He went on. "Because of the change, I found it very difficult to arrange duties for the trainees. Who should be responsible for the most simple tasks? The difference between the junior trainees and the senior trainees have become unclear, thanks to the blanket term (residents). The authority put guidelines for our educations towards them. For example, they said the juniors should know how to do hemostasis (simply: stop the hemorrhage). But what kinds of hemostasis should they know? Stop the bleeding from portal vein? (which cannot be stopped without experienced hand)"
"We as teachers were not told precisely how to teach in a new way for the registrar. In the past, we know who should do the basics and who should do the difficult tasks, because we were taught in that way. Now, the system change, but we did not. I tried to learn how to teach, but the guidelines were not clear and practical that I spent many times to learn. How can I ensure my teaching quality? How can I promise that the juniors and seniors can learn what they should learn in a timely way?"
"Most importantly, I was not sure how the examination would run. In British system, we learned how to solve clinical problems. However, in American system, we needed to know a lot about the origin of the problem (also known as pathogenesis). I agreed that the pathogenesis was important. But I have forgotten the cellular mechanisms when I dissect the stomach!" He was not satisfied. "British system was practical in a way that the examination runs to test on flow of thinking clinically. That's why it worked so well for so many years in many countries in the world, including this city." He said. "I see no point that we should change our system. I was pessimistic about the doctors and even the medical students whom we trained for the next five or ten years. They would not receive good training like what we did in the past. If they do not know how to solve problems. The final suffering would go to our patients."
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