I suppose someone has conveniently forgotten about the part about teaching in the original Oath. Of course, the H.O. was intended for physicians only - there seemed to be a huge change in perception, as surgeons used to be called "barbers" or "butchers", and physicians had absolutely nothing to do with them. So I suppose, we must forgive him for his oversight.

And I also chanced upon another article. It's alarming, since we got it straight from the horse's mouth (with no amount of disrespect intended here) that education in overseas institutions are much less barbaric as compared to ours. Their residentship (house officership) are strictly on the basis of 9 to 5, as local law prohibits overworking of students even. Their night shifts, if any, are truly and purely "night" shifts - they start at night, off-in-lieu, and that's it.

"We have too little doctors, therefore they have to be overworked. It's inevitable." AFAIK, Singapore has one of the highest doctor-to-patient ratios around (don't they keep boasting about this in demographic listings?). Yet, we are overworked? I seem to have missed a strand of logic here.

I love the way this particular doctor expressed it - "medical education, both undergraduate and graduate, brutalises its students".

I guess this comes at a time when I'm frustrated over certain people who offer to teach but yet do not give or have joy in teaching. Sir William Osler would have baulked at this sort of education, for in his inspiring articles on medical education, I always get transported to a fantasy world - a world where education is both a joy and a need, information is relished and not just dull necessity, and positive teaching is the norm of the day; where budding young doctors are encouraged, not put down; where the kindest and best education is offered to us, so that we, in turn, will offer our best practices and empathy for our patients in future.

"As a senior medical student about to move on to residency, the overwhelming emotion I have at this time is one of disillusionment. At the heart of the Hippocratic Oath, both classical and modern, is the vow to avoid doing harm and to help when appropriate and necessary. Yet medical education, both undergraduate and graduate, brutalizes its students.

Sleep deprivation is the norm -- I have seen residents working up to 120 hours a week. With such inhuman work hours for so many years, alienation from one's family, health, and peace of mind is often the result. Falling asleep at the wheel is common, and deaths of both residents and medical students have been noted in the press. Medical mistakes are inevitable when people are so exhausted. The medical literature clearly and unequivocably states the risk to health and even life when people are sleep deprived, but medical educators seem to believe that somehow, magically, doctors can rise above their own physiology. Physical and psychological abuse from attending physicians are common complaints of both residents and students.

To quote from the Annals of Internal Medicine, "For many residents, fatigue cultivates anger, resentment, and bitterness rather than kindness, compassion, or empathy" (Annals of Internal Medicine 123(1995):512-517). How are we to provide compassionate care to others when our own educational system is the model of abuse? Primum non nocere indeed -- the hypocrisy of this oath is that we can't even manage to muster nonmaleficence to practitioners of our own profession, let alone our patients."

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