WHILE the shortage of medical specialists must be addressed, an overemphasis on producing clinicians can hamper healthcare efforts, particularly during outbreaks like the Covid-19 pandemic.
The focus of medical schools on producing clinicians, rather than clinician-researchers who are able to bridge the gap between fundamental and clinical research, is due to the low specialist-to-population ratio in Malaysia, noted Universiti Malaya (UM) Medicine Faculty dean Prof Dr April Camilla Roslani. But such emphasis, if we are not careful, could derail Malaysia’s plans of becoming a developed nation, she cautioned.
“If we are aiming for developed country status, a strong research culture must be established, with the emphasis shifted towards training well-rounded clinician-researchers who have expertise in both areas,” she told StarEdu.Clinical researchers, she said, work to understand health and disease by studying people, data or tissues, and their discoveries lead to the prevention, or better treatment, of diseases, thus improving healthcare in general.
Limitations in the number of clinical researchers and other resources, she added, prevent or delay the initiation of research, or slow down its progress.
“This is particularly problematic when there is a deadly outbreak of a new disease, as researchers must race against time to discover the source of the problem and concurrently develop a treatment which, under normal circumstances, might take years.
“This was the case with the Covid-19 pandemic, which required the collaboration of governments and industries from around the world to enable rapid yet safe identification of the SARS-CoV virus and suitable vaccines to save lives,” she explained.
Dr April Camilla went on to say that in the case of a known virus, such as influenza, researchers are able to track and anticipate mutations and, thus, create new vaccines with less time pressure. “By preventing or reducing the severity of diseases in this way, the overall healthcare of the nation can be safeguarded,” she asserted.
Pointing out that conventionally, clinicians and researchers have distinct and separate early training pathways, Dr April Camilla said this can create problems of integration when conducting clinical research in the future.
“Researchers must receive input from clinicians and be informed about real-life problems in healthcare so that they research topics that have impact on clinical work.
“Clinicians, on the other hand, have to understand the research process so that they do not misinterpret the results of existing studies, which could potentially lead to wrong decisions made for patients or the entire healthcare system,” she said.
Drawing a comparison between medical schools in the United Kingdom and Malaysia, Dr April Camilla shared that the former offer medical degrees with the option of an additional year for intercalation dedicated to research, resulting in the award of a bachelor’s degree, while in the latter, formal research opportunities for medical undergraduates during their five-year programme are limited.
“When undergraduates are involved in research, it is usually because their clinical supervisors during a specific rotation happen to be conducting clinical research and may invite the students to participate in it, or the students may request to be part of that project.
“While it is a requirement for UM medical undergraduates to complete a six-week elective at the end of Year Three, students are usually only involved in small research projects, such as a clinical audit or something of that nature which can be completed within a short time,” she said.
Dr April Camilla is of the view that opportunities for research should be made available to medical undergraduates – in order for them to have a broader perspective of what career to pursue – but remain optional only for those who are interested to participate in it.
“There are some who are gifted in conducting research whereas others are better as clinicians, but both need to be there in order for medicine to progress.
“A year of optional intercalation for research provides students not only with training and exposure, but also gives them an additional recognised qualification,” she said.
