LETTER TO THE EDITOR PISMO UREDNIKU LETTER TO THE EDITOR PISMO UREDNIKU

THE ROLE OF PHD TEACHERS IN MEDICAL EDUCATION

Dhastagir Sultan Sheriff 1 and S. Omer Sheriff 2 1Department of Biochemistry, Al Arab Medical University, Benghazi, Libya and 2Priyadarshini Dental College, Chennai, India

“Most ideas about teaching are not new,but not everyone knows the old ideas.” Euclid, circa 300BC

Many understand the value of in the field of research of a very high standard. Some universities award hon- education, whether it be science, engineering or medicine. orary doctorates to an individual for his/her contributions to a The field of research and its development depend upon the particular field or for philanthropic efforts. In certain Europe- doctorates who devise, guide and conduct research projects an countries, is the highest academic qualification and also teach. Therefore, it is worthwhile to understand the a person can achieve by his/her own pursuit and is still used status of doctorates in education, particularly in medical edu- for academic recruitment purposes in many countries within cation. With this view in mind, an attempt has been made to the EU. It involves either a new, long (a second book) or outline the role of PhD teachers in medical education. a portfolio of research publications. Habilitation demonstrates independent and thorough research, experience in teaching What does the degree Doctor of and lecturing and, more recently, the ability to generate fund- Philosophy (PhD) mean? ing within the area of research. The habilitation is regarded as a The term , derived from the Latin word docere senior post-doctoral qualification completed many years after meaning “to teach”, is shortened from the full Latin title the research doctorate and can be necessary for a Privatdozent licentia docendi meaning “teaching license”. or for a professor position in Germany.2 A similar system tra- A doctorate is an academic or that, in ditionally exists in Russia. Previously in the Russian Empire the most countries, represents the highest level of formal study (doktor nauk) marked the or research in a given field. In some countries it also refers highest academic degree that can be achieved by an examina- to a class of degrees that qualifies the holder to practice in tion. This system was generally adopted by the USSR/Russia a specific profession (such as law or medicine). The best- and many post-Soviet countries. known example of the former is the PhD (Doctor of Phi- Research doctorates are awarded in recognition of aca- losophy), while examples of the latter include the U.S. degree demic research that is (at least in principle) publishable , a doctoral degree for physicians. in a peer-reviewed academic journal. Criteria for award The , abbreviated PhD, or alterna- of research doctorates vary somewhat throughout the tively D Phil, from the Latin meaning “teacher of philosophy”, world but typically require the submission of a substan- is an advanced academic degree awarded by universities. tial body of original research undertaken by the candidate. Historically, it was thought that PhD teachers or scien- This may take the form of a single thesis or dissertation or tists had been trained to become university professors. The possibly a portfolio of shorter project reports and is usu- United States is reported to be the greatest producer of PhDs, ally assessed by a small committee of examiners appointed generating about twice as many as the next leading country, by the university and often an oral examination of some Germany. Countries with small populations, such as Canada kind. In some countries (such as the US) there may also be and Switzerland, produce relatively few PhDs. However, many a formally taught component, which typically consists of other countries that have huge populations, such as India and graduate-level courses in the subject in question as well as China, also produce relatively small numbers.1 training in research methodology. The minimum time required to complete a research doc- Types of PhD: torate varies by country and may be as short as three years (ex- PhD students or doctorates usually fall in one of several cat- cluding undergraduate study), although it is not uncommon for egories. Research doctorates conduct academic research in a a candidate to take up to ten years to complete his/her degree. stipulated period of time and submit a thesis with a substantial In Spain, Doctor Degrees are regulated by Royal De- body of original research. At a higher level in India, a Doctor of cree (R.D. 778/1998) (Real Decreto in Spanish). They are Science (DSc) or (Dlitt/LittD) is awarded by a granted by the university on behalf of the King, and the university based on the submission of a portfolio of published diploma has the force of a public document. The Minis-

