Recommends doubling intake of medical students to meet doctors' shortage
The Medical Council of India (MCI) has recommended major reforms in the undergraduate course in medicine by converting conventional education into a competency-based module to develop skilled doctors through early clinical exposure. It has also suggested doubling the intake of medical students to meet the healthcare needs of the country in the coming years.
Pointing out that the current undergraduate curriculum in medicine did not make an MBBS degree holder feel equipped with adequate skills and competence to take care of the common problems at the secondary and tertiary level, the Undergraduate Education Working Group has said this factor also prevents young doctors from going to practice in the rural and primary health centres. The goal of training is not focused on providing health care to the needy and the disadvantaged, the eight-member working group has said in its report.
Distance education
It recommends options for distance education towards a fellowship or diploma in areas such as diabetic care, HIV medicine, geriatric medicine, hospital infection control, hospital management, and inclusion of medical ethics, forensic medicine and hospital infection control in the regular curriculum.
According to the report, the current intake of medical colleges and the critical mass of doctors would have to be doubled if India had to achieve the world average doctor-population ratio of 1.5:1000 by 2031 as against the present 1:1700.
Taking into consideration the existing medical colleges in the country, it was felt that the current intake of medical colleges and the critical mass of doctors should be doubled to achieve this target.
At present, there are 330 medical colleges with an intake of approximately 35,000 and with the present intake the shortfall of doctors by 2031 is estimated at 9.54 lakh.
To offset this, the report has suggested increasing the intake in the medical colleges wherever there is adequate infrastructure of teachers, equipment and clinical load and to augment infrastructure in relation to clinical load by attaching established medical colleges to district-level hospitals or secondary hospitals run by government agencies; upgrading existing larger district hospitals and augmenting their infrastructure to become community medical colleges through private-public partnership or public-private partnership and starting new medical colleges and hospitals preferably in States and underserved areas with doctors and medical colleges.
Clinical training
Chaired by George Mathew, Principal of the Christian Medical College, Vellore, the group stressed the need for restructuring the MBBS course with a four-year course and six months elective with a one-year internship. Clinical training should be included from the first year itself.
The past curricular revisions have mostly added to the existing content without undertaking the exercise to remove what is obsolete and outdated. This exercise needs to be taken up in a detailed and extensive manner and make the curriculum as efficient as possible, the report has said. It has to be discipline-based curriculum and lack of integration between basic and laboratory science and clinical medicine should be addressed.
It goes on to add that each medical college should be linked to the local health system, including Community Health Centres, taluka hospitals and primary health care centres that can be used as training base for medical students.
The Working Group was set up in July last year to evolve a roadmap for medical education in India and to evolve a broad policy on the duration and curricular changes that could be adopted as future strategies to make medical education in India comparable to global standards.
Keywords: Medical Council of India, education reforms
Linking medical college to the local health system would be the good decision. Introduction of elective subject will definately yield a good result in terms of producing skilled human resource in various subjects.MCI can think of introducing Hospital Management as one of the subject in every semester at UG level.Student will have study this subject in a phased manner and write the exam in the last semester.But marks need not be considered for his/her promotion or graduation.
As a medical student in a leading government college we never understood the importance of learning basic sciences till we really began to practice. Even during clinical year postings the students were often considered an extra burden for the assistant professors. CMC vellore has a practice of clerkship for medical students which enables the students to get a first hand experience of being part of the clinical management team.This model is worth pursuing in all institutions.
Medical education should be re-cast to impart thorough working knowledge in pharmacy,laboratory, nursing,anesthetic etc. The idea is people should be able to attain proficiency in their choice once they finish minimum three years according to their choice. Once you finish sixth + 1 year competent surgeon should cast, 7 + 1 year should produce an specialist. There can be one year internship in between for graduation and additional year for those who specialize. The course should be open for admission after class ten. There should not be any other stream for any of these medical job.
The worst thing about the educational system in India is,none of these people(Working Group) consider the opinion of students community.They decide what is good for students and they just implement it.They never ask the student what is his ambition,his fears etc.As long as they don't consider the opinion of students the standard of education will never improve.
In fact students of first year should be attached with paramedical staff and in second year their services should be used as paramedicals. So that the shortage of paramedical staff can be addressed as well as the new commers get clinical knowledge.
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