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Observations from the Field

Fellows share personal reflections on health professions education, health care, and life around the world.

Converting a Dream into a Reality: Dinesh Badyal Tells the Story of His FAIMER Fellowship Innovation Project

Dinesh Badyal, M.D. Dinesh Badyal, M.D.
Professor and Head
Department of Pharmacology
Christian Medical College
Ludhiana, India

Outcomes of Dinesh Badyal’s fellowship innovation project
Outcomes of Dinesh Badyal’s fellowship innovation project
(click image to enlarge)

I have been associated with the CMCL-FAIMER Regional Institute (CMCL-FRI) right from its inception—I am a CMCL-FRI 2007 Fellow. One of the requirements for the fellowship is completion of an innovation project, and I did my project on “Implementation of Computer Simulation Models (CSM) as Replacement of Animal Experiments in Teaching Undergraduate Pharmacology.”

As all Fellows do, I worked on my project thinking of it as a one-year assignment to go along with the fellowship. Then I started the first residential session in January 2007 in Ludhiana, India. During the program evaluation and project discussion sessions, I came to know that I needed to think about the bigger picture for my project. I was told to develop intermediate and long-term outcomes at that time. I had never thought of that when I planned my project. I was a bit confused and worried about how I could make a difference with my project. However, the words of faculty members about how the project will benefit the community had a big impact on me. I started thinking about the usefulness of the project to others, expanding it, and making a big difference.

The next year I worked on my project and completed it successfully with few hassles. I got very good insights about my project when I started it at my institute. I read a lot of information related to simulation, simulation in teaching, etc. I thought of modifying the curriculum of pharmacology practical exams, including using simulation to replace animal experiments. In the process, I wrote my first book, Practical Manual of Pharmacology, published by Jaypee Brothers, the leading medical book publisher of India. The book was released in April 2008 during a workshop on medical education sponsored by the Medical Council of India (MCI). An MCI representative released my book. This was one of the outcomes of my project.

The book has become very successful and the publisher has asked to print a second edition to coincide with the new curriculum for medical undergraduate courses from MCI in 2010. This curriculum mentions that simulation should be used to replace animal experiments. This is exactly what I had written in the introduction to my project.

I presented my project during the second residential session of CMCL-FRI in January 2008, and then went ahead and expanded it. I completely replaced animal experiments in undergraduate pharmacology teaching during the next year (2008), and animal mortality was reduced to zero. I then presented a paper on the expanded project at the 6th Asia Pacific Medical Education Conference at the National University of Singapore, Singapore, in February 2009. I interacted with other international medical educationists there and acquired more knowledge about research in medical education. I went deeper into scholarship and published the extended project as full paper, “Computer simulation models are implementable as replacements for animal experiments,” in the indexed international journal ATLA (Alternatives to Lab Animals). The paper was highly appreciated, and I still keep getting requests from around the world for PDF copies.

While I was writing the paper, I came to know that most of the teachers in pharmacology are not aware of alternatives to animal experimentation, which are available freely or at a negligible cost in India. I planned to conduct a Continuing Medical Education (CME) program to make other teachers aware of these alternatives. I extended it to other subjects where alternatives are needed (one of the intermediate outcomes of my project). I chose physiology, as this is the other subject where alternatives to animals are needed. I struggled hard to find a physiologist, as well as alternatives that are available in India. I contacted a lot of physiology faculty in India. After two months of searching, I found the appropriate resources. I needed funds for the CME program, because I planned to call on pioneers in simulation in India in pharmacology and physiology. I contacted them; they happily agreed.

Somehow my personal growth during the fellowship period helped me to project myself as a good pharmacologist and medical educationist, and I was elected as the Editor of The Clinical Researcher, the official publication of the Clinical Research Board. I conducted two big events at my institute: a CME program on depression and a three-day “Workshop on Clinical Research,” sponsored by the Indian Council of Medical Research (ICMR). Just two months after that I was invited as a guest speaker at an international conference by the University of Hong Kong. After that I was a guest speaker with Dr. K. Satyanarayana, Editor of the Indian Journal of Medical Research (IJMR) (the only Indian journal with an impact factor of 1.883), to conduct a workshop on writing scientific papers at the National Conference on Health Professionals’ Education in Pune.

These developments helped me a lot, and with each development, CMCL-FRI was somehow involved. I got a lot of support from FAIMER Fellows. A number of Fellows belong to my specialty, pharmacology, so we got together to improve our specialty at a national level.

I wrote to MCI in July 2009 to ask them to sponsor a CME program. They agreed and we successfully conducted “Alternatives to Animals in Medical Education” in February 2010. The CME program was attended by 150 delegates from all over India. Some of them (including one of the top medical colleges in Delhi) have now written me that they have started using simulation models. This was another of my project’s intermediate outcomes.

