|Year : 2019 | Volume
| Issue : 2 | Page : 68-70
Medical education: The language barriers
Department of Medicine, MGIMS, Wardha, Maharashtra, India
|Date of Web Publication||17-Sep-2019|
Dr. O P Gupta
Department of Medicine, MGIMS, Sewagram, Wardha, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gupta O P. Medical education: The language barriers. J Mahatma Gandhi Inst Med Sci 2019;24:68-70
“I was examiner recently in one of the colleges of MP, I found that some of the students cannot communicate well in English. When I explained my questions in Hindi, they answered the questions with ease” told my colleague recently. I had a similar experience when I used to go as examiner for the final-year students. Even while I have bedside discussion about a patient with the students, sometime I have to explain things in Hindi. Not being the mother tongue, the English as the medium of instructions in medical education, a perceptible gap in communication is well noticed. Likely, the majority of students do not find any difficulty, but for some of the students, it may really be difficult to understand what is being instructed through English medium. Someone has said that “if a learner cannot really understand the language of instruction, it becomes difficult, if not impossible, to grasp the content of the subject.” Learning by rote without comprehension is not desired at this level. In India, all students ambitious to seek admission in medical courses do not come from English-medium schools. Especially in rural areas, there is a shortage of qualified teachers, lack of appropriate instructional materials and above all, the absence of a sociolinguistic environment in which English is meaningful.
The National Eligibility Cum Entrance Test (NEET)-2018 examination was conducted in 11 languages because there was such a demand from the student community. This in itself is indicative of perceived difficulty in understanding the question paper in English and answering it properly. It is noted that 80% of the candidates wrote the exam in English, 11% in Hindi, 4.31% in Gujarati, 3% in Bengali, and 1.86% in Tamil. About 20% of 1.1 million students who appeared in NEET wrote in regional languages. How can we ignore this 20% or about 2 lakhs of students clearly asking for justice so that they can also be at the same levels with those of other students. That can happen only if the language of the knowledge being transferred is a national language or a regional language.
It is a different thing that Hindi is not included as a “National Language,” but Hindi is the language spoken, read and written by the majority of Indians and understood by remaining even if they cannot read or write. “Why can India not have Medical Education in Hindi right now”? a question came up in our parliament in 2018, (Lok Sabha starred question No. 255 for August 3, 2018). The reply placed by then the Hon Health Minister Shri J P Nadda is being given here –
“Medical Council of India (MCI) is the apex body to regulate the medical education in the country in accordance with the provisions of Indian Medical Council Act, 1956. The MCI has examined the matter of imparting medical education in Hindi as a medium of instructions. Further, the curriculum and syllabi is required to be of Indian Medical Council Act, 1956. The MCI has examined the matter of imparting medical education in Hindi as a medium of instructions. Further, the curriculum and syllabi is required to be updated in a timely manner on the basis of scientific and technological advancement, the bulk of which is available in English language. The MCI has also observed that the developed countries and most of the neighboring countries have English as a technological advancement, the bulk of which is available in English language. The MCI has also observed that the developed countries and most of the neighboring countries have English as a medium of instructions for medical education. Instructions in English provide opportunities of international exposure and experience to Indian medical graduates. Therefore, MCI keeping these concern in mind has decided not to impart medical education in Hindi at this juncture.”
Dr. MC Mishra, former Director of AIIMS, was a guest speaker in one of the conference here in our institute, and I noticed that he is explaining part of his subject in Hindi. Being curious, after the completion of his talk I asked him about his opinion whether Hindi can become the medium of instructions in medical education? He said that the standard of education at 10 + 2 level is not uniform all over the country, the students are admitted through all India tests, but at times, it appears that they do not feel comfortable with the instructions in English medium, and they need explanation in Hindi. I further asked, if the time has come to change the medium of instructions from English to Hindi. His reply was in negative because there is no availability of resource material, like medical text properly translated in simple Hindi, etc., though the students may accept it happily. The present faculty is also nor prepared for this transformation. Moreover, Hindi as a medium of instructions may not be acceptable in all states of India.
