Final Year Medical students feedback on Classroom Teaching

How to make Classroom teaching more effective and inclusive in Medical Sciences ?

I being a Cardio Thoracic surgeon, hence not a very experienced teacher of UG students in medical college, as super speciality departments don’t get to take many classes of MBBS. But teaching has always been my passion as I feel that when I teach, it’s a bilateral flow of knowledge transfer. In the process I gain a lot. I get a chance to transfer the knowledge of my teachers, the experience I gained from patients, cases and surgeries. If I am able to ignite or awaken few minds in my journey as teacher, I will be very happy person as I feel an awaken mind can find everything on his or her own later.

Once I asked final year medical students via online survey ( Name of colleges who participated not to be disclosed ) regarding their suggestions and feedback on class room teaching and how can it be made more inclusive and purposeful. 

In general, low attendance in classes prompted me to do this exercise. Around 40 final year students participated in feedback. I am summarising the inputs they gave with respect to classroom teaching, academic activities and atmosphere and also some related issues. 

I will also be thankful if respected teachers can also give their valuable suggestions and experiences, so that student’s satisfaction remains high.

If you have any suggestions or comments please feel free to post below.

Final Year Medicos (MBBS) feedback summary, as they have written

1. . .    PowerPoint presentations: slides are at times very lengthy, too many and it becomes very boring. Mix of black board teaching and ppt is very welcome.
   
   
   2.    All presentations by teachers can be uploaded online from where the students can download them later for better understanding.
   
   
   3.    Short MCQ session / Q and A after the class.
   
   
   4.    Theory lecture supplemented by a real scenario case history , wherever feasible.
   
   
   5.    Exams should have both descriptive and MCQ.
   
   
   6.    Exam timings, class timings and Syllabus notices to be shared well on time and also available on line.
   
   
   7.    Canteen which remain open late night and serves good multiple variety hygienic, protein rich, non-junk food.
   
   
   8.    Evening postings: students are of the opinion that they are hardly left with time for self study. Should not be more than 4 days a week.
   
   
   9.    No class on day of sessional exams and there should be one day gap between the exams.
   
   
   10. More integrated classes with theory and practical together and different disciplines involved teaching together. 
   
   
   11. Counselling sessions for PG branch/course to be held.
   
   
   12. Breakfast should be available before 8 am class in hostel.
   
   
   13. Clinical postings should have a syllabus of cases that needs to be seen.
   
   
   14. Attendance sheet should be shown to us every three monthly.
   
   
   15. Answer sheets of exams should be shown.
   
   
   16. Classes on communication skills, personality development. 
   
   
   17. Library should have more seating capacity.
   
   
   18. Lecture theatre infrastructure: Mikes, speaker, lack of Air conditioning, bad acoustics, un comfortable seats, dogs entering classrooms were common mentions.
   
   
   19. Training about financial planning and research methodologies. Also, how to write a paper and make a presentation.

I am sure we will ponder on above points.

Dr. Siddharth Lakhotia

MBBS, MS, M.Ch, FIACS

Professor and Head

Cardio-Thoracic Surgery

Institute of Medical Sciences

BHU, Varanasi

drslakhotia@gmail.com

https://www.ctsnet.org/home/slakhotia

Thanks Dr Siddharth, at least in my knowledge, you are the first person who raised the issue of teaching. In present scenario everyone assesses the status of Institutions by quality research outputs and projects grabbed. One should realise that proper understanding of the subject forms the plinth of quality research. We must introspect about the quality of teaching which we are catering to our students. 

Green Environment Friendly Hospital and Medical College

Siddharth Lakhotia

How should be Our Future Medical Colleges and Hospitals with respect to Greenery ?

Nature Heals, Nature Cures !!

Nature is the only true Medicine.

Though it looks like a dream to think of such public hospitals, but if we don't act now, overcrowded concrete hospitals will become a major cause of disease themselves.

With increasing need of humanity we are rapidly developing more and more concrete infrastructure to fulfil our needs. But this all is occurring at a big big cost, which we all know, rapid destruction of Nature, trees and open grass lands, and with it comes many modern diseases and problems.

Modern hospitals slowly are becoming a home for diseases themselves, due to their concrete, centrally air-conditioned, all artificial light designs and many other reasons with hardly any space for cross ventilation, open gardens, sunlight, natural air, blue sky, trees and other elements of Nature.

