Confucius School of Medicine: the way to great learning
BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7327.1458 (Published 22 December 2001) Cite this as: BMJ 2001;323:1458
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I agreed with MS Chong that Confucianism had indeed confused many
generations in the East. However, I am in the opinion that this is due the
rigid and inflexible interpretation of Confucianism. Confucian did
encourage students to ask questions. In fact, the original teaching of
Confucian was written in "question-and-answer" form between the teacher
and the students (very much like the question-answer guide books for the
present membership examinations!). The problem might be with the teachers.
Are they welcoming questions or different opinion? Or they just expect the
student to accept what they said?
Medicine is a disciplined discipline. In her article, Cindy LK Lam
had emphasized "Develop virtue and self discipline",
"Practise being kind and respectful", "Learn to talk to people nicely and
to listen as their first clinical skills". These are all essential human
skills. One needs great discipline to develop these skills. As for
memorisation of "hard facts", this is sometimes unavoidable. The are
certain "top 10" important "hard facts" we need to master. Treating an
acutely ill traumatised patients should start with assessment of "airway-
breathting-circulation" and immediate "resuscitations". A breast lump in a
40 year old lady with family history of breast cancer alarmed us about the
high possibility of malignancy, not a creative possibility of some
previously-undiagnosed "prion-like" lesion of the breast.
The "neo-Confucian" School of medicine must encourage both the
teachers and the students to be inquisitive, develop the correct positive
attitude to all people, and the disciplined pursue of basic knowledge.
This would take the next generation of doctors to stand on the shoulder of
giants and be able to look farther.
Competing interests: No competing interests
This sounds like the worse medical school of the three. Learning by
rote memory is fine but there are too many who rely solely on this method
of practising medicine (and life) leading to rigid thinking and ossified
behaviour. How many medical students have we encountered who can reel off
a list of differential diagnosis without thinking whether it is relevant
to the clinical problem!
Confucius has left a great tradition but also many problems. I spent most
of my early years struggling against principles like not questioning my
teachers, placing more value on males more than females, be subservient to
my elders.
There is also a danger that someone trained as a doctor in this tradition
will too easily allow this to spill over to judging patients' behaviour
and values.
Confucianism has had too strong a hold over too many people, especially in
the East. He was a great philosopher but only one of many and the
temptation to resurrect him as one is tempted to with one's advancing age
is to be resisted.
I would rather be treated by a dishevelled, humane doctor than an
automaton who can tell me all the causes of finger clubbing.
Competing interests: No competing interests
Confucious School is a great start.
It is my humble opinion that the idea of a Confucious way of learning
is definately a step in the right direction. All of those principles
should be present in a prospective doctor. But there should also be room
for different personalities. Allow me to explain.
Discipline is a great concept, as is honesty, and sincere
professionalism. However, while honesty is trait that is a must, the
other two can have variation. Not all doctors need to be stiff Vulcans.
There is always room for doctors who lighten the mood. But this type of
doctor should be aware of when and when not to be in good humor.
Therefore I submit that dicipline has its place, but should allow room to
"joke".
Competing interests: No competing interests