Should medicine be taught in local languages?

The demand to teach medicine in languages ​​other than English has been repeated over the years, and was Recently reiterated by the Union Home Minister Amit Shah When he said that instructions in medicine, engineering and law should be made available in Indian languages. Over the years, academics have pondered the advantages, drawbacks and challenges of such a move. Explore different facets of the issue in a conversation moderated by Dr. Sudha Seshayan and Dr. M. Janakiram Serena Josephine M. Edited excerpt:

Do you think it is possible to have a regional language as a medium of instruction in medicine? And is there a need to promote Indian languages ​​in higher education?

Sudha Seshayan: First, the question pertains to a long-term perspective. So it is possible. I have traveled to countries where medicine is taught in Spanish, German etc. So, with some modifications it is possible. We might not be water-tight with our words, especially with technical terms. When we say a regional language, there may be overlap of words from different languages.

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Second, looking at the same question from a slightly different perspective on what is currently possible in India… Medical students are guided by the rules of the National Medical Commission (NMC). The medium of instruction for these students is English. Therefore, teaching in a regional language can only be supplemented if a student does not understand English or has previously studied at a Telugu-medium institution. As of now, students cannot study solely in the regional language as the NMC declares the medium of instruction to be English.

M Janakiram: I would like to add a few points on standardization in the field of medicine. The Greek and Latin physicians were the first to determine the context as far as language is concerned. The present physician should have zeal for higher education rather than merely treating patients. The National Education Policy 2020 proposes to promote regional languages. In medicine, much of our curriculum is based on learning by doing, whereas in most other disciplines it is learning by doing. Before choosing regional languages ​​as the medium of instruction, we have to keep some things in mind. We have to develop a standardization tool for every other course through which we can compare and correlate things easily.

Sudha Seshayan: At some point, it was mandatory for a medical student to learn Latin. It is not so now. However, we still use Greek and Latin words. There has come a stage where some Greek and Latin words have been dropped. Across the world, English words are changing. So, I don’t think it’s a big problem.

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Enthusiasm for higher education is required for the students but this does not hinder the use of the regional language. Yes, there is a need to promote Indian languages ​​in higher education, simply because it will improve one’s thinking and possibly communication. The complaint we get from society today is that doctors rarely communicate. If we learn regional language then thinking and communication skills will improve. At the same time, I would like to emphasize that there should be standardization in technical terms in Indian languages.

Engineering courses are being offered in Tamil. Has there been an attempt to give medicine in Tamil? An initiative has been taken to find Tamil equivalents for English Medical Terminology.

Sudha Seshayan: Yes, there have been efforts. Some of the early attempts to translate medical textbooks into Tamil were made in Sri Lanka. In our part of the country, we have made some efforts under Professor Lalita Kameswaran, who was the first Vice Chancellor of this university. When she was director of medical education in the 1980s, she brought in a large team, and we would sit for about three to four hours every day before deciding on a term for a particular technical term. About 12,000-13,000 words were formed. The movement subsided. Over the years, our university has contributed around 10,000-12,000 technical terms, which have been translated, standardized and handed over to the Tamil Nadu government’s ‘Soorkuvai’ scheme, which is a collection of technical terms. Anyone can access and use that word if found appropriate. These efforts have been going on. But some concerted efforts have also been made to teach in the regional language in the medical college. This effort is not a complete change in Tamil; It is a supplement. There are also some students who come through other means of education. We try to give them extra classes.

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M Janakiram: As rightly noted, as a student enters medical school, there are issues of linguistic dualism as well as a sudden change in the medium of instruction. We have found that some students find it difficult to grasp concepts. The language of standard textbooks is not easy, and some find it difficult to convert their thoughts to English during exams. We have alumni associations that come up with material for students who studied in Tamil till class XII. Translation is done wherever required. The medical terminology is maintained as such – when we interpret the pathogenesis of a disease, the course of the disease is translated into the regional language. But many such measures have not been documented.

Often, the discussion focuses on whether language is a barrier to higher education. Do you think accessibility is an issue for students pursuing primary education in their mother tongue or for people in rural areas?

