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The World Health Organization (WHO) recommends the requirement of human resource for health (HRH) stands at 44.5 skilled health workers per 10,000 population. WHO recognizes India as one of the countries which has HRH crisis. Karnataka, a southern state in India, has the highest number of medical colleges yet faces the shortage of specialists in the public hospitals. We conducted desk review to understand the HRH crisis, particularly the medical specialists in India. Simultaneously, we conducted secondary research to explore the initiatives taken by the Government of Karnataka (GoK) to mitigate the shortage of medical specialists in the rural areas. GoK scaled up the National Board of Examination in Medical Sciences (NBEMS) postgraduate and super-speciality courses such as Diplomate of National Board (DNB), Diploma, and Doctorate of National Board (DrNB) in district hospitals (minimum 250--500 bedded) and taluk hospitals (minimum 100 bedded) by utilizing the existing resources. Karnataka is the first state in India to expand the NBEMS (DNB and Diploma) courses in taluk hospitals and to begin DrNB courses in district hospitals. The paper documents the process of implementation of the NBEMS courses at district and taluk hospitals of Karnataka, which has supported in strengthening these hospitals in the state. [ABSTRACT FROM AUTHOR]

The McNamara fallacy refers to the tendency to focus on numbers, metrics, and quantifiable data while disregarding the meaningful qualitative aspects. The existence of such a fallacy in medical education is reviewed in this paper. Competency-based medical education (CBME) has been introduced in India with the goal of having Indian Medical Graduates competent in five different roles – Clinician, Communicator, Leader and member of the health care team, Professional, and Lifelong learner. If we only focus on numbers and structure to assess the competencies pertaining to these roles, we would be falling prey to the McNamara fallacy. To assess these roles in the real sense, we need to embrace the qualitative assessment methods and appreciate their value in competency-based education. This can be done by using various workplace-based assessments, choosing tools based on educational impact rather than psychometric properties, using narratives and descriptive evaluation, giving grades instead of marks, and improving the quality of the questions asked in various exams. There are challenges in adopting qualitative assessment starting with being able to move past the objective–subjective debate, to developing expertise in conducting and documenting such assessment, and adding the rigor of qualitative research methods to enhance its credibility. The perspective on assessment thus needs a paradigm shift – we need to assess the important rather than just making the assessed important; and this would be crucial for the success of the CBME curriculum. [ABSTRACT FROM AUTHOR]

Objective: There has been an observable trend towards developing medical competency frameworks across the globe. These competency frameworks are intended to improve societal trust in the medical education system in developing appropriately competent medical practitioners. A framework developed by the Royal College of Physicians and Surgeons; Canada has been widely accepted by several institutions across the world. Medical Council of India has also published a similar framework of medical competencies. Most of these frameworks does not consider ancient Indian frameworks which have existed for several thousand years. Current paper examines the medical competency frameworks from ancient India and compares it with current frameworks. Method: A review of literature available in reputable libraries and online on the medical competency framework from ancient India has been attempted. Key words including 'competency framework, medical framework, ancient India and fully equipped physician' were used. Results: A medical competency framework was written and implemented more than two thousand years ago. The framework identified key competencies including: Medical expertise, Communication skills, Scholar, Health advocacy and Professionalism. This framework was used for medical practitioners at the time and used during the training and subsequent medical practice. Conclusion: There is striking similarity between ancient Indian and current model of competency framework. Teachings and wisdom from ancient India can prove invaluable while developing future medical competency frameworks. [ABSTRACT FROM AUTHOR]