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Correspondence to: [email protected] 23 try of Science keeps a National Registry of Theses called ing is vital for medical students to become accomplished, TESEO. According to the National Institute of Statistics responsible and service minded. To accomplish this goal, (INE), less than 5% of M.Sc. degree holders are admitted to medical education needs to balance knowledge, skills and PhD programs, and less than 10% of 1st year PhD students values during the students’ period of learning. Instead, are finally granted a Doctor title. All doctoral programs are theoretical, scientific knowledge of formal learning has research in nature. A minimum of five years of study are superseded clinical, patient-oriented education. Now, the required, divided into two stages: knowledge of medical research is grounded more in basic 1) A 3-year long period of studies, which concludes medical sciences.6 Therefore, there is currently a cry for with a public dissertation presented to a panel of three pro- more clinical teachers to teach students in a clinically ori- fessors. If the project receives approval from the universi- ented, patient-centred fashion. ty, he/she will receive a “Diploma de Estudios Avanzados” Therefore, to give importance to teaching and to pro- (partially qualified doctor). vide time for clinicians to be more patient-centred, PhD 2) A 2-year (or longer) period of research. Extensions teachers are trained to teach basic medical sciences. may be requested for up to ten years. The student must These PhD scientists and teachers are considered to be write his thesis presenting a new discovery or original the torchbearers of not only teaching these subjects but contribution to science. If approved by his “thesis direc- also developing basic biological science research programs tor”, the study will be presented to a panel of five distin- in medical schools. In this context, the PhDs of the medical guished scholars. If approved, he will receive the doctor- faculty with knowledge of clinical subjects are considered ate. A Doctor Degree is required to apply to a teaching scientist cum teachers.7,8 position at a university. A medical educator is usually a medical scientist and clinician with a special interest and expertise in medical The combined MD-PhD program in the USA and, more education. A medical educator may be someone who is: recently, in Australia aims to produce clinician–scientists a) Specially skilled in teaching committed to pursuing research that reflects their experi- b) A person trained in the educational theory and ence of clinical practice.3 practice in the context of medicine In Libya the faculty are required to have a PhD award- c) An administrator in medical institution ed by a professional university in the subjects they teach. For example, a PhD awarded by a medical university is re- Therefore, the role of PhD teachers in the faculty of quired for teaching medical students and other respective medical schools is clear-cut. They teach and develop re- universities or faculties for other subjects. search programs in medical institutes. In a changing social context of medicine, basic science research and its teaching Role of a PhD in medical education: need to develop because they form the foundation stone of Medical education is the science behind the teaching basic and applied research in the field of medicine. and learning in medicine. It has developed from problem identifier domain to that of solution provider. Abraham REFERENCES: Flexner of the Carnegie Foundation placed emphasis on the 1. Frank Gannon What is a PhD? EMBO reports scientific basis of medical practice. Therefore, formal ana- 2006;11:1061 (2006) lytic training, integral to the natural sciences, was thought 2. Kemp, S. Professional Doctorates and Doctoral Education. to be inculcated in the intellectual training of physicians.4 International Journal of Organ Behav 2002;7:401-410 Clinical phase education, it was thought, would encourage 3. Sutton JS,K. The MD-PhD researcher: what species of physicians to consider pursing research to provide better investigator? Acad Med 1996; 71: 454-459 care for their patient. 4. Flexner. I. I remember. The autobiography of Abraham Flexner, New York, Simon, Schuster, 1940. Transformation from patient care to 5. Berger TJ, Ander DS, Terrell ML, Berle DC. The impact molecular research of demand for clinical productivity on student teaching Currently, there is a real transformation of thinking in academic emergency departments. Acta Emerg Med about teaching, which is considered subordinate to re- 2004;11:1364-1367. search. This transformation is due to the development of 6. Maria A, Brian D H Donald W Understanding the the “publish or perish” attitude. Previously, the integration Challenges of Integrating Scientists and Clinical Teach- of investigation with teaching and patient care made the ers in Psychiatry Education: Findings from an Innova- field of medicine dynamic. However, the shift from patient tive Faculty Development Program. Acad Psychiatry care to molecular events has diminished the standard of 2009;33:241-247 clinical teaching in favour of laboratory research.5 This 7. D.S.Sheriff, Medical teachers must have an open mind. shift is a result of economic need wherein to generate rev- The Hindu, Daily from India, 2000,Sep.29 enue, the physician is forced to provide care for paying pa- 8. Sheriff DS and Roberts, Medical Education, Health Ed- tients. Therefore, clinical teachers have less time available ucation and societal needs of India- a general perspec- for teaching. The importance of responsible clinical teach- tive. Meducator 2001;1:16-18.

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