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Saturday, November 28, 2015

Teaching

 By Nihal D Amerasekera
“The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires.”
― William Arthur Ward
We were medical students in the Golden era of medical education in Sri Lanka. Our teachers educated and inspired us to become who we are today.

Teaching is one of the most rewarding aspects of professional life. It began in 1979 when I was appointed Senior Registrar to the University College Hospital in London rotating to the Childrens’ hospital  in Great Ormand Street and the National hospital at Queens Square. I must confess lecturing to medical students was initially a shock to my system until I acquired the skills for public speaking. Then on it became a most satisfying experience to which I look back with great pride.

As a Consultant Radiologist in a District General Hospital where medical students came on rotation from Cambridge and the Royal Free hospital in London the teaching was less structured and to a smaller group at a time. Teaching registrars in Radiology and coaching them for the fellowship was a most fulfilling commitment.

As we all know teaching is an art and a science. Some are born with it and other acquire it in the fullness of time. Sadly there are a few who just cannot teach and end up in important teaching positions in university, bungling their way to retirement. The ability to teach has no direct relationship to the ability to pass examinations. Nowadays after a lecture the students are encouraged to fill up a questionnaire about the performance of the lecturer and such feedback helps to eliminate “incompetence”. Help is at hand to learn the teaching skills in a Diploma Course in Education which can be done part time in 12 months. This is now an important requirement for all full time lecturers in Universities in the UK.

It is a wonderful experience to meet medical students and registrars whom I have taught, many years later at conferences and medical meetings. Fortunately I don’t recall any “Rajasuriya” moments.

Although I enjoyed teaching I was not prepared to give up my clinical commitment to embark on teaching fulltime.  Teaching patients is now a team effort. The Clinical Meetings are attended by all relevant disciplines when the diagnosis and treatment is discussed. This is far removed from the scene in the old days when the consultant clinician was the king of all he surveyed and did what he pleased. The downside of the new system is the lack of a clinical lead who is responsible for the patient from admission to discharge. But the benefits of the new method outweigh the drawbacks.

I admire enormously the decision  Sanath and Chandrasiri have taken to remain in Sri Lanka to teach medical students who will take care of the health of the people of our motherland. We applaud their commitment to medical education. 





15 comments:

  1. Just want to add that besides Sanath and Chandrasiri, there were others in our batch who taught medical students full time in Sri Lanka.

    They were: Manel Ratnavibhushana Wijesundera (Professor Emeritus in Parasitology at the University of Peradeniya), Lalini Seebert Rajapaksa (retired as Professor in Community Medicine, University of Colombo) and Kusuma Jayasuriya Ruberu (retired as Senior Lecturer in Pharmacology, University of Sri Jayawardenepura).

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  3. Lucky
    Thank you for including those names. Having been away from Sri Lanka for 41 years and not attending the batch reunions the information I have is grossly outdated. My sincere apologies to those I have left out. You too belong to the elite brigade of eminent teachers whose names should be written in Gold for your commitment to teaching in Sri Lanka.
    ND

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  4. Of course I am full of admiration and respect for those of us who stayed behind and served Sri Lanka, but those who know me are aware that I always point out that it is wrong to regard those who left as being unpatriotic. Let me leave aside my own personal circumstances and look at this with an open mind. Many who left had very good reasons for leaving and many have continued to provide support for Sri Lanka in a variety of ways. On the other hand, some who didn't leave, and I need to stress the word 'some', stayed behind for very good personal reasons and not because they were "patriotic". It does not help at all when some who stayed behind level the accusation that those who are trying to help are doing so because they have a guilty conscience. This is not imaginary as it has been said.

    Let us recognise the good in everybody and not be judgemental.

    Let us recognise that major decisions in our life are taken after taking into account a whole host of factors.

    Let us accept any helping hand extended without being suspicious of motives.

    Let us try not to be self righteous and let us be generous in our outlook.

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  5. ND,

    Thank you for giving recognition to my small contribution. Yes, I have done a few lectures in Community Medicine (Public Health) for some batches in the Colombo Medical Faculty. I have also done so for some post graduates at the PGIM (M Sc and MD in Community Medicine). But I have never been a full time academic. I have also served as a member of the Board of Study in Community Medicine and supervised post graduates in their research projects for the M Sc and MD. So much for my contribution to medical education in Sri Lanka.

