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.
Keywords: MBBS, medical education reform, medical graduation, health issue, Medical Council of India, government healthcare
This is just another well thought-out disaster that is waiting to happen, in the long line of mistakes that the honorable MCI has committed in the past few decades.
While, everywhere in the developed world, medical education is moving towards consolidating degrees and making medical curriculum and training relevant to the actual needs of the patients, we are busy creating more courses, more degrees, and more ways to foster corruption. I have never heard a more ham-handed solution to our healthcare woes. A single licenciate exam is good, but will it necessarily raise the standard of doctors? Will this curriculum take care of the most basic need of having ethical, empathetic, and dedicated general practitioners churned out in increasing numbers every year and how many of them would be in a position to serve in our rural and far-flung areas. Invariably, the GP is the first link in primary care, which is what makes or breaks a nation's health care indices! Change just for change's sake
'The national-level exit exam is expected to set a standard for doctors.' It looks a good idea. In my view it will at best start new coaching institutes to enable passing the exam. Will it thus truly filter those who are not qualitatively fit to practice public health care ? How can deficiencies of those found not fit be cleared? Again just through theoritical exams ? I think it is better if such students donot pass MBBS rather than testing them and filtering them in own home country after 51/2 years of rigrous study. This mechanism is understandable when one has to undergo test to practice abroad.
What about ensuring easy access to soft finance/ loans for the people who have chosen this career, as it has a very long gestation period, before they are sef reliant and start earning.
Less number of students are taking biology after class 10. This new system should simplify and reduce number of tests. If difficult and more, tests will actually reduce the enthusiasm of the students. Also it is easy to earn money as a software engineer than as a doctor. Kindly make the MBBS system easy as IIT with five day week and long vacations. There are no vacations in MBBS and inhumanly hours of duty. Rural areas should have good schools for doctor's children to pursue education and good roads and approachability.
The changes proposed will have far reaching effects for the Indian medical community. I hope the MCI has the guts to continue with it and not get swayed by money in between as is their norm. We are hopefully going to create a licensing exam that will be recognized the world over. And hopefully remodel our education system to become the best. At present, MBBS graduates do not know head nor tails in treating a patient. I hope that in the future all this changes. In addition to the proposed changes, I do hope that the MCI intervenes to reduce the substantial cost the colleges charge. I see that many doctors are passionately set against the proposed changes. But I strongly believe that these changes are what was lacking and should be implemented swiftly and thoroughly.
Why this new M Med? In what way it will be different from Diploma Specialist? When already so many diploma specialists are suffering because of injustice the why MCI making this M Md? Why can't they recognize diploma specialist and give them promotions to the level of professors at least for Undergraduate teaching.Diploma holders are working on par with master degree holders and there is no difference between two out side medical college then is it not the time to give them justice & promotions? staff shortage will be reduced significantly. MCI should think about this & take necessary steps soon.
I am a student myself. It wrong to believe that medicos are not interested in serving the underprivileged. Medicine is such a vast and fascinating subject. After finishing One's studies if he/she starts working in rural areas, it will in a way put an end to their learning. Also there is little scope for my professional growth. One will be entangled in a system riddled with corruption which will take away your satisfaction of serving the poor.There is strong Top down influence and there is utter lack of professionalism. So First i want to study and learn the subject of my choice with as much passion and perseverance. when i become a confident and grow in my career, I will definitely serve the poor in villages on my own, to the best of my abilities. Without being have to subservient to the corrupt system.
MCI has not made clear as to what teaching posts would the MMed postgraduates be eligible for? Tutor? As post pg diploma? Or asst. prof. and not beyond that later on?
Change must come. Medicos should be taught importance of NF Kappa B known to be "NF Kappa B", which is the molecular target for future drug development. There is traditional medicines which are known "NF Kappa B" inhibitors and medicos should get over their biases for these medicines. For example active content of Haldi /Turmeric curcuminoides) is known "NF Kappa B" inhibitor and this can be used for managing variety of chronic conditions. Similarly other Ayurvedic medicines like Giloi and Black Seed (Kilongi) can also be used very effectively, rather then doctors DISHING OUT COX INHIBITORS indiscriminately.
There is no point in increasing medical seats without proper infrastructure.The in take of students should be around hundred and if proper care is taken during the clinical curriculum, further training may not be necessary.As it is the MBBS course is very tedious and remuneration is not comparable and lot of physical and mental stress. Life is important for everyone and that should be impressed on the Medicos. Simple passing of exams and getting a PG seat is not sufficient. The student who is really interested in medical profession should join the course. The Humane approach should be impressed on them. The curriculum should be revised so that more practical training should be imparted to the Medicos.
This is a good move to ensure the quality of doctors our country would have.
It would be good if the full text of the proposals, especially on the undergraduate programme, is made available at a website. May be 'The Hindu' could obtain it and post in their Resources folder. Every body has a stake in this. It is also to be hoped that the Health Ministry will act as the custodians of public interest in this matter, ensuring that the reforms will promote the societal obligation of the profession to mediate unversal health coverage.
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