Facing the challenges in medical education today

A saying goes, “Good doctors understand responsibility better than privilege and practice accountability better than business.” We cannot think of having such a battery of doctors in the nation, if our education system is not adept to nurture such doctors. Sadly, the reality is just this. According to Deloitte 2015 study on medical tourism in India, there is a dearth of well qualified healthcare professionals in the country; one of the reasons for a high mortality rate in India.

Also, many young medical professionals are refusing to move into villages and remote areas where medical facilities are needed. It is estimated that India’s has merely 0.7 doctors and 1.5 nurses per 1,000 people; dramatically lower to the WHO average of 2.5 doctors and nurses per 1,000 people.

At the root of it all
Currently, India’s 398 medical colleges have failed to look after the healthcare needs of 1.2 billion people of the country. We can blame it on the archaic medical educational system. There is also a need to nurture emotional intelligence in medical practitioners. Patients need more care and compassion than merely technical medical know-how. Most medical practitioners are forced into cramming knowledge, to perform academically well. Another roadblock is the dismissal state of internship assessment and regular curricula development. This is the reason behind an evident fissure between requirements and availability of doctors, especially in remote areas of India.

There are also other factors affecting the quality of Indian medical practitioners. There is maldistribution of resources and unregulated growth in the private sector. Apart from this, faulty and disorganized admission procedures in private medical colleges (most of these are not recognized by any accredited agency) makes the educational journey questionable.

Fixing the problems
Undeniably, health of a medical industry defines the health and well-being of a country. For that, every honest youngster dreams to be a part of one of the top 10 best medical colleges in the country. The list includes All India Institute of Medical Sciences (AIIMS), Delh; Christian Medical College (CMC), Vellore; Armed Forces Medical College (AFMC), Pune; JIPMER College, Puducherry; Maulana Azad Medical College (MAMC), Delhi; Lady Hardinge Medical College (LHMC), Delhi; Madras Medical College, Chennai; Grant Medical College, Mumbai; Kasturba Medical College (KMC), Manipal and Sri Ramachandra Medical College and Research Institute, Chennai. But for those who can’t make it to these, the only hope is the other private institutions. With selections based on a National Ability and Entrance Test, chances of securing a seat are bleak for the rest of the aspiring lot; and then curricula and governance at such colleges has also become questionable.

This means, a serious and significant alteration of the existing curricular at every level and for all medical institutions, whether well know or not. There is also a great need for less emphasis on the theory component and more on the practical usage of the same. Therefore, the medical educational system should cater to a horizontal and vertical integration of pre-clinical, para-clinical and clinical subjects that can assign more time to clinical teaching. With this will emerge a new generation of doctors that are more equipped with clinical competencies and a right attitude to serve the patient.

Problem solving- a mindset
There is another interesting way to ensure that medical practitioners are not merely churned out as better crammers. Indian medical practitioners must be proficient in problem solving. For this, some medical learning institutions like Yenepoya University have introduced a self learning and interactive E-learning platform, especially for MBBS and BDS courses. They use inbuilt software called the ‘YENGAGE’. Through an open forum, students get to be continuously evaluated on their understanding and practical application.

Progressive evaluation
In order to have a more robust workforce of Indian medical practitioners, there is an urgent need to revamp the existing evaluation system as well. There needs to be tectonic shift; from merely evaluating memory power to accessing objective application. The Art and Science colleges are now happy; making use of choice-based credit system and a continuous evaluation framework. The same can be applied for doctors and medical practitioners in the making.