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Science and communication (Part 1)


Medical education (Part 3)
David Weatherall Scientist
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We’ve not, I don’t think, prepared our youngsters for the complexities of what they’re going to meet in the future. We’ve tended to teach the basic biological sciences, anatomy, physiology and so on, and biochemistry, I think it’s taught a lot by people who feel that medics need something rather didactic and uncritical, and so a lot of them would, end of that period of training, with thinking that in certain ways biological systems were definable and perfect, if you like, then you go into a ward full of old crocks, and none of it works, and I have a feeling that’s why a lot of the youngsters have been put off. What I think everybody should read before they even start medicine, is Ernst Mayr's, one of his latest, his last book I think, or next to last book, "What is Biology?", because he struggles himself, he said, been on numerous NIH committees, and all the time he’s trying to define, you know, basically it’s a layered system, first of all it’s descriptive, and that shouldn’t be denigrated, as it’s often as, yeah, you know, it’s just descriptive, it’s the description of a phenotype, and then it’s, what he says it’s then the proximal and the distal causes. The proximal causes being what is describable in physiological and then more recently in molecular terms, but then the most distal causes of the kind of ecology and ethology and how things actually got like that, evolutionary biology, and that if you look upon living things as this layered sort of complexity, at least gives you some kind of basis for realising that when you go into a ward, you’ve, every one of these people you see there is that, and there will be no simple explanations. And after that, then one’s got the problem of how are we going to train people who I think are vital in the interface between the basic biological sciences, and in a system which is so totally kind of oppressive in terms of rigorous step by step, and how do you, how do they step out and step back? It’s got very, very difficult. And I think if we don’t do that, and really seriously re-look at some of those key issues in education and post-graduate education, it’s going to be very difficult, even more difficult, to train the next kind of cohort of clinical scientists. A lot, a lot more is expected of them, of course. Now, the other issue which I think we’ve touched on while we’ve been talking, is the issue of trying to encourage many more clinical scientists, and the universities in this country, to take a more global view of disease. It’s been fascinating talking around, I mean, wonderful tropical school in Liverpool, for example, the, there’s no interaction, the under-graduates and under-graduate teaching at all. What we did in Oxford, when I got to Oxford, we started something called the Tropical Day, so every student was, did nothing else that day, it was tropics, and we brought in a series of people with, who’d had a lot of experience in global aspects of medicine, and we brought a couple of chaps down from Liverpool with bags of worms and revolting things for these kids to see under the microscope, and that, that’s still going, it’s been very popular, and I think now about, I think somewhere around about 60 or 70% of the Oxford students do an elective period in the developing countries. And I think that’s obviously, a lot of that’s happening in other schools now, but again, what one’s trying to do is to just interest, perhaps even a small cohort, in the possibilities of at least spending part of their working time in research, and service work in the developing countries. What I’d like to see is more of the British universities developing these kind of, I hate this jargon, but the north-south partnerships, that we talked about earlier, that have been pretty successful in our place. So, there are problems for medical education, particularly for people like ourselves who firmly believe still, that there must be a place for what I’d call a kind of clinical scientist. I notice even in my own institute now, that there seems to be more of a division between the people who are doing kind of basic science and, and there is a feeling, and I’ve certainly met it in the States, that its not possible anymore for one person to have a foot in both camps. I don’t know if you believe that, then it worries the heck out of me actually, because who’s going to make the ground between the two halves? I mean, I’ve probably been kind of singularly unsuccessful in both halves at times, but at least occasionally you could at least fool yourself you were bringing the two together. I think if a person gets properly clinically trained and is then able, as they have been in the past, to take a few years off to get really, proper scientific training, and when they then develop their careers and are fully localised in their clinical activities, it is still possible, and must be still possible. But it’s going to take our successors a huge amount of fighting to stop these, I think our government at the moment seems hell bent on just a kind of generation of barefoot doctors, and think that a lot of the scientific background and the kind of early stuff that we have taught in the past is just a waste of time. They could produce a barefoot GP in 18 months, two years, perfectly adequately. It’s only that’s what, I think, the kind of thing we have to face in the future.

British Scientist Sir David Weatherall (1933-2018) was a world renowned expert on blood diseases, in particular thalassaemias, and used his expertise to help control and prevent these diseases in developing countries. He founded the Institute of Molecular Medicine at Oxford in 1989 and was knighted in 1987.

Listeners: Marcus Pembrey

Marcus Pembrey, now Emeritus, was Professor of Paediatric Genetics at the Institute of Child Health, University College London and consultant clinical geneticist at Great Ormond Street Hospital for Children London. He is a visiting Professor at the University of Bristol UK, where he was the Director of Genetics within the Avon Longitudinal Study of Parents and Children until 2006. A past president of the European Society of Human Genetics, he is also the founding Chairman of the Progress Educational Trust.

Duration: 7 minutes, 15 seconds

Date story recorded: July 2007

Date story went live: 02 June 2008