India currently hosts the largest medical education system in the world with 650 medical colleges and 98613 MBBS (undergraduate) training seats. The reasons for Indian Medical Graduate's international migration and internal distribution within India have been multifactorial. There are push factors (with India) as well as pull factors (international host countries). Almost the same reasons are implied to the distribution and availability of the medical workforce geographically within India. To address the regional disparities in medical education and the availability of human resources in health, the policy of establishing one medical college in each district in India was initiated. Impressive progress has been achieved so far. However, the policymakers must look at it critically to be able to steer this project towards meeting the public health objectives of the country in the coming century. The discussion must include arguments on the type of doctor India needs. Indian can no longer afford the policy of having many cardiologists as compared to miniscule number of trained family physicians. All specialist system is being perused at the cost of a generalist health system. This paper critically looks at the district medical college scheme and exponential growth in the number of medical seats in India. Statistical success alone cannot address the public health needs and medical care of the Indian population. The creation of the National Medical Commission (NMC) has eased the criteria for recognition of new medical colleges; however, several limitations of the Medical Council of India are being carried forward within the functioning of NMC. Unless, there is a focus on creating employment and retaining medical graduates within the health system, it is worthless producing millions of them. [ABSTRACT FROM AUTHOR]

Background: Interactive teaching methods aid post graduate students in learning qualitative research. Four academic researchers from the United Kingdom had an opportunity to teach qualitative research methods, specifically consensus methods, to the Master of Public Health students (MPH) during a visit to India. This teaching formed part of a work package with All India Institute of Medical Sciences Rishikesh, India exploring the concept of family resilience among families with children under 6 years. Aims: To use the experiences of the MPH students to gain knowledge and create meaning about using the consensus methods. Participants: The participants were the MPH students. Methods: We used the workshop method to introduce the concept of family resilience by using the question, ‘What will be the three top public health priorities in India to support family resilience in the 21st century?’ as a central theme for all the workshops. Furthermore, we introduced qualitative research methods and hands on experience of consensus methods to the students. The students were introduced to Delphi and Group Concept Mapping (GCM) methods during workshop 1. Workshop 2 introduced Nominal Group Technique (NGT) through a short presentation followed by a practical hands on session using GCM data from workshop 1. The last workshop (3) focused on the World Café method. Results: The students evaluated the workshops highly and asked for online sessions on GCM, NGT, and World Café which will be planned in the future. Conclusion: We concluded that the post graduate curriculum for master’s in public health studies would benefit from teaching using interactive research methods which will enhance their critical thinking and autonomy. Second, although the MPH curriculum had quantitative methods in place, introducing qualitative consensus methods will open new avenues into future research. Finally, teaching using practical demonstration gives students a voice and makes learning effective and enjoyable. [ABSTRACT FROM AUTHOR]

Background: Properly constructed single best-answer multiple choice questions (MCQs) or items assess higher-order cognitive processing of Bloom's taxonomy and accurately discriminate between high and low achievers. However, guidelines for writing good test items are rarely followed, leading to generation and application of faulty MCQs. Materials and Methods: During lockdown period in 2020, internal assessment was taken through online mode using Google Forms. There were 60 'single response type' MCQs, each consisting of single stem and four options including one correct answer and three distractors. Each item was analyzed for difficulty index (Dif I), discrimination index (DI), and distractor efficiency (DE). Results: The mean of achieved marks was 42.92± (standard deviation [SD], 5.07). Dif I, DI, and DE were 47.95± (SD 16.39) in percentage, 0.12± (SD 0.10), and 18.42± (SD 15.35), respectively. 46.67% of the items were easy and 21.66% were of acceptable discrimination. Very weak negative correlation was found between Dif I and DI. Out of total 180 distractors, 51.66% were nonfunctional one. Conclusion: Item analysis and storage of MCQs with their indices provides opportunity for an examiner to select MCQs of appropriate difficulty level as per the need of assessment and decide their placement in the question paper. [ABSTRACT FROM AUTHOR]

