Medical Education
Biochemistry Education in medical Schools
Is it a basic Science or Clinical Science or Advanced Science?
As it is pointed out in the Case Files in Biochemistry –The Approach to reading involves Six key questions
1. What is the most likely biochemical mechanism for the disease causing the patient’s symptom or physical examination finding?
2. Which biochemical marker will be affected by treating a certain disease and why?
3. Looking at graphical data, what is the most likely biochemical explanations for the results?
4. Based on DNA sequence, what is the most likely amino acid or protein result , and how will it be manifest in a clinical setting?
5. What hormone –receptor interaction is likely?
6. How does the presence or absence of enzyme activity affect the biochemical (molecular ) conditions, and how does that in turn affect the patient’s symptoms?
Biochemistry as Basic Science
If these questions are considered for undergraduate teaching, some aspects are covered and many aspects are not covered. Even those aspects which are covered, it is done in a situation where the students are not exposed to any of the clinical situations and they have to imagine the clinical scenario , for which the explanations are taught.
We can consider a situation when Biochemistry can be taught at the first year level, the terminology, normal biochemical pathways- normal physiological chemistry in coordination with other first year basic sciences like anatomy and physiology. In that case many of the above said questions will not be answered and the teaching biochemistry in a medical school will be very much below the expectations in a medical student’s point of view.
(this is the reason even now many students think that biochemistry is some handful of pathways)
Biochemistry as Clinical Science
When actual clinical science teaching comes, rarely there is chance for the students to understand the disease at a molecular level. The biochemical mechanism of disease process need to be taught by the clinical teachers. The load will be huge for them to discuss along with the aetiology, clinical manifestations, investigations and therapeutic management.(this situation changes when there is total integration or universities adopting Index of presentations as medical education)
There are varied reasons `
Biochemistry as advanced Science
With the latest flare for evidence based medicine (teaching and Practice)now there is a need to introduce the every day changing concepts in the field of clinical biochemistry ,by making the students to actively involve in “Recent advances in Biochemistry” –project or Seminar or exhibitions. The learning is directed to create awareness in the advancement in the field.
Finally I would like to add the three dimensions of the subject as ……..
It has width in covering the various areas of medicine, and has depth in forming the molecular basis being dealt in this training and has heights to understand the latest concepts of diseases.
I would expect the students to learn biochemistry in three ways.
• Understanding Basic facts
• Molecular basis of normal body functions
• Biochemical basis of disease conditions ( atleast few common examples.
As educators ,we the teachers of Biochemistry have a major responsibility in designing a text book, to incorporate the widely practiced integrated , system based curriculum or index of presentations.
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contributed by: Ursula Sampson, Ras Al khaimah, U.A.E: 11 November 2007
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