India has a strong and solid homoeopathic infrastructure. Yet, students need to introspect about how they are making the most of that infrastructure. Being in academics for many years, I have realized that 80% of the students coming for B.H.M.S. come by CHANCE rather than by CHOICE. So, in those 80% of students, there is a natural indifference for homoeopathy. Due to this natural indifference, homoeopathy looses 80% of its productive young generation’s passion. The majority of boys coming for homeopathy aspire to become a doctor (just to be able to practice allopathy) rather than being a homoeopath. Most of the girls coming to homoeopathy are there just to get a doctor’s degree, so they find a highly educated groom. Therefore only 10-15% of B.H.M.S. graduates stick honestly to their profession. The rest of them either go for allopathic practice, RMO or housemanship in allopathic hospitals, or prefer to leave their profession completely. In India, despite having the strongest and biggest homeopathy infrastructure, why is this outcome becoming so rampant? Let us think who is at fault. Is it the fault of students who are taking homoeopathy for granted?
Students must realize that education is an investment for a lifetime. Therefore they need to approach it from that point of view. This point becomes even more significant when it comes to medical education. We find that educational practice is not relevant to actual practice. There is a huge gap between theories taught and the actual practice, which the students will face during their internship. In the practical application of medicine, this can have disastrous consequences for the community as well as the profession. All of this results in a total lack of faith in homoeopathy and ultimately lack of public support and government support. Unfortunately we are facing such a situation, today.
As B.H.M.S. institutes are mushrooming, it is obvious that we must have total clarity with regard to the type of homoeopathic physician we want to produce, in terms of our needs, not only for today but also in the future. In other words, we need to produce a homoeopathic physician who can successfully adapt himself to the changing patterns of patient-care and organization of Health Services.
Now let’s check the practical relevance of the subjects and their method of teaching during first to final year.
1. In the final year the homoeopathic repertory was hardly ever touched. The emphasis was only on finishing the course by giving theoretical lectures, and the examinations were merely tests of the performance of memory. One of the most practical subjects was sacrificed as a mere memory exercise related to the history of repertory, number of chapters of any repertory, number of editions, rubric and pages of different repertories. To be precise the actual art of repertorization is entirely lacking.
2. As a student, one could hardly get interested in the phenomena of sickness or the science and art of alleviation or cure of human suffering. The curriculum in its execution, fails to excite their curiosity or satisfy them regarding the Hahnemannian concept of sickness. The course appears merely something which had to be gone through, to get a degree and license to practice.
3. Lectures on Materia Medica and Organon; These two most practical subjects are, throughout all four years, uninteresting and sterile. The clinical relevance was never explained, even when students are posted in OPDs right from the second year.
4. As far as anatomy and physiology, the major para-clinical subjects are concerned, the study of man as a whole in function and structure was absolutely absent in the teaching and its applied aspects in clinical subjects like pathology, surgery and medicine fall short in the subsequent three years.
To sum up, this is the situation in which our students are supposed to learn the most difficult topics of human sickness, its prevention and cure by homoeopathic medicines.
We need to evolve a kind of training model at undergraduate and postgraduate level which will help our students in the following ways:
- We should design our training model in such a way that the spirit of inquiry and continued self-education with an open mind, is promoted. The study of man as a whole, both in health and sickness, should be emphasized. The course should also to be related to the needs and socio-economic conditions of the community.
- The Syllabi of the basic course (direct degree and post graduate degree), although very well planned, must be matched by excellence in execution.
- Generally, schools view the student as being a sponge for knowledge. Learning, however, is a dynamic and interactive process in which the behaviors and experiences of the student are vital components; the student must not only receive but also contribute his perception of what is happening to him. Our targets:
To develop a level of competence:
- The student makes use of the literature and scientific material in a suitable way; he is in a position to process adequately the data that he receives from the patients and members of his community and can solve problems either by himself or with the help of books, journals or other colleagues.
- The student must acquire basic skills (and not merely basic knowledge); he must be able to demonstrate that he can do things. The role of memory is acquired through usage. He must learn by doing things.
- The student should acquire his professional competence through the practice of professional acts of increasing difficulty, compatible with his level. Practice in a controlled environment can lead to the revelation of basic principles.
This integrated approach to teaching and learning is essential if we want to inculcate the Hahnemannian concept of studying Man as a whole, in both health and sickness. Through it the student is led to realize that in the complex human organism, there is a very thin line dividing balance and imbalance. The holistic approach to human sickness and treatment has to be evolved in order to be able to help create homoeostasis.
Educational programs are meant to initiate a process for changing the behavior of students in a desired direction. The term behavior means thinking, feeling and acting and thus behavioral change involves acquiring new ideas, habits, attitudes, interests, ways of thinking and professional skills. Unless students are in the process of practicing problem-solving again and again, the desired precision of thinking cannot be developed. Thus in planning a particular course it is desirable to provide learning situations in which the students will encounter problems which need a solution. This allows them to gain understanding and develop critical thinking.
A homoeopathic physician is expected to develop a deep understanding of the people to whom he is offering his professional services, and particularly an insight into their personal motivations, feelings, needs and the interaction of physical, psychological, social and emotional aspects of human behavior. Without understanding the total individual, it is not possible to apply curatively the homoeopathic agent, nor is it possible to help solve other problems by wise counseling.
We have to plan learning experiences for developing effective thinking, attitudes and interests. A learner has to be involved in the learning situation be guided to think, feel and act in ways appropriate to the situation. In planning a program, it is necessary to build a closer and more appropriate connection between the theory and the practice; between the art and the science of the profession. The various signs and symptoms of the deviation from health, become a study of great importance. This shows how a man in sickness reacts to internal or external ‘inimical’ influences (agents, bacteria, viral, emotional, environmental, etc.). Knowledge of such structural and functional changes (pathology) is a part of education.
The application of homoeopathic medicines to human sickness involves mental faculties and accumulated knowledge which are not required to the same extent in the prescription of allopathic drugs. The homoeopathic prescriber has to be an artist and has to be conversant with human psychology. The training, and the curriculum, therefore, have to be planned accordingly and should not merely copy what has been done in the allopathic schools.
From the above considerations students must realize the ideal standard of the institution and curriculum needed for their training and ultimately the competence and success they aspire to achieve. They must think of what kind of educational module should be designed so that they turn out to be really competent and confident Homoeopaths