Medical Education in India - Problems and Prospects
Rita Sood, BV Adkoli
The state of medical education in India presents a scenario marked by rhetoric and wishful thinking rather than concrete steps in right direction. The search for a need-based curriculum is not new. It has been felt for ages, but the curriculum has not really changed. It is an oft-repeated criticism that our medical colleges are producing graduates who are not well equipped to tackle the health care needs of the society. What is the reason behind this notion? While the graduates generally possess reasonably sound knowledge of medical science, they are often found deficient in the performance of clinical skills and problem-solving which form the core of clinical competence 2 . There is growing level of mistrust among the public for the medical profession as one hears of cases of negligence, misconduct, and unethical practices leading to legal suits. There is increasing public demand for the accountability, transparency and quality assurance among the health professionals. While the commercialization of medical profession is cited as a common reason for the dilution of quality, doubts have been raised regarding the quality of training. Are the graduate doctors well trained to perform their clinical responsibilities? Are they aware of their ethical, moral and legal responsibilities?
Let us look at the curriculum. The medical colleges in India have traditionally followed a curriculum stuffed with a large body of knowledge pertaining to basic science and clinical disciplines. Once qualified, students are expected to synthesize this information and apply it to the care of the patients. With the expanding body of knowledge, there is over-burdening of the student with the content information. In order to grapple with this problem, it is essential to define the core content which every student 'must learn', things that are 'useful to learn' and 'nice to learn' but do not need the same emphasis. There are areas in the curriculum, viz., medical ethics, behavioral science, communication skills, managerial skills which do not receive due attention in the existing curriculum as they should do 23 . Following MCI guidelines, medical colleges in India have adopted a pattern of one year of basic sciences, 1 1/2 years of para-clinical sciences and 2 years devoted entirely to clinical subjects. In most of the colleges, the subjects are taught in isolation with little or no attempt to integrate the basic sciences with the clinical disciplines. .....continued.....
