Thread by @docbhooshan

Breaking bad news.
A skill never taught at medical college in India is one of the most important skills for a doctor in real practice.

I see a lot of patients for 2nd/3rd/4th opinion (I am sure this is true of all specialists).

Discussing diagnosis and prognosis

is THE most important part. It is important to be sensitive but not to mince words.

Few days ago I met a family with 14yr old child with schizophrenia. They had already been in treatment with two different psychiatrists till then.

Both previous doctors had treated the child with textbook protocol and necessary investigations were done.
No fault at all.

But diagnosis was never clearly discussed.
It is a daunting task to tell a 14 yr old and their parents about one of the most complicated diagnosis.

But it can not be avoided.
I had a clear advantage of being third doctor. Family took the diagnosis well. They had already done their reading and needed a confirmation from a person they could trust.
It is not a lot to ask , isn't it?
It is their right. A right thing to do.

I am told that new medical curriculum actually includes this skill.
I believe that including it is a good start and trainee doctors MUST see their seniors using it in daily work.

Unless professors sit in primary OPD and active ward rounds, this will not happen.

This was a huge difference between my training in India and in the UK.

All trainers in UK were practicing consultants with primary responsibility of care.

It makes all the difference.

You learn a lot more seeing vulnerability and responsible behaviour of your teachers.

Fortunately even in India, I trained in a department where junior most were paired with the seniormost in the department.

Structure of training is vital in medicine.

I truly hope that new curriculum actually involves inputs from REAL working doctors.

Senior nurses teach a lot of valuable practical and human skills. Why are they absent in formal training of doctors in India?

When will this change?