.Md. Zahirul Isalm¹, Md. Faizul Bashar²

Dr. Md. Zahirul Isalm, Junior Consultant (ENT), OSD, DGHS, Mohakhali, Dhaka, Bangladesh.

Dr. Md. Faizul Bashar, Professor & Principal, Patuakhali Medical College, Patuakhali, Bangladesh.

Correspondence:  Dr. Md. Zahirul Isalm, Junior Consultant (ENT), OSD, DGHS, Mohakhali, Dhaka, Bangladesh.Mobile-8801788554400,  Email: [email protected]

Healthcare system is constantly changing. So, to keep pace with this rapidly changing system medical education also need to evolve with time. Supervised postgraduate medical training has become an area of focus in recent years as the healthcare system continues to evolve. This structured program, controlled by Bangabandhu Sheikh Mujib Medical University (BSMMU) and Bangladesh College of Physicians and Surgeons (BCPS) in Bangladesh and accredited by Bangladesh Medical and Dental Council (BMDC), prepares newly graduated physicians to provide high-quality care to their patients. Through supervised training, postgraduate physicians gain hands-on experience and develop their clinical skills under the direct guidance of experienced supervisors. This helps them become knowledgeable and skillful, enabling them to provide safe and effective care to their patients.

Learning by doing is very popular theory in postgraduate medical educational training.¹ As part of this training period, the trainee is expected to develop their skills, knowledge, and attitude through interactions with academic personnel at various levels, including supervisors, peers, and subordinates. Trainees must also interact with patients, their families, and hospital staff to gain practical experience. Establishing good relationships with all individuals involved creates an effective learning environment.²

In Bangladesh, the scarcity of skilled personnel and the high patient volume pose significant challenges for both trainees and supervisors in the learning environment. At times, they may be required to work beyond their levels of competence, and it can be difficult to define trainee duty hours. The issues of education, research, and ensuring safe clinical services also arise in this context.³ All of these factors create a highly complex learning environment, particularly for the trainee. Postgraduate training comprises both clinical service and research work, both of which are critical components. Therefore, trainees must strike a balance between the two fields. Being a supervisor in postgraduate medical training is also a challenging but rewarding job. The challenges that a supervisor faces are diverse in nature that includes balancing clinical duties with his supervisory responsibilities, meeting the varied needs of trainees, keeping up with changes in medical education, addressing trainee performance issues, managing his workload.⁴       

With the advancement of information technology in recent years postgraduate training program in Bangladesh has radically changed its nature, duration, supervision and overall success rate in exam. Now a day’s residency program is very much popularized especially to the doctors who have no government jobs. As because this residency program in post-graduation training gives some monthly allowance to the private doctors who have been enrolled to these courses in different institutes. 

Both the trainee and supervisor play significant roles during supervised training. It is crucial for the trainee to follow the program diligently, but in many institutions, accommodation is limited after working hours. A few institutions provide subsidized meals exclusively for postgraduate trainees. Unfortunately, the psychological well-being of trainees is often neglected, and errors can result in psychological trauma, necessitating a space for discussion. In some cases, students enrolled in the same course may not have comparable levels of knowledge or learning capacity, which can pose difficulties initially.

Supervised postgraduate medical training is essential for ensuring that newly graduated physicians are prepared to provide safe and effective care to their patients. Monitoring the program regularly, assessing the need, and revising the curriculum in consultation with eminent academicians are crucial steps that must be taken. 

REFERENCES

1. Greenaway D. Securing the future of excellent patient care. Shape of Training, 2013.

2. Wiese A, Kilty C, Bennett D. Supervised workplace learning in postgraduate training: a realist synthesis. Med Educ. 2018;52(9):951-69.

3. Cantillon P, De Grave W, Dornan T. Uncovering the ecology of clinical education: a dramaturgical study of informal learning in clinical teams. Advances in Health Sciences Education. 2021 May;26(2):417-35.

4. Nguyen VN, Rees CE, Ottrey E, Davis C, Pope K, Lee S, Waller S, Palermo C. What really matters for supervision training workshops? A realist evaluation. Academic Medicine. 2022 Apr 5:10-97.

5. Volpp KG, Grande D. Residents' suggestions for reducing errors in teaching hospitals. New England Journal of Medicine. 2003 Feb 27;348(9):851-5.