Hopefully We Can Keep Practical Learning Going for as Long as Possible

Dean Prof. Vladimír Komárek explains why it is not reasonable to suspend on-site learning for state exam students, offers his comments on epidemiological measures at the faculty and election of a new dean.

The Medical Faculties Deans Association issued a declaration last week opposing potential imposition of civilian duty on medics. What is the Association´s stance concerning another disruption in the teaching process?

We already had huge gaps in teaching in the spring and in the fall of 2020 followed by another one in early spring of 2021 and now it is looming ahead again. Within the Association we have agreed, and informed the Health Minister accordingly, that we want to preserve the practice at hospital beds for students in the 5th and 6th years at any cost. In particular, in subjects that will end with state exams, students need to learn to handle urgent conditions, understand differential diagnostics and master a whole lot of practical skills. I am hopeful that we will be able to keep practical teaching going for as long as we can, whilst of course keeping in mind maximum concern about patients and hospital staff.

What is, in your opinion, the reasonable level of medics´ presence at the bedside?

As already practiced in the past, I find it reasonable to have no more than five persons in the hospital ward; for instance, two patients, one educator and two students. All wearing face masks, of course, with completed vaccination or having had covid or negative PCR test.   

How does hospital management respond to this?

To some extent they understand our stance but hospital director wants to completely ban all presence of medics at the bedside except for state exam specializations. We are awaiting the official statement to be released which we have not obtained as yet. I would be extremely unhappy, though, if we were to completely abandon the practical teaching because our students badly need it. In this we are in line with the current recommendation of the Rector of Charles University: „to honour our commitment to students and the public, and to try and maintain the on-site format of teaching across the board.”

Having concerns about students being not so well prepared for performing their profession, have you observed any indications thereof at state exams?

Surprisingly enough – and luckily so – I haven´t. The guarantors of state exam specializations have given me a pleasant surprise: they say that students who graduated in the summer of 2020 were well prepared – despite the online teaching, volunteering etc. Those who graduated in 2021 had their learning disrupted as many as three times – in spite of this I never heard any complaints that they would have done poorly or more than a few of them possessed poorer knowledge; it was obvious that they made every effort to make up for the disruptions. However, those who will graduate in 2022 will have their learning disrupted at least four times if another disruption occurs – and the disruptions will add up. Of-course, this statement is not evidence-based – we are still lacking the comparisons of pre-covid and current education quality and job attainment success rate of the graduation year students.

How should this burden be spread out among university students and other components of the public sector to avoid this scenario?

The help needs to be differentiated into three areas. The first comprises sanitation work, cleaning of surfaces, making beds – this can be done by anybody. I did that as a freshman at the Faculty of Medicine, and likewise it can be done by a soldier, firefighter or a non-medical student. Then there is the work of nurses – administering medication, checking pulse and blood pressure, perhaps also some types of blood collection – and this is where medical students could indeed be of practical use, especially those with completed eight semesters. After all, the amended legislation already makes it possible to hire them as practical nurses. Under supervision of an experienced ward sister they can learn the required skills and combine the help to the hospital with practical learning. But students in their fifth and sixth years of medicine should never have to be performing unskilled work as part of civilian duty, thus being prevented from fulfilling the requirements for getting properly prepared for their future profession.

How is your faculty responding to the current epidemiological situation and the measures in place?

We are calling upon our students and staff to respect the measures to the maximum extent. We have both groups quite well vaccinated by two doses. Older staff should get a third one after five months, and students after six months, so that the spreading of covid in the hospital and at the faculty is minimized. We are making sure that the non-vaccinated employees and those who had the illness are getting tested – for instance in the Charles University Testing Centre in Celetná, or in the hospital, or at the workplace. Tests are available, we have bought enough.

Nonetheless, even though the vaccination rate among our students and staff is high, we are putting restrictions on certain events – we cancelled the pre-Christmas gathering of faculty management with heads of clinics and academic senators that was scheduled for December 9. For a smaller number of registered listeners, and only for vaccinated ones and those who had covid, we are organizing a concert in Karolinum on December 6. Everything is already prepared. Instead of the ball that had to be cancelled we will announce the Teacher of the Year Award winner and I would also like to take the opportunity to introduce the newly elected dean.

Are we going to test the vaccinated?

The measures in effect do not mandate testing of the vaccinated. Therefore, as of now we are not.

How do you assess the presentation of manifestos and personalities prior to the election of the dean last week, in which the senate elected Professor Marek Babjuk?

Both candidates, Professor Babjuk as well as Professor Lebl, played fair, I have not noticed any below-the-belt comments or invectives. They were in agreement about faculty development, scientific programs and investments, they also had a similar view on cost-centre management. One of the candidates was more specific whereas some goals presented by the other one seemed to me as not very realistic. But then again, when I look back at my own pre-election manifesto, I have managed to implement about two-thirds of it. Certain things simply do not get done regardless of the dean´s personality and effort. I am glad that Professor Babjuk (who in the past eight years belonged to the more hardworking vice deans) has won with such a strong mandate (Prof. Babjuk got 19 votes out of 24).                                                       

Created: 14. 12. 2021 / Modified: 13. 6. 2022 / Responsible person: Mgr. Petr Andreas, Ph.D.