    As for "giving back", I have absolutely no regrets. Having served the Government of Sri Lanka for 23 years, I have given back amply for the free education I got (a mere Rs 55 Registration Fee per term and the outright gift in the form of an 18 months MPH Program at the University of California, Berkeley plus a monthly stipend). For my MD project, I received a grant from the National Science Council (aka NARESA). Apart from my country of birth, I have also served the international community during my stint with the UN and had the opportunity to serve the children in South Carolina, USA when I worked for the SC Health Department for 13 years.

    Lucky

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  6. Mahen
    We left SL in our youth with all our lives before us. The reasons were to improve our careers, financial and family or a combination of all or some of them. I do not believe patriotism entered the equation at that stage except perhaps for a cursory glance.
    In SL my career was going nowhere, my family life was in turmoil and I needed to improve my finances. Leaving SL was one of the best things that I have done in my life. My career took off and my finances improved and so did my quality of life. I have now spent most of my life in the UK. The National Health Service gave me their top job within 8 years of my arrival and it was a most rewarding career of my own choice. My family thrived with both my sons being educated in one of the finest British Public Schools and the University of Cambridge. I have had a wonderful lifes journey since my arrival on these shores. The only regret I have is about my parents and not being there for them in their hour of need. I have supported my country by sending money over a period of 41 years, supporting my school and the Faculty. I feel no remorse or regret on that score.
    I am just intrigued why you brought up the topic of patriotism when my article on Teaching did not allude to it. Rest assured the issue about patriotism never entered my mind when I wrote the article. Patriotism is a vexed issue and would need a separate article allowing everyone to give their personal stories. This is an ideal forum for such a discussion.

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    1. UK is now my home. I am eternally grateful to the UK and its people for the wonderful life I have now. My gratitude extends to the country of my birth for giving me such a fine education and a good childhood. Thoughts of SL , its culture and its people will never leave me as I have left my heart in that beautiful island.

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    2. I owe you an explanation ND. I agree that my comment was a big jump in interpretation! It was brought up because at times and by some the sentiments expressed by your worthy and true observation "I admire enormously the decision Sanath and Chandrasiri have taken to remain in Sri Lanka to teach medical students who will take care of the health of the people of our motherland" is extrapolated to a sense of patriotism (Motherland) in those who stayed behind and conversely lack of it for those who didn't. Just refer to some early posts in our Blog and you will see this coming through from time to time and many people I know who live abroad and tried to help have been regarded with suspicion as to their motives. I have absolutely no personal axe to grind but merely wanted to point out that it is good to be "Not self righteous and always maintain a generous outlook". I suppose I took advantage of your article to bring something often not discussed publicly,into the open . My apologies if it caused any misunderstanding. As you say, Patriotism is an altogether difficult subject and personally speaking I always regarded myself first and foremost a citizen of the World!

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  7. Just to bring your attention to a previous Blog, you can probably come to the conclusion quite justifiably that I have a "bee in my bonnet" about this subject. The following are excerpts from a Blog post in May 2015:-
    http://colombomedgrads1962.blogspot.co.uk/2015/05/a-comment-on-wind-of-change-by-mahendra.html

    "Just a brief distraction, I do worry about generalisations. For example, some of us who stayed on in Sri Lanka and gave yeomen service to the Country (not all of us I hasten to add), regard those who chose to live abroad as ungrateful and may be a bit treacherous and I hasten to point out that very few were motivated solely for patriotic reasons, not to seek pastures abroad. Of course there are some admirable people who did so but we are all driven by circumstances which unfold without pre-knowledge and we react accordingly. Without looking at individual circumstances which led to the decision "to stay or not to stay", it is not possible to come to conclusions. Accept people as they are now and for what they are and we shall all be better off" -----------and ND's comment in reply.

    Mahen
    There you touched on another contentious but interesting topic - Staying behind or leaving Sri Lanka to continue our professional life. Let us write about it. We must have our own stories to tell. We are now old enough to have a sensible discussion and have lived long enough to acquire broad shoulders and thick skins to accept the fallout. It is great our stories now have a forum.
    ND

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  8. This is or should be a part of what the Blog should be about - a healthy and calm discussion about important issues such as the one under discussion. I wish more people would put "pen to paper" or more accurately "fingers to the keyboard"!

