Chris Lancelot - Medical students must leave college as 'all-round' doctors

I remember my first day as a practising doctor.

There I was, fresh from medical school, working in casualty, already knowing the difference between megacolon and Hirschsprung's disease, as well as all the myriad causes of hypoadrenalism, only to find that my first case was - a wasp sting. And I hadn't the faintest idea what to do.

More than anything else this event impressed upon me the large gap that then existed between my theoretical medical knowledge and the practicalities of healthcare outside the teaching hospital.

What else was missing from my medical armamentarium? Quite a lot, as it turned out - some understandable, some not. Last week I mentioned my surprise that many medical students still aren't taught about personality types. This is inexcusable, bearing in mind the crucial function personality types have in understanding interpersonal relationships and making teams and units run smoothly.

Are we still teaching our students in a high-powered medical hothouse without giving them a fully rounded preparation for the real world? I suspect the answer is 'yes' - and in some surprising areas, too.

I have often said that the first qualification I acquired for my GP career was my driving licence. Many other abilities are central to high-quality healthcare, yet are still not seen as worth teaching at medical college.

Chief among these are keyboard and IT skills. Most primary care clinicians now make notes directly onto a computer, though many hospitals still use paper. Although typing will eventually be replaced by voice-processing, this is still some way off, especially in secondary care. The ability to touch-type will be essential if hospital doctors are to avoid the same dip in recording detail that occurred when GPs first started two-finger-typing their notes into the patient record.

Many other abilities are similarly important, yet aren't necessarily part of the medical curriculum. More rounded teaching would include basic business skills - understanding accounts, leadership skills and a rudimentary approach to business law; a detailed understanding of the complexities of NHS management structure; and (bearing in mind my debacle over the wasp sting) courses in bandaging and first aid.

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