Sudha Seshayan: I don’t think language is a barrier to people’s learning. The difficulty comes when people have difficulty understanding because of the weight. Whatever discipline of medicine you take, it is an ever-expanding field. There’s a lot to learn. For him, [students] Information has to be accessed immediately. If you don’t have access to information, it inhibits you, and the motivation to learn is lost. More information is available in English. And that’s where knowing English is essential so that you can get the information. In the field of medicine, I want to know about new modalities of treatment, new techniques of surgery. If I can’t find that information, I have to rely on someone to translate it. There may be errors in translation. To access the information, we need a language like English right now. That’s why I have been saying that the information should be available in the regional language so that people can understand. You do not need to take the test in Tamil, but at least for you to understand and upgrade your knowledge, it is necessary for the generations to come that we keep all this information in the regional language.

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What are the challenges in getting medical education in local languages?

M Janakiram: Medical education is all about research. By UK standards, a doctor must be a social scientist, a scholar, a researcher as well as a physician. Hence, every other aspect must be covered by the doctor after obtaining a medical degree. English is required for professional qualification; It is the international language of science and medicine. There is also a new concept called English for medical purposes. Therefore, taking medical education in the regional language will always be a challenge.

Sudha Seshayan: So far, it may seem that if we move to another part of the country, or if we move to another country, we will not be in a position to understand things. But I don’t think it’s a big challenge. Many Indian students have gone to the US and UK, not because they were very good at English, but because they were good at their subjects and skills. It depends on the learning ability of the person. It is also a skill to adapt and survive in difficult situations. Maybe a doctor needs to learn this too.

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When I was a student of Madras Medical College, we used to have a very active Tamil Mandaram (Tamil Association). But the irony is that Tamil Mandram was also trying to teach spoken Telugu. We also brought publications like beautiful telugu, It’s the 1980s and 1990s. About 50% of our patients in government hospitals were Telugu speaking. Talking to them and getting their history, complaints and information would be a challenge which we wanted, especially during exams. Hence, the students learned spoken Telugu. I am saying this because it is necessary for the doctor to communicate with the patients.

But again, medicine is a field where we need to have a uniform understanding on certain aspects across the globe. Same nomenclature is required. We have to know regional languages ​​to deal with patients. English may be a common factor in breaking down barriers for the time being, but after that regional languages ​​will come into play.

What are the pros and cons?

Sudha Seshayan: All our teachers have to be equipped first. Competency based medical courses have come up in the country in the last three years. Now we are training our teachers in medical education technology. It will take more time to train them to teach in regional languages. But we must also have books and material before training them. I’m not sure what the future holds [in the context of] Examination and medical syllabus with respect to the medium of instruction. The central regulatory agency will take a call. But every language should be equipped with proper information, even to help one study better. They can study in English, but they may need to study the same thing in Tamil for better understanding and clarity.

M Janakiram: Competence has several components – knowledge, skills, values ​​and attitude. We have to see what needs to be optimized depending on the situation. For example, interpersonal communication is important when dealing with patients. Knowing the regional language here will help the students. To develop our reading skills during graduation, in terms of medical knowledge [studies] And move on to post-graduation and research, English will help us. As far as the practice is concerned, it covers both regional and English languages. So, the regional language can be a supplement, while English is the essential language.

What is the way forward?

M Janakiram: As of now, we should stick with English as the medium of instruction for medical schools. Depending on your interest, regional language can be taken as a complement to better understanding and innovation. If a doctor communicates well in a regional language, it will help them to bridge the gap with the patient.

Sudha Seshayan: I would like to add something related. People think that to study anything related to science, people should not be inclined towards language. But I have taught medical students for 34 to 35 years. I have realized the importance of language. Language is required for proper communication and understanding. I would request medical academics not to say that the study of language is not a requirement for someone studying medicine or science.

M. Janakiram is Assistant Professor in the Department of Community Medicine, Government Vellore Medical College; Sudha Seshayan is the Vice Chancellor of Tamil Nadu Dr. MGR Medical University