February 05, 2011

Flutter over post-MBBS plan

Medical education in the country is set for a makeover. But the recommendations of the Medical Council of India (MCI) for creating "competent" doctors have kicked up controversy.

The most contentious point is the introduction of a two-year MMed course, which the MCI believes will equip MBBS graduates with better clinical competence. The MCI wants all MBBS graduates to get MMed degrees before starting practice or opting for higher studies.

But many medical teachers do not find much merit in the idea. They say that on one hand the MCI wants many "basic doctors" to serve as general physicians or in villages, while on the other it is lengthening the process of creating such doctors by introducing a mandatory two-year post-MBBS course.

A senior professor from the Topiwala National Medical College, attached to the civic-run Nair Hospital , said doctors will not be open to the idea of serving in villages after spending an extra two years in medical school. "We are again committing the mistake of creating specialists . That will definitely not answer the concern of skewed doctorpatient ratios in rural areas."

A component of the proposed course is that students will have to spend six months at a district hospital or in industry. Students who do a rural sting will get a 5% incentive. But the MCI has not clearly spelt out the evaluation model. Also, it is yet to come out with clear guidelines on the duration of the bond period for the postgraduate programme.

Teachers are concerned about the significance of the MMed course for paraclinical subjects like anatomy, physiology and pharmacology , where students usually take up teaching as their profession. "What are these students going to do at a district hospital or in industry ?" said a professor from the GS Medical College.

An MCI official said the idea is to create a vast pool of doctors on these subjects. "Once we have enough professors, students opting for these subjects can be directly allowed to go for their MD."

But, teachers say, this entails a risk of driving aspiring teachers towards private practice.

Brushing aside the apprehensions , Dr Avinash Supe of KEM Hospital , who was part of the MCI panel that has made the recommendations , said the idea is to have better doctors. "Our country lacks family physicians. We have (ensured in our plans) that a considerable number, or 15,000-20 ,000, of MMed graduates get into family medicine."

ROADMAP FOR DOCS

PROPOSED
Entry to MBBS course through single national level entrance exam Course duration: 4 years Post-MBBS internship: 1 year Direct entry to MMed course of duration 2 years Entry to post-graduate course (MD/MS) through national or state level entrance exam Course duration: 1 year Entry to super-specialisation courses (DM/MCh) through national or state level entrance exam Course duration: 2 years Minimum time from entry to MBBS to completion of super-specialisation : 10 years

EXISTING
Entry to MBBS course through national or state level entrance exam Course duration: 4.5 years Post-MBBS internship: 1 year Entry to post-graduate course (MD/MS) through national or state level entrance exam Course duration: 3 years Entry to super-specialisation courses (DM/MCh) through national or state level entrance exam Course duration: 3 years Minimum time from entry to MBBS to completion of super-specialisation : 11.5 years

IMPACT OF PROPOSED CHANGES
Projection for 2020 MBBS | 50,000 per year M Med | 50,000 per year MD | 25,000 per year Fellowships | 7,500 per year DM/MCh | 5,000 per year

Link: Original Article

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