Holistic eco friendly sustainable development is very much the need of hour. Let our trees, gardens, sunlight, fresh air and flowers be heart and lungs of our medical colleges and hospitals. They too are Doctors of Nature !! We need to strike a balance with nature

Health of a patient is directly related to presence of fresh air, sunlight and healthy nature around him or her. It makes him or her joyful and happy, so badly needed for quick recovery

Green Policy and Statement : Should be Must 

1.     50 % land area of medical colleges and associated hospitals will always be kept as open green unconstructed land occupied by large trees like Neem, Banyan, Peepal, Mahua, Mango

2.     Green architecture. It is a method of sustainable building design where the design and construction of a building or structure is done while keeping the environment in mind.

GRIHA, an acronym for Green Rating for Integrated Habitat Assessment, is now the National Rating System of India. Conceived by TERI (The Energy and Resources Institute), and developed jointly with the Ministry of New and Renewable Energy, Government of India, GRIHA is a green building design evaluation system.

It provides basic prerequisites for green buildings in terms of the following:

a) climate-based layouts and designs to minimise energy consumption

b) waste water treatment and recycling with zero external discharge

c) use of fly ash blocks for walls and slabs to maximise use of recycled material

d) maximum use of natural lighting and optimum indoor air quality

e ) rain water harvesting

Dr. Siddharth Lakhotia

MBBS, MS, M.Ch, FIACS

Professor and Head

Cardio-Thoracic Surgery

Institute of Medical Sciences

BHU, Varanasi

drslakhotia@gmail.com

https://www.ctsnet.org/home/slakhotia

Joy of Becoming a Cardio Thoracic Surgeon

Beauty of Cardio Thoracic Surgery and My Journey 

https://www.ctsnet.org/home/slakhotia

I would love to share a bit about my profession and work of our team at Institute of Medical Sciences, BHU, Varanasi a tertiary care 2000 plus bedded university teaching hospital and medical college under Govt of India. I joined here in 2011 after I finished my MBBS in 1998 from Calcutta, MS Gen Surgery in 2003 from Rewa and MCh in cardiovascular and thoracic surgery from Kanpur in 2007. I worked at RML Hospital Delhi, LRS Institute of TB and RD Delhi, BM Birla Heart Research Centre, Calcutta and SSSH Hospital, Rajkot for my further experience in cardio thoracic surgery. During all this period of around 20 years (1992 -20011) I got chance to learn and learn more about medical sciences and then my speciality of heart and lung surgery. I was blessed to have some wonderful teachers , got enormous chances to see and work with some great surgeons of India during studies, residency, job, seminars and workshops. They all shaped my profession and future.

Since last many years working in government sector is like rowing a boat against a mountain stream, but yes at end of day when you see a kid smiling and saying thank u or a mother in joy to see her kid recovering or to see stopped heart beating again after surgery is over or to see a blue baby becoming pink after surgery, these are the moments which heal your all pains and sacrifices you have made in this journey. Getting chance to treat poorest of poor and mentor young bright minds of future doctors  is a blessing and it overshadows the poor service conditions and other hardships of working in a government system .

Nothing happens without team , In our team there are around 20 members behind a successful heart surgery... anaesthetics, perfusionist, OT technicians, residents, assistants, ot nurses, icu nurses, paramedics, physiotherapists and many more. And mistake of any can lead to fatal outcome. So we all work as highly coordinated dedicated team where work is not guided by watch but by passion, with cardiac surgeon as team leader.

Sadly we are the only government centre doing these procedures between Lucknow and Patna, a geographical distance of around 500 kms and we roughly cater to a population of around 50 million for their cardiac and lung surgery needs. This results in enormous patient load on us.  

Most of times our patients get financial help from prime minister or chief minister relief fund.

It’s a humble beginning and we feel happy that God gave us chance to serve humanity of this region and help in laying down foundations of Open Heart Surgery programme in this part of India.

Our team has now done more than 1000 successful open heart surgeries which includes many complex congenital heart surgeries, valvular replacements and repairs, CABG , cardiac tumours etc. Apart from cardiac, our department is one of very few centres in India where lung surgeries are also being done in large numbers. I am thankful and grateful to all, especially Prof Damyanti Agrawal Madam for giving me enormous opportunities to contribute in the development of our department.

