Madam, - I read with interest the report by Muiris Houston on the approval of a new graduate medical school at the University of Limerick (Health Supplement, March 27th), where teaching will be based on a problem-based learning (PBL) system developed at McMaster University in Canada.
It would be interesting to review the evidence for this method of education in medical schools, for there in no published evidence to show unequivocally that there is any difference between medical students who have gone through a traditional teaching method and those who have undergone PBL in terms of their subsequent behaviour as doctors.
As recently as March 30th Prof Stephen Klasko, dean of the college of medicine at the University of South Florida, told me: "We have 300 medical students in each year. We have 150, self-selected, in each stream. One is entirely PBL and the other is traditional. There is absolutely no detectable difference in either group when they become doctors."
As for conducting intimate physical examinations on actors or other medical students, this approach was tried when I was a fellow at the University of Minnesota in the 1970s. It was rapidly discredited and we removed it from the undergraduate programme more than 30 years ago. The idea of using actors or students for vaginal and rectal examinations is an anathema to this school of medicine. Medical and other students and lay volunteers are used in all four public medical schools in Ireland currently to assist in teaching clinical skills apart from intimate examinations.
No public medical school in Ireland requires medical students to dissect full bodies but use a combination of prosection, dissection and radiology to teach anatomy. As for communicating, teaching and research skills, I received my undergraduate medical education at University College Dublin in the 1960s and I consider myself and my colleagues at Trinity College School of Medicine to be expert communicators, teachers and above all world-class researchers.
Incidentally, I think most patients would be reassured if we make the correct diagnosis as without this skill all else is for naught. - Yours, etc,
SHAUN R McCANN, Professor of Academic Medicine and Director of Undergraduate Teaching and Learning, School of Medicine, Trinity College, Dublin 2.