Culture of med school in Kenya

In many ways, the culture of the medical school here feels like what I imagine med school was like in the 1950s in the US. The consultants (attendings) often laugh at or berate students who get things wrong and the byproduct is that the students very rarely speak up. They don’t ask questions in morning report or on rounds and they often don’t answer questions even when they know the right answer. One consultant is particularly mean and one of the residents here actually wanted to yell at him to stop. She didn’t. But it is tempting. It is so clear to see from the outside why the med students act so timidly, and it also can obviously feed back to worse patient care because students and residents become afraid to speak up. As I mentioned before, the interns work 365 days per year – not a single day off – and the registrars (residents, like fellows in the states) rarely help them out when they are overburdened. There seems to be a perpetual idea that “I had to do this when I was an intern, so you must suffer too.” But that can clearly be a dangerous (not just sadistic) mentality because overburdened doctors provide worse care. This makes me appreciate the culture of medicine back home at Brown. Interns and residents (and med students) work really hard but there is generally a more helpful and collaborative environment. I appreciate the willingness of students to ask questions and attendings to listen and teach, rather than speak down to all of us.