In October 2009, I attended the FAIMER Institute in Philadelphia in the United States. On International Medical Education (IME) Day, I met an administrator from a national body in India, who encouraged me and, in principle, agreed to sponsor my expanded project on “Simulation Lab to Replace Animals” (my project’s long-term outcome). The suggestion was made to develop such a lab to cater to basic and paraclinical sciences, and then replicate it at other colleges.

When I started writing my project in 2006, I never thought of all the possible outcomes. Now in 2010 (five years down the line) I am planning to start the long-term outcomes. A bigger dream became reality. My wife says, “You Pisceans dream a lot,” and I tell her I do this so that I can convert them into realities. I thank all medical educationists; FAIMER, in particular FAIMER Fellows and CMCL-FRI; MCI; ICMR; and my mentors for their constant support and encouragement.

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Vanessa Burch, M.B.Ch.B., M.Med., Ph.D., Gives Inaugural Lecture as Professor and Chair of Clinical Medicine at University of Cape Town

Vanessa Burch, M.B.Ch.B., M.Med., Ph.D. Vanessa Burch, M.B.Ch.B., M.Med., Ph.D.
Professor and Chair of Clinical Medicine
University of Cape Town
Cape Town, South Africa

Vanessa Burch (PHIL 2001) recently gave her inaugural lecture as professor and chair of clinical medicine in the University of Cape Town’s Department of Medicine. Her lecture was entitled Health Care in South Africa Today and focused on the challenges facing South Africa in meeting the United Nations 2015 Millennium Development Goals. Her perspective is that of an educator facing head-on the health care needs of her region. Following are some highlights from her lecture, which began with excerpts from a few recent articles from the South African newspaper Cape Argus on the subject of health care:

Health Care Today

Epidemics: Disease & Injury

Funding Health Care

The Health Care Workforce

The Way Forward

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David Cameron, M.B.Ch.B., M.Med., M.Phil., Reflects on Providing Care in Rural South Africa

David Cameron, M.B.Ch.B., M.Med., M.Phil. David Cameron, M.B.Ch.B., M.Med., M.Phil.
Associate Professor, Department of Family Medicine
University of Pretoria
Pretoria, South Africa

Here’s a brief reflection I wrote two years ago following a home visit in a small rural village where I was working:

Home based care? Flies circle like lazy vultures parting the air saturated with the smell of
cervical cancer. Too weak to sit up, she reached out and grasped my hand, 33
degrees outside, it felt like 40 under the low tin roof.
"Hospital?" I suggested.
"No, people die there."
Six pairs of weary eyes watch my every move.

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My Experience in Sierra Leone

Elsie Kiguli-Malwadde, M.B.Ch.B., M. Med. Elsie Kiguli-Malwadde, M.B.Ch.B., M. Med.
Head, Department of Radiology
Makerere University
Kampala, Uganda

Sierra Leone thumbnail image 1 Sierra Leone thumbnail image 2 Sierra Leone thumbnail image 3 Sierra Leone thumbnail image 4

At the beginning of this year, I found my self in Sierra Leone. If you had asked me a few years back whether I would ever go there, I would have asked you, “What for?” Here I am in Sierra Leone and enjoying it.

Sierra Leone is a small country of 71,740 sq km with a population of 6 million, in comparison to my country, Uganda, of 236,000 sq km and 26 million people. In many aspects, both countries are similar: they have had civil wars and are developing countries that are on their way to recovery. Uganda has had a relatively longer period of peace, 20 years, compared to Sierra Leone, which has been peaceful for seven years. Both countries became independent around the same time in the early 1960s and were colonized by the British.

The people of Sierra Leone are friendly and very welcoming. They will greet and welcome you to their country in a warm way that makes one feel welcome instantly. They have many languages but the local official language, Krio, is the one that’s widely spoken. Krio is a mixture of English, Portuguese, French, and local African languages. It is distinct from Pidgin English. Most people are fooled into believing at the beginning that English speakers will understand Krio, but they get surprised when they start hearing it. I have started taking classes in Krio and I love it. It is challenging but enjoyable.

The health structure in Sierra Leone, like in so many African countries, is not functioning properly and the hospitals are poorly equipped. Brain drain has not spared it, with most of the professionals working in developed countries. Life expectancy is 46 years. There is one radiologist in the country. They have one medical school and their basic training takes six years. Their curriculum is community-based and teaches radiology in an integrated manner. Both aspects are similar to what is done at Makerere University where I teach; my university has just started this while, in Sierra Leone, they have been doing it for a long time. Unfortunately, most of their doctors don’t stay.

Sierra Leone is a beautiful country; it is green and has tropical forests but what have attracted me most are its beaches. This may be because I am from a landlocked country. They have great beaches with clean sand and ideal conditions for swimming, especially since the temperatures can be quite high — 30 degrees Celsius. Freetown, its capital, is a hilly city and one can see the beach from most places in the city. I learned from Page at FAIMER to look out for the good in life and appreciate it, and that is the attitude that has made my life a lot more enjoyable far away from home.

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[last update: June 17, 2010]