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  9. I am glad the comments generated some heat and even a bit of steam on this cold and blustery winters day in England. It is an ideal day to listen to Vivaldi's Four seasons and recall the colours and the warmth of the summer gone and the lovely Cherry blossoms of the spring to come.

    I've looked at life from both sides now
    From win and lose and still somehow
    It's life's illusions I recall
    I really don't know life at all ... From Joni Mitchell

    Take care
    ND

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  10. I am posting this long comment from Razaque on his behalf.

    Dr. Razaque Ahamat
    21:17 (1 hour ago)

    I came into teaching quite by accident. Bored being a DMO with a bleak prospects of career progress, in particular PP being abhorrent to my principles ,joined the Blood Bank as a 'stop gap' measure in order to take stock of my future career path. A chance meeting of Prof.C C Balasubramania, the then Pathologist @ Kandy paid us a social visit (--actually to pay house rent as he was occupying a property owned my wife's parents!!). In passing he requested me if I would teach Med Students basic aspects of Blood Transfusion as I was in-charge of the Unit. This was where "the awesome forces of Fate & Destiny" played its hand & 'dealt' me a hand that was going to be my future Career Path!!! At that time there was a serious transfusion reaction in one of the wards due a clerical error, (fortuitously not fata)l, in patient identity that sent shivers down the Medical & Nursing staff!.. As you are aware vast majority of the population in the area was a Banda or a Manike!!! As such as I was now not only teach Med Students, but also asked to orientate the Nursing fraternity as well. But there was an issue as I had to teach in Sinhalese as it was the first language of most of the nurses. Fortunately I was fairly proficient in the lingo!!

    TEACHING MED STUDENTS;- ......MY "TWO CENTS WORTH" CONTRIBUTION!!!

    That was the beginning of my foray into Teaching. From here I went on to 'greater' heights. All in all I have taught in five(5) Med Schools in four countries around the world --( Peradeniya in SL, St.George's in London ,England, Aberdeen and Dundee in Scotland, and finally Auckland, New Zealand..).... in three( 3) Continents, criss-crossing three (3) Oceans (--of course barring the Arctic & the Antarctic!!), crossing the Date-Line and criss-crossing umpteen Time Zones!!!ne In Aberdeen one of my students was SL girl called Nelun who was the daughter of Padmini Karunaratne Wijeratne and Upali Wijeratne ---aka "Cunningham"!!! I missed out on Harindra - Kusuma Jayasuriya Ruberu's son as I was away attending my brother's funeral in London!!!

    ND-- that's how, "The awesome forces of Destiny works & when Fate deals a good 'Hand' that makes the difference!!!

    I am glad that I had the opportunity to impart my experience and 'meagre' knowledge to the future generations. I must emphasise that all this was possible only to a chance meeting of Prof.Bala and the 'large' helping hand and the 'leg-up' given to me by the late Prof. Flute at St. Georges Med School, London. I too got back a great deal from this experience. Most importantly is the satisfaction of knowing that I if helped to save at least one life (there were many, too long to be told at this Forum)., then I have served my purpose on this Earth. Monetary gratification NEVER came into the equation,-- only the satisfaction of giving. Another thing that I got back from this escapade is that I was able to get over my sometimes irritating Stutter /stammer I had from a very young age and was at the butt end of bullying and name calling as "Gothayar"/Dumber etc.... @ school.
    I am most eternally grateful to these two individuals for their encouragements and support they gave me toward this end.

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  11. Raz
    It is an interesting example of the awesome power of the forces of destiny.
    Thank you
    ND

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  12. There is no doubt that all of us who were fortunate enough to be entrusted with the noble act of teaching , enjoyed it very much and without asking for reward, we nevertheless got it in the form of gratification second to none. As my good friend Harris Total said, "Those who know, do and those who understand teach"

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  13. Those who can, do; those who can't, teach is attributed to George Bernard Shaw in 'Man and Superman', although I dont agree with his logic
    ND

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