Medical training in Ghana: the more difficult the better?

I did not enjoy medical school, especially from the second year to final (6th) year. There were lecturers who reminded us always about how difficult medical school was and how we were likely to fail our examinations. What I found strange was that in our examinations (interim assessments), we were given questions that were taken away from us after the examinations. Some of the questions were very difficult for many of us, and we saw them for the first time in the examination room. Of course, many of us got them wrong. Yes, the question papers were taken away from us after the examination. Most of time they were not discussed with us. Interestingly, some of these same questions would be brought again in a subsequent examination. It was as if some of the lecturers enjoyed seeing us unable to answer the same questions.

I was amazed. I asked myself: “Will I do the same thing to young medical students when I graduate as a medical doctor?” I couldn’t believe I would do that. I led a ‘revolution.’ From our second year in medical school, our class compiled all the questions we were given during our examinations, including our final examinations. I was in charge of the compilation. Everybody in our class was given a number. Their duty was to memorise their question(s) after which I would come for them and put them together (write them out). My roommate who had access to a printer would print them out. Every member of the class would buy a copy and use it to prepare for the next examination. So about 5 minutes to the end of an examination, some of us would stop trying to answer questions and concentrate on getting questions for the future. It was a worthwhile investment.

Sure, there were a few people who were more interested in maximising their scores in the examination than in memorisng questions. They did not have any questions for me after the examination. I usually sat with some of my friends to recall these questions. Some of my mates had wonderful memory! Michael Ayepah (now practising in the USA), Eugene Vortia (now practising in the USA) and Felix Agyekum (aka Mebroni or Obronsuo, now practising in the UK) had wonderful memories! I will never forget them. When we met, we could put together almost the whole examination paper, often over 50 questions.

I operated under the pseudonym ‘Alhaji Sani.’ The Alhaji Sani compilation of questions in medical school was a hot commodity, and a great legacy for many medical students who came after us. We used them to guide us in preparing for examinations. When one Pharmacology lecturer got to know that we were memorisng questions in the examination hall, his response was to use long sentences so that we would struggle to memorise the questions.

I am not into ‘academia.’ Some of my mates who complained then are. I do not know the situation now. Earlier this year we trained nurses in Module 2 of our cervical cancer prevention programme at the Cervical Cancer Prevention and Training Centre in Catholic Hospital, Battor. As a pretest, we asked them to answer some questions. After the test I gave them back the questions (fulfilling the promise I made nearly 3 decades ago). In our training programme, our trainees do not take written examinations. They are assessed at the end by PowerPoint presentations they make followed by questions from the audience.

An old gynaecologist told us a story about how his lecturer sat close to him in a flight to Nigeria (years ago, all Ghanaian doctors had to go to Nigeria to take the postgraduate examination in Obstetrics and Gynaecology), flashed an instrument in his face (did not discuss it with him), but the next time he saw the instrument was in the oral examination in Nigeria where he struggled to answer questions on the instrument. This ‘instrument’ was not used in routine clinical practice in the hospital he worked in with the examiner in Accra. The only time many people saw these instruments was during an examination.

So the question that comes to mind is: Do our lecturers really want their students to know, or they enjoy it when their students struggle in examinations? In my postgraduate studies in Obstetrics and Gynaecology in Ghana, I had a colleague who trained outside Ghana and struggled to understand how we do things in Ghana. He told me in the country he trained, for the postgraduate examination in Obstetrics and Gynaecology, there was a bank of over 200 essay questions that the doctors in training were given. They were assured that 5 out of the 6 questions in the final examination would come from the bank of questions. Only one question will be new. The lecturers encouraged the doctors to get used to these questions, answer them over and over again because if they knew the answers well and could practise them, they (the lecturers) would have achieved their aim.

In ‘Ogyakrom,’ things must surely be different, and we must make things more difficult for the young ones so that they respect us? As our national anthem begins: God bless our homeland Ghana!

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