Around 25 years back, in the spring of 1991, idea of becoming a Doctor dawned on me as one of my friends suggested me that if I love helping needy and poor, then I should choose medical profession. Since then after joining medical college in 1992, dream of touching a live human heart fascinated me and my romance with heart came true twelve years after in 2004, when I joined MCh residency. After that God has given me fascinating opportunity to touch, see and feel thousands of human heart , which is core of our life,  which if beats we are there and which if stops … we are no more.

A typical day in cardiac surgery is filled with variety of emotions ranging from joy to happiness to grief to frustration and anger to excitement and satisfaction. Training, working and then getting established in field of cardiac surgery is like rowing a boat against a mountain stream, full of uncertainty, frustrations and sacrifices in personal life but at the end of day when you see a kid smiling and saying thank you … or a mother in joy to see her baby recovering or a baby becoming pink from blue … or to see stopped heart beating again after surgery … These are the moments which actually heal all your sacrifices, struggle and pain you have made in this journey.

Opening the sternum, seeing the heart beating, then cannulating, going on Cardio Pulmonary Bypass, arresting the heart, cooling it, operating inside the heart, repairing it, constructing pathways in it, replacing damaged structures , doing various anastomosis, closing it back, removing air from heart chambers, reperfusing the heart, seeing it beat again, weaning from CPB, removing cannulas, hemostasis and closing back the sternum are the various steps involved in Cardiac surgery. And then starts the equally important post operative care which may extend from few hours to many days. There are hardly any U turns, a small error in any step by any of team members can lead to high morbidity or mortality.

Taking a lecture class of Final Year students

PROFESSIONAL CONTRIBUTIONS:

1.        Great role in establishing the regular open heart surgery programme along with our team at Institute of Medical sciences, BHU, Varanasi .

2.        Construction of state of art cardiac surgery ICU in IMS, BHU 2011-12

3.        Starting of MCh in CTVS programme in IMS, BHU 2013

4.        Starting of Diploma in Extracorporeal Perfusion Technology in 2015

5.        Construction of state of art thoracic surgery ICU in IMS, BHU 2016

6.        In charge , planning and designing of CTVS wing in centenary super speciality hospital, BHU

7.        Member and/or Chairman of DPC and PPC of department, hospital 

 PPC and other bodies from time to time.

8.        Purchase of new equipments for continuous up gradation of CTVS department.

9.        Administrative responsibility as Head 2017-2020 and May 2024 till date.

10.     Starting of new course PDCC in Thoracic Surgery from 2020.

11.     Publishing a book first of it's kind showcasing the complete journey of Medicos and Doctors from beginning to end along with the life inside medical colleges and working of hospitals. More than 3000 photos spread over 500 pages. Must have book for lovers of medical sciences and those aspiring for it.  https://amzn.eu/d/4Al18pf

Some of the humble contributions which I have been able to make in the Department of CTVS due to grand support from everyone in IMS and BHU are:

1.      Starting of M.Ch in CTVS course in 2014 ( LOP )

2.      Recognition of M.Ch in CTVS by Medical Council if India in 2019 ( LOR )

3.      Organised many cardiac surgery workshops in association with eminent cardiac surgeons from around the India

4.      Starting of PDCC in Thoracic Surgery course

5.      Starting of Diploma in Extra corporeal perfusion technology course in 2015

6.      Recruitment of three faculty members

7.     Renovation and Construction of six bedded state of art CTVS ICU in 2011-2012

8.    Renovation and Construction of five bedded HDU in 2015-16

9.     Modernization of CTVS OT complex and keeping them fully functional.

10.  Purchase of some high end modern equipments like Heart Lung machine, ICU ventilat0rs, Heater Cooler machine, Defibrillators, Multipara Monitors, OT Table, Oscillating saw, Echo Machine with Transesophageal probe, Blood gas analyzer etc.

