation of good delivery of services, it is even better for acquiring practical skills. You would have found some role models in the consultants who would naturally become friendly life-long companions! 

M.C.Mathew(text and photo)