Clinical audit and lifelong reflective practice as game changers to integrate medical education and practice

Dear Editor,

I read with interest the article on misplaced priorities for the Union Health Budget 2015.[1] The article was well-written and kudos to JFMPC for having shared it on the journal's platform. One of my recent patients, a health insurance agent, pointed out that if I wanted to let my patient benefit financially from their scheme I would have to write a “medicine/drug” and I could not just write “diet and exercise” as sole advice in the discharge summary.

One of the offered solutions in the order of “key priorities” pointed out is “clinical audit.” This is an important potential game changer. Since this is not formally taught in the medical curriculum at our institute, we are organizing a blended learning program on clinical auditing through online learning portfolios that we hope will empower future physicians to curb “nonevidence"-based unethical practices in hospitals as well as in communities.

Again, this is another unrelated issue perhaps more related to “education” and how humans have evolved strategies to “manage” information but I wonder if “not providing a diploma or certificate for learning” ensures that “learners” have to keep on proving their “education” and “capabilities” through their “work.” Does empowering health professionals with more degrees foster an environment that discourages further learning (post attainment of degrees) and allows them to rest on their past laurels (professional degrees they have earned in the past)? Does this “license” to practice (but not learn or update oneself continually) encourage an unethical and corrupt health care ecosystem? Can this be tackled by fast track mechanisms for “reflective practice,”[2] such as the abovementioned “online learning portfolios,” to ensure transparent and accountable “reflective practice” in the health professions?

We sincerely need to think about these issues too in terms of medical education while the key priorities mentioned in the article are being implemented.