To understand the problems of a patient, doctor has to have a long conversation with him and the accompanying persons, naturally this can be done in the language which they know or understand! The language of communication with the patients, their relatives as well as the general public is usually the local dialect, be it Hindi or any other language. Any doctor whether one has his own clinic, working in a corporate hospital, or in a teaching institution comes across the patients who can only speak in Hindi or local language, where ever it be. Taking history of his present illness, day-to-day follow-up, talking to his relatives, taking consent for some important medical procedures or surgery, explaining the condition of the patient or telling about his prognosis, giving instructions about the drugs, how and when to take, etc., all these conversations are never in English but in the native language of the patients. So for doctors or nurses who have to deal with the patients day-in and day-out are using Hindi or any other local language. Will it not be better if the medium of instructions for them is also changed accordingly?
In an interesting study in Lebonan by Raad and Raad et al. (2016), it was noted that the participants had as good confidence in history-taking in Arabic as in the foreign language of medical education. Approximately 87% of participants who were not confident in conducting history-taking in English/French were still confident in conducting a medical history in Arabic. This difference was consistent across both clinical years ( first clinical year: 80% vs. second clinical year: 95.2%).
The MCI has examined the matter of imparting medical education in Hindi as a medium of instruction and decided against it, citing “paucity” of adequate teaching and learning resource material in the language. This is correct up to some extent, though some vocabulary is available in Hindi,,, and some attempts have been made to bring out books in Hindi., For medical terms which have no parallel in Hindi, original English terminology can very well be used. I did my matriculate through Hindi medium where the whole text was in Hindi, but scientific terminology was in English. With this pattern, I had no difficulty in comprehending the same terminology in higher classes and medical studies. Moreover, Hindi has the capacity to adopt any new vocabulary, for example, words such as station, rail, bus, table, stool, mike, and even the the medical terms such as hospital, operation, and ambulance are freely used by people not knowing English. In the text books even those terms having their parallel in Hindi can continue to have the English term in parenthesis for better comprehension. It is heartening to note that some specialists are publishing their articles on some important topics in Hindi newspapers and magazines, particularly on Sunday issues for public benefit.
By chance I had a meeting with Professor M Chhipa, then Vice-Chancellor of Atal Bihari Bajpayi Hindi University, Bhopal, while he visited Mahatma Gandhi Antarrashtriya Hindi University, Wardha (Maharashtra). He inquired about the medium of instructions in medical college, knowing very well that it is English only. He has made efforts to introduce Hindi as the medium of instruction in MA college of Technology, Bhopal, a regional college of Engineering and asked me about introducing Hindi as the medium of instructions in medical colleges. On telling the same thing as stated above, “nonavailability of resources,” his suggestion was “why not to start developing resources from today” and it will not be long when you have all resource materials with you. The resources can be developed provided there is inclination, political will, and determination to go for it.
The MCI has also observed that the developed countries and most of the neighboring countries have English as a medium of instructions for medical education. The neighboring countries such as India got freedom from the colonial rule, which imposed its language and we are still persisting with it. As far as developed countries are concerned, some of them have English as the main language of communication, naturally they would have all education systems using English; however, why we forget the other developed countries which are imparting all education through their national language, for example, France, Germany, China, Russia, Japan, etc., and they are doing very well globally too. I do not mean that student should not learn English, rather they should learn English as good as they have the knowledge of their mother tongue. It will not cause them any problem to read and comprehend the world literature, bulk of which is in the English language. “Instructions in English provide opportunities of international exposure and experience to Indian medical graduates” is the view of the MCI. However, where is the difficulty to Indian medical graduates to have international exposure, if they know English well even if the medium of instruction is Hindi or any other local language. Those who still wish to continue with English medium, they can very well continue to do so.
It is not to impose Hindi but to provide equal opportunities to those having difficulty in comprehending the subject in English. Similar may be the problem for the students coming from the non-Hindi speaking states; as forNEET, the question papers were made available in different languages to those who had asked for. If the states so desire, it can develop the course in the regional languages as well and solve their problem.
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