- This academic year, 33 lecturers from the Faculty of Medicine (22.3%) are heads of service or unit of hospitals or care centres throughout Catalonia
- These two facets of teaching staff, that is, professional work and teaching, favour the transmission of knowledge, experience and values to the students.
With a surgical gown or a white coat, in their day-to-day life they combine patient care and work in the consulting room, operating room, hospital ward, laboratory or any central hospital service, with training students of the UVic-UCC Faculty of Medicine. During part of their day they are specialists in oncology, traumatology, ophthalmology, cardiology, family medicine, internal medicine or other specialties; heads of service or unit; or coordinators in a primary care or intermediate care centre. During another part of the day, they dedicate their time to teaching and preparing the new generations of medical professionals. This academic year 2021-2022, the UVic-UCC Faculty of Medicine has 33 professors, 22.3% of the total, who have combined the two facets of head of service or unit, and member of teaching and research teaching staff (PDI).
“Hospitals and university health centres try to ensure that the heads of services are also teachers and researchers associated with medical schools,” said Marina Geli, director general of the Foundation for Advanced Studies in Health Sciences (FESS), the entity that owns the UVic-UCC Faculty of Medicine. This relationship between the health field and academia is a common feature of all universities, “but now we have had the opportunity to create, from scratch, a strategic alliance in which we all gain: the health system, the education system and, above all, the society we serve,” explained Ramon Pujol, Dean of the Faculty of Medicine.
The Faculty has been committed to this profile of professionals/lecturers in the development of its studies. "The fact that heads of service are teachers also means that the doctors on their teams can get involved in the students’ learning tasks in clinical practice. In turn, the students learn by watching what the professionals do, so that they can put it into practice the next day,” explained Ramon Pujol.
“The extensive experience that these doctors have in their specialty, some with more than 30 years in the profession, gives them a wide range of expertise in transmitting the knowledge and skills that a good doctor of the future must have,” said Geli. According to her, “the transmission of clinical knowledge and the long career of the professionals gives students a mirror that reflects not only theoretical content but also clinical practice.”
An added value
Some doctors stressed that to combine the two facets, a broad view of medicine and an overview of professional practice are required. In other words, a perspective of both the care side and the managerial side is needed. “Apart from knowledge of care, the head of service organizes teaching and research, has deep knowledge of health and socio-health resources in the territory, and can offer a vertical and cross-cutting view of medicine that is very closely linked to reality,” explained Carme Serrano, head of the Department of Medicine and Emergencies at the Hospital Sant Joan de Déu de Martorell Foundation and professor of Neurology at the Faculty of Medicine.
However, others believe that the main value is accumulated experience. “In general, the head of service has been passing on knowledge to students and medical residents for many years, and knows how to do it easily,” said Lluís Guirado, director of the Nephrology Service at the Puigvert Foundation and lecturer in the same specialty in the Faculty. Another skill that these doctors have in common, according to Elena Hernández, head of the Otorhinolaryngology Service at the Hospital de Viladecans and lecturer in this specialty, is organizational capacity: “Order and systematization help us to be more efficient and this is very important for students of a degree like medicine, with a very broad syllabus that forces us to have many fronts open at the same time.”
«In general, the head of service has been passing on knowledge to students and medical residents for many years, and knows how to do it easily»
Why combine teaching and healthcare?
“I like ‘basic’ teaching, such as how to take a good medical history, carry out a physical examination, and understand the needs of the patient and their environment, rather than scientific research (the effects of new drugs, recent genetics studies, molecular biology, etc.). When the chance came up to become a lecturer in the subject of Clinical Examination and Practice, I thought it was a good opportunity to be able to do what I had always liked,” said M. Antònia Baraldés, Health Care Director of Catalunya Central-Hospital de Berga and lecturer in Clinical Examination and Practice at the UVic-UCC Faculty of Medicine. Teresa Torrent, head of the Ophthalmology Service at the Althaia Foundation and lecturer of the same subject, already had previous experience teaching at the University of Girona and in problem-based learning (ABP). “Being in contact with students is stimulating because they ask you questions that sometimes you have not asked yourself, or they ask you to explain problems in a different way from normal. The truth is, you don’t get bored,” she said.
«They will be our doctors in the future, so I am very selfishly interested in them learning everything we can pass on to them»
Some doctors consider that physicians should combine, as far as possible, care, research and teaching. “It is in this last aspect,” said Dr Eduardo Kanterewicz, head of the Rheumatology Service at the Vic Hospital Consortium, “that the opening of the UVic-UCC Faculty of Medicine was a great opportunity to contribute knowledge and experience and, at the same time, continue learning from the university world.” The different, exciting project of UVic-UCC, and the possibility of transmitting knowledge are factors that some doctors took into account when they combined the two facets.
Is it easy to coordinate?
Combining the two facets during the intensive theoretical and practical weeks in the sequential, unique model of courses at the Faculty of Medicine is not always easy and requires a significant number of extra hours of work. The jobs are a constant responsibility. When this is added to teaching, free time in the evenings or at weekends often needs to be dedicated to the tasks. However, organization and enthusiasm are key. “It's a question of interest; for me it is not a job, because I enjoy it. The training and curricular system of UVic-UCC means that there are moments of great dedication and others of not as much,” mentioned lecturer Domingo Ruiz, Head of Internal Medicine at the Althaia Foundation.
Elena Hernández noted that during the three weeks that her subject lasts, she dedicates about 12 hours a week to teaching and, although it is an additional effort because the care and management work cannot stop, “the advantage is that this makes you more up to date with your specialty.”
Beyond the contents of the curriculum, what should be transferred to the students?
Without neglecting learning of the basic profession and all aspects of medical activity, teaching staff of the Faculty of Medicine consider that it is important that students not only learn the contents of the subjects, but also how to apply them. Baraldés stressed that students “need to be trained in values such as empathy, good treatment, understanding, knowing how to listen to the patient’s opinion, doing thorough examinations and understanding what is happening to the person in front of them and why.” He added: “In this way, they will practice much more valuable medicine, ask for additional tests that really help the diagnosis, and apply the most appropriate treatments for the disease and the patient’s preferences.”
Selfishness, Ruiz argued, is at odds with the essence of medicine. Therefore, one of the tasks and challenges of teachers is to provide or help to develop what Philip Jackson called the “hidden curriculum”: “What the student learns is not just what is on the academic curriculum but also something more complex, such as feelings, how to express them, values, ways of behaving, and adapting to different areas.” Similarly, Serrano stated that the profession of doctor cannot be learned in books or at the faculty: "You have to experience it at health centres, and be responsible for passing it on to the next generations.” For her, beyond Harrison’s principles of internal medicine, what needs to be conveyed to the student is the overall approach to the patient. “They will be our doctors in the future, so I am very selfishly interested in them learning everything we can pass on to them,” concluded Torrent.