|Year : 2019 | Volume
| Issue : 1 | Page : 2-3
Medical education in India - General Profile
Professor Emeritus of Ophthalmology, Chief of Medical Services, Jubilee Mission Medical College, Thrissur, Kerala, India
|Date of Web Publication||15-Apr-2019|
Professor Emeritus of Ophthalmology, Chief of Medical Services, Jubilee Mission Medical College, Thrissur, Kerala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Joseph A. Medical education in India - General Profile. Kerala J Ophthalmol 2019;31:2-3
Today, we are living in an era of knowledge explosion where availability of healthy knowledgeable human resources has become the most crucial factor for the development of the society. So much so health and education have become the top priority for all countries in the world. Health-care education is meant to make the people more aware of health problems, and the medical education is meant to train human resource persons who are involved in the health care.
Modern medicine was introduced to India during the British colonial rule, and the first medical colleges were started almost simultaneously in Calcutta, Bombay, and Madras in 1835. After the introduction of the medical education, many structural changes have been effected mainly by the influence of individual recommendations, commission reports, and policies of the government of India, United Nations, and Medical Council of India (MCI).
From the era of Susruta and Charaka, when devout disciples learned the art of healing in ancient Gurukulas, we are now in an age of rolling out the modern-day physicians and surgeons along a conveyor belt. Medical students are not receiving the kind of one-to-one attention that was once the hallmark of medical education, neither during the years of teaching in the basic science laboratories nor during the clinical training, and the way medicine is thought and learned has changed beyond recognition. The technology of education has undergone a tremendous change. Further, the revolution in information technology has placed the advances of medical research at the doorstep of the common man. In a world that is becoming increasingly quality conscious, physicians have a moral, and maybe even legal obligation in the foreseeable future, to stay updated and to deliver the best available care to their patients.
The year 1947 was a major landmark in the history of medical education of India. The Government of India on the recommendation of the MCI promulgated “the regulations on graduate medical education” through gazette notification. The MCI stipulated that undergraduate medical education shall be oriented toward “Health and Community” as opposed to “Disease and Hospital.” Graduates shall develop humanistic qualities in discharging professional obligation and be able to work as team leaders of the health team in urban and rural settings.
“We give medicines of which we know little to treat disease of which we know less into human beings of whom we know nothing.”
(French writer + poet – 1694–1778).
From this, it is clear that the doctor has to be proficient in nonclinical subjects such as pharmacology, pathology, and microbiology. For the study of clinical subjects, it has to be bedside medicines. Osler's advice that the students have to see, to smell, to hear, and to understand, to study medicine.
“To study medicine without books is to sail an unchartered sea
While to study medicine only from book is not to go to sea at all.”
- William Osler.
| Competency-Based Medical Education|| |
This involves multiple competencies so that an undergraduate, after completing the course, shall have the competence of a “Basic Doctor.” Competency-based education is an approach to preparing physicians for practice that is fundamentally oriented to graduated outcome abilities and organized around competencies derived from an analysis of social patient needs. It De-emhasize time-based training and promises greater accountability, flexibility, and learner centeredness.
| Evidence-Based Medicine|| |
The essential feature of evidence-based medicine is that the consultants/students, when faced with any problem or dilemma in the clinical context of patient, should be able to perform a literature search, identify the evidence available on the clinical, critically evaluate it, and determine the best evidence to diagnose/treat/manage the patient.
| Problem-Based Learning|| |
“A problem is a chance for you to do your best.”
- Duke Ellington.
In fact, the bedside learning in the clinical posting is a form of problem-based learning and the student acquires problem-solving skills.
“Problems are not stop sign. They are guidelines.”
- Robert Schur.
| Patient-Centered Care|| |
In treatment, the primary focus shall be the welfare of the patient. We must make sure that patients have access to the safest and highest quality care.
In patient-focused care, observe the following guidelines:
- History: Is half clinical examination
- Clinical examination: Is half diagnosis
- Diagnosis: Is half treatment
- Treatment: Is half life style
- Life style: Is half diet.
A pat, a smile, and a kind word complete the treatment.
| Continuing Medical Education|| |
Doctors practicing modern medicine remain a student throughout their professional career. The process of education is a continuous process and consists of learning, unlearning, and relearning. Continuous medical education forms the sheet anchor of progress in medicine and prevents mediocre quality. Continuing medical education is defined as “Any and all the ways by which doctors learn after formal completion of their training.”
| Medical Council of India|| |
The MCI is believed to be the watchdog of medical education and practice. Originally, it was Indian Medical Council (IMC) and established in 1934 under IMC Act 1933 as a selected body for monitoring medical register and providing ethical oversight. The Parliament provided statutory status for the IMC. An amendment in 1956 mandated the MCI to maintain uniform standards in medical education both in undergraduate and postgraduate.
In the year 2018, the MCI introduced “Competency based undergraduate curriculum” which will be effect from August 2019. Updating and reorganization of the postgraduate curriculum in fifty board specialty disciplines to the competency pattern were already accomplished by the MCI.
The existing regulations on graduate medical education 1997 are of 20 years old.
The MCI visualized that the undergraduates should be able to recognize “Health for all” as a national goal and to provide clinician who understand and is able to provide preventive, promotive, curative, palliative, and holistic care to his/her patients. The thrust in the new regulation is more learner centric, patient centric, gender sensitive, outcome oriented, and environment appropriate. Emphasis is made on alignment and integration of subjects both horizontally and vertically. Importance has been given for ethical values, responsiveness to the need of patients, and acquisition of communication skill. Great emphasis has been placed on collaborative and interdisciplinary team work, professionalism, and respect to professional relationship. We hope that the curriculum shall create a new generation of medical graduates.