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It’s the beginning of November, and the academic year in Italy has started in the last two to four weeks. Here in Brussels we already had three full-time weeks of classes, and I’m now getting ready to for my first stage (en français) in the ER of one of the local hospitals – and I have to admit the thought is a bit scary. With this air of fresh starts and new beginnings, I decided it’s time to write about something which bothers many of the wannabe students for our courses of medicine taught in English, and perhaps some of the new first year students: the English itself.

I’ve often been asked about this, and I repeatedly see posts on our Facebook group where students pose this very important question: “Our professors will all be Italian; how is their English? I fear my preparation might suffer from this”. If you’re busy and don’t have time to read all my article, I’ll tell you my opinion here very quickly, that is…

not too good, not too bad, but most of all, not important.

For a more in-depth analysis, I hope you won’t mind if I tell you the story of how I came to this conclusion.

It was the faraway spring of 2012, and I was still a young and carefree high-school student; I had already made up my mind to try and get into Pavia’s Harvey course, since my goal was to graduate and then move to the UK. (I’m not too keen on this plan anymore because thank you Brexit… but who knows?) One day I managed, through friends, to sneak into the lecture hall of the first year to attend a lecture; for your information, this is something anyone can do, because lectures in Pavia are not at all private. Therefore, I suggest you go should you happen to find yourself in town.

I found myself in the middle of a biochemistry class about glycolysis, of which I knew nothing. So, rather than focusing on the subject, I had a lot of time to focus on the lecture the professor was giving. I must say, it felt terrible: used, as I was, to high-school English teachers with slightly posh British accents, my ears suffered at the sound of a dozen pronunciation and grammar mistakes in just one hour. I even asked a nearby student if this professor was one of the worst or not, and was sort of shocked when she replied with a “no, he’s actually pretty good”.

Time passed, and I got my high-school diploma with great compliments on my English from the professor who was testing me in the subject; then came the IMAT and (very) luckily I passed that as well.

After I struggled somewhat through the enrollment procedure, finally the first day of class arrive. If I remember correctly, we had two hours of genetics, followed by two hours of physics, and chemistry in the afternoon. I admit, after the first day I was shocked by how bad an English theirs was; never had I heard people speaking so poorly without making fun of them afterwards. Yes, I’m a bad person.

Class after class, my first impression didn’t turn into a much different opinion; what changed was my point of view, if you can say that. As I became more content-oriented rather than context-oriented (out of necessity, as what I needed to study was the subject and not the lecturer) I realized that the classes I liked the most were the ones in which the professor had proper teaching skills. I preferred clear, over eloquent, concise over prolix, logical over exuberant.

Clarity and order acquired an even greater importance after the first few exam sessions, when the more directly medical subjects came up, and I noticed that a course or lecture was good or bad depending on how well-structured the professor’s s teaching was.

I’ll give you an example: we have two professors, both teaching a clinical subject, with 20 hours allocated to each of them.

-the first spends the first 5 hours explaining thoroughly the physiology of his body system, hinting every time at what diseases are caused when something goes wrong with each part of the system; in the following 15 hours, he addresses the different diseases without an apparent order, but going in such depth in each topic as to present you with scientific articles published three months before describing the novel experimental therapies for each disease.

-the second spends the first 2 hours recapitulating briefly the physiology, then another 2 hours talking about the basic concepts of his discipline (like what part of the physical examination you should focus on, or which lab examinations are more used), and then for 12 more hours he goes through the different components of the body system, talking about them systematically (etiology – pathogenesis – signs & symptoms – treatment – differential diagnosis). He shows maybe one or two milestone articles, and then uses the last 4 hours for a clinical case and to allow students to ask questions.

Which one would you like to be your teacher? I’m not saying the first one is bad and the second is good; I’m saying that the first one surely makes a great speaker for a conference, but if I want to learn a discipline from someone, I’d rather be in class with the second. OK, now let’s add this: the first one speaks a flawless English (with a hint of a British accent) because he spent five years teaching in the UK; he gives beautiful lectures. The second professor’s English is so-so. He spent one year in the US but never managed to lose a strong Italian accent, and it sounds funny sometimes.

Did your preference change? Trust me: after trying both, mine wouldn’t anymore.

Hers would.

Hers would.

So far we’ve talked about studying and exams, but how do Harvey students fare in clinical practice?

In our third year we start clinical rotations, and often this happens in the same wards and at the same times as our dear Golgi colleagues (for those who don’t know, Harvey and Golgi are the names of the two courses of Medicine of Pavia, respectively in English and in Italian). Since there has always been a bit of a rivalry between the two classes, students from one course always compare their performance with those from the other course. I’m not implying that we dislike each other, but sometimes we do ask ourselves: “Are they better? Are we better?” You know, even just out of curiosity.

I’ve met many students both inside hospitals and inside libraries and study rooms, and let me say it once and for all: I have never noticed any difference. If I was asked a question, sometimes I replied correctly, but some other times I didn’t, and a man or woman from the Italian course gave the correct answer. One of my Harvey fellows made a very good physical examination, but the student from the other course took a much better history. Good students and bad students were coming from both sides. They had been taught medicine in perfect Italian, we in an array of different English levels. Language never made any difference.

After a few years, it becomes apparent how lessons are just a vehicle for the information we need to pass exams. They’re not useless, as they give you an idea of what’s important and what’s not, and good teachers can easily improve your understanding of a certain subject. However, what you know is just so much more dependent on how well you study your material, be it Italian books, English books, books written by our professor, notes from classes, or whatever. When we are required to put that knowledge into practice, we will not remember the accent in which our fourth-year professor spoke; we will remember all the effort we put into our studies and practice.

P.S.: If I still didn’t convince you, I’m glad to inform that most of the first-year professors of Pavia who spoke a rather bad English now have been changed. Three years ago, anatomy was very difficult and the professor’s knowledge of the language was lacking. Now, the professor has English as a mother-tongue, and the course apparently is even more difficult. Have fun with it. <3

Stefano Doria (Pavia)

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Emergency medicine physician, graduated in Pavia. After going through six tough years of med school, I know how valuable information and encouragement can be; so here I am, trying to provide a bit of both with my posts.
Stefano Doria (Pavia)