11.  MCI visit for increase in MCh seats.

12.  Regular Open Heart Surgery programme. Our team has so far done more than 500 major cardiac and thoracic procedures including many complex congenital heart diseases ( like Tetralogy of Fallot, PAPVC, difficult VSDs ), high risk valve replacement surgeries, cardiac tumors, pericardiectomies, lung resections, mediastinal surgeries, peripheral vascular surgeries and much more. Some surgeries like VSD closure, ICR for TOF, PAPVC etc and procedures like deep Hypothermic Circulatory arrest were done for the first time in our Institute. We have been able to do all this with morbidity and mortality that is comparable to any best international centre.

My team has so far done more than 600 major surgeries in IMS with mortality rate of 3.7 %.

13.    In this period I also authored more than 25 articles and ten books. https://www.researchgate.net/profile/Siddharth-Lakhotia www.amazon.com/author/siddharthlakhotia

14.    I have been also making a popular You Tube series on CTVS Educational Surgical Videos. Till now it has more than 40 videos. https://www.youtube.com/playlist?list=PLe_safEIr_soxeGLRgE65OYDQa 1r_pR36

15. One of the videos on thoracic trauma is now the most watched surgical video from India on You Tube  https://youtu.be/QeknY30NvSU It has been watched in over 50 countries.

16.   Our teams work has been appreciated widely by local and national media. ( cuttings attached )

17.    Our team has been felicitated on various occasions by various dignitaries including Vice Chancellor of BHU, Director of IMS and Medical Superintendent of SSH.

18.  Made widely circulated video encouraging young medicos to take CTVS as career. https://youtu.be/6wMs1LGcUSU

Some of my humble contributions to IMS in general have been:

1.     Daksh Foundation: To promote extracurricular activities amongst medical, ayush, dental and nursing students. https://www.youtube.com/dakshtrust . It was founded by me in 2018.

a.     Musical Programs

b.     Debates

c.      Poetry recitation

d.     Dance classes

e.     Heritage walks

f.       Drawing Classes

g.     Yoga Classes

h.     Nature excursions

i.        Photography classes

j.       Inspirational Lectures

k.     Documentary production

l.        Skits

m.  Regular online competitions

 

2.     Planted around 20 trees in IMS premises and taking care of them

 

3.     Made many movies on IMS on wide range of topics from history to its grandeur, to academics to library, it’s facilities, events, programs etc. They can be seen on following link : https://www.youtube.com/playlist?list=PLe_safEIr_srtTRM1O9UJXz77KZ 9ac_iS

 

4.     I have been making movies and recording lectures on general health awareness. They can be seen at https://www.youtube.com/playlist?list=PLe_safEIr_sppvf39VSwMHGqY WzHvLNyV

 

5.     Published a historical book showcasing the journey of IMS, BHU since 1919, when the idea was first conceived. First of its kind book in its over 500 pages showcases the beautiful world of Medical Sciences and journey of Medicos & a premier government Medical Institute plus University Hospital in India, in the form of live and vibrant 3000 plus photos along with captivating captions & articles. What goes behind making a Doctor and working at a medical college and hospital has been beautifully portrayed in this book. ISBN : 978-93-5406-429-6 Hard Bound. The book IMS BHU : A Legendary Dream https://youtu.be/ kF4BLF8lqG0

 

6.     Regularly organises IMS picnics and get together https://youtube.com/playlist?list=PL1S4HNjf_sFsVpUX3YHffIBFn1MOpY Cz3

 

More than 500 videos made by me of general interest on nature, traveling, heritage and education. They can be watched on:

https://youtube.com/playlist?list=PLe_safEIr_srEQ84HGy1et_0NaVxMBFHD

GOALS IN LIFE:               

A.        Establishment of Cardiac Surgery in Varanasi region and making it affordable to poor

B.        Development of integrated cardiac sciences centre.

C.        National Programme for prevention of Rheumatic Heart Diseases

D.        Integration of Ayurveda knowledge and practice of Yoga for well 
  being of cardiac patients

E.         Stem cell research in field of cardiac sciences

I invite students and residents to consider joining this beautiful speciality full of rewards, hard work, dedication, challenges, excitement and joy... in nutshell a blessed career.

 

Being a cardiac surgeon can allow you to work hard and party hard !!

Dr. Siddharth Lakhotia

MBBS, MS, M.Ch, FIACS

Professor and Head

Cardio-Thoracic Surgery

Institute of Medical Sciences

BHU, Varanasi

drslakhotia@gmail.com

https://www.ctsnet.org/home/slakhotia