A graduate would have to pass an exit exam or licentiate examination in order to practise medicine

The Board of Governors of the Medical Council of India (MCI) has proposed major changes in the undergraduate curriculum and training programme that would create an “Indian Medical Graduate,” who will have necessary competence to assume his or her role as a healthcare provider.

The “Indian Medical Graduate” will have to pass an exit exam or a licentiate examination after an internship to get licence to practise anywhere in the country. The national-level exit exam is expected to set a standard for doctors. The MCI also proposes to introduce the National Eligibility-cum-Entrance Test from 2012.

A new two-year Master of Medicine (M. Med) programme is also proposed with focus on skill development. Degree holders will be eligible to teach undergraduate courses. There will be no competitive exam for this course and the assessment will be based on the student's performance during the course and the national exit exam.

The restructured curriculum laid emphasis on clinical exposure, integration of basic and clinical sciences, clinical competence and skills and new teaching-learning methodologies that would lead to a new generation of graduates of global standards, Dr. S.K. Sarin, Chairperson, Board of Governors of the MCI, said here on Tuesday, after a day-long national meet on “Implementation of Reforms in Undergraduate and Postgraduate Medical Education” where the proposed reforms were adopted.

The proposals will have to be approved by the Ministry of Health and Family Welfare before their implementation in 2012.

The licentiate system, if approved, would be optional between 2012 and 2016, but mandatory thereon, Dr. Sarin said. While the duration of the undergraduate course would remain five-and-half-years, a two-month Foundation Course after admission to prepare a student to study medicine effectively is proposed. This would help in orienting students to national health scenarios, medical ethics, health economics, learning skills and communication, life support, biohazard and environment safety.

The new curriculum had been structured to facilitate horizontal and vertical integration between disciplines and bridge the gaps between theory and practice. In the first year, focus would be on basic and laboratory sciences (integrated with their clinical relevance), while in the second and third years, focus would be on clinical exposure and learning. Clinical training would start in the first year and there would be more focus on common problems seen in outpatients and emergency settings.

Importantly, an ‘elective' subject had been added to the ‘core' subjects to allow flexible learning options in the curriculum and the options include clinical electives, laboratory postings and or community exposure in areas that students were not normally exposed to as part of the regular curriculum.

The post-graduate specialisation would essentially involve a research component and prepare this group of specialists to pursue the academic stream.

Dr. Sarin said that after M. Med, students would have the option of pursuing one of the five doctorate streams depending on the aptitude and professional aspirations. After M. Med, the graduates would be able to compete for Doctor of Medicine or Master of Surgery or other dual programmes (MD-PhD, MHA, MD-DM and MD-fellowships).

An additional weightage of 5 per cent would be given to candidates for putting in six months of intensive rural service during the M. Med course. The duration after finishing MBBS course would be M. Med (2 years); one more year will get candidate an MD degree. Candidate would get dual degrees after four years and he or she has a choice to go on a fellowship programme or a Ph D programme or a DM degree in five years.