Despite tremendous changes in health systems over the last century, medical education curricula has remained mostly outdated. The key elements that define today’s global health systems include ageing populations; demand for quality, equity and dignity; transition from communicable to non-communicable diseases and from episodic illnesses to lifelong ailments; double burden of disease in some countries; and disruptive advances in medical knowledge, IT, and biotechnology.
Medical education is the bedrock on which the needs of ‘human resources for health’, one of the major building blocks of any health system, are met. Today’s health professionals are required to have knowledge, skills, and professionalism to provide safe, effective, efficient, timely, and affordable care to people. They are required to: be proficient in handling disruptive technologies, understand the economics of healthcare, have the skills to work in and handle large and diverse teams, be ethical, demonstrate empathy, and be abreast of rapid developments in medicine.
Today’s medical education should be able to groom such professionals to face medicine of the 21st century. In addition to raising the standards of medical professionals, the system should innovate to meet the growing shortage of health professionals to serve ageing populations with lifestyle and lifetime ailments.
First, there is a pressing need to revisit the existing guidelines for setting up medical schools and according permission for the right number of seats. Methods of education across fields are undergoing changes on account of advances in e-learning methods and tools, including remote learning, virtual classrooms, digital dissections, and simulation systems for imparting skills. Extending teaching privileges to practising physicians and allowing e-learning tools will address the shortage of quality teachers across the system. Together, these reforms could double the existing medical seats without compromising on the quality of teaching.
There are ongoing innovations in medical education to prepare professionals for the complex and rapidly changing healthcare system. In fact, The Lancet report, ‘Health Professionals for a new century: transforming health education to strengthen health systems in an interdependent world’ (2010) outlines key recommendations to transform health professional education. According to a study by Densen P. (2011), “it is estimated that the doubling time of medical knowledge in 1950 was 50 years; in 1980, 7 years; and in 2010, 3.5 years. In 2020 it is projected to be 0.2 years — just 73 days.”
At this pace of change, a student can be prepared to process information that is readily available than to know past knowledge. Periodic re-certification based on continuing learning systems may become essential to keep up with the fast pace of change. Virtual learning tools eliminate the need for didactic classrooms. Dynamic curricula designed around specific health systems will become more relevant than the systems designed for the classical hospital-based care. Since health professionals work in teams, inter-professional combined learning methods are being introduced. Even the concept of the teaching hospital is changing from a single, large hospital to a network of hospitals and community health centres.
For a more responsive system
The Medical Council of India has been mired in controversies, resulting in deterioration in the quality of education. Also, its policies and strategies were delinked from the rapid changes happening in health systems within India and globally. By monopolising control over every aspect of medical education, it bred the culture of deep-rooted corruption. However, if MCI splits its functions into four well-defined areas, and stipulates fixed and rotating terms to key people, it could enable the creation of a more responsive system.
Krishna Reddy Nallamalla is a senior cardiologist and currently Country Director, ACCESS Health (India)