Competency-based medical education curriculum (CBME) has received traction worldwide. However, its adoption and implementation have significantly varied across the globe. The National Medical Commission, India (2019) has adopted CBME to improve the quality and content of training of medical students. However, the ongoing COVID-19 pandemic has spawned several challenges implementing the CBME. Therefore, there is a need to reflect on using novel teaching and assessment methods to enrich medical and psychiatric training. In this paper, we aimed to study global trends and characteristics of competency-based psychiatry training programs and how these experiences can be utilized to overcome challenges and facilitate the implementation of CBME in Psychiatry in the Indian context. A literature search was conducted using PubMed and Google Scholar databases. The findings are presented narratively. Psychiatry training for medical students greatly vary across the globe. High-income countries mainly have implemented CBME and have incorporated psychiatry training during the foundation/pre-clerkship period itself. There is more reliance on skill development and flexible and learning-based training vs. time-based training. Various enrichment activities have been incorporated into the medical curriculum to promote and strengthen psychiatry training for medical students, particularly in developed nations, which have yielded positive results. Although the COVID-19 pandemic has adversely affected the medical student's training, it has reiterated the significance of skill-based education and opened novel avenues for implementing the CBME. Medical educationists need to adapt themselves to provide CBME to the students. Making structural, curricular changes, orienting teachers, and students about the CBME, mentoring teachers, adopting novel training and assessment methods, utilizing enrichment activities, collaborating with educational institutions and technology providers, periodically evaluating the implementation of the CBME, and making appropriate course corrections are essential. In addition, there is a need to address structural barriers, such as lack of workforce, for better realization of the CBME objectives.eriodically evaluating the implementation of the CBME, and making appropriate course corrections are essential. Additionally, there is a need to address structural barriers, such as lack of workforce, for better realization of the CBME objectives. [ABSTRACT FROM AUTHOR]

The quality of training is a major contributor to workforce proficiency in healthcare, and there is a definite need to achieve a uniform level of knowledge and skill in medical education programmes. There is a paucity of literature comparing postgraduate anaesthesia medical education training structure and requirements across the globe. In a zeal to achieve uniform competencies and technical skills, the strengths and scope of training programmes need to be identified. In this article, we describe the core elements of postgraduate training in various countries while proposing an amalgamation of strengths of each programme and providing a roadmap to evolve further the competency-based comprehensive curriculum proposed by the National Medical Commission of India. [ABSTRACT FROM AUTHOR]

In 2012, India Today, a news agency, reported that 'Family Physicians are dying silent death' in India. The number of practicing family physicians is declining rapidly in the most populous country in the world with pressing public health needs. The previous generation of general practitioners/family physicians/family doctors has entered the age group of the seventies and eighties in both urban and rural areas. Unfortunately, no new family physician is opening the practice in these areas. The recent COVID pandemic has clearly demonstrated the ongoing need, demand, and popularity of family physicians among the general public as first-contact dependable and trustworthy doctors. While it may be an enigma why MBBS doctors are no longer opting to become family physicians, to the experts of this domain, it is not a surprise. To outside observers, this phenomenon may appear to be an outcome of changing times, the expansion of medical sciences, new emerging career choices for medical students, or competition within the healthcare market. However, a closer study reveals that the decline of family physician services in India is not a default situation but an outcome of decades of institutional neglect and perhaps a deliberate exclusion. According to the recently released National Medical Commission (NMC) draft curriculum 2023, the undergraduate medical education program is designed with the national goal of creating an "Indian Medical Graduate" possessing the requisite knowledge, skills, attitudes, values, and responsiveness so that she or he may function appropriately and effectively as a PHYSICIAN OF FIRST CONTACT of the community while being globally relevant. However, we are disappointed to note that the Family Medicine subject (discipline of family physicians) component has been entirely excluded from the draft of the MBBS curriculum. The words such as 'Family medicine', 'Family Physician', 'General practitioners', and 'Family Practice' have not even been mentioned in the entire 83 pages of the draft MBBS curriculum document. This is not an inadvertent occurrence or a default situation. The erstwhile MCI, the Medical Council of India, played a significant role in diminishing the role of family physicians in the Indian health system. It is to be seen Kumar: The curious case of extinction of family physicians from the Indian Health System -- An open letter to the members of the National Medical Commission if the NMC is able to reverse this trend by easing the regulatory restrictions on family physicians/family medicine training by including it in the MBBS course. [ABSTRACT FROM AUTHOR]

INDUSEM was established as an INDO-US Satellite Knowledge Network in 2005. It brought together the academic leaders and innovators from India and the US with the goal of creating collaborative synergies and creative solutions to advance the knowledge and science of emergency medicine (EM) in India. Since 2005, the leadership of INDUSEM devoted substantial resources, effort, and expertise to ensure that newly implemented clinical institutes and training programs have the necessary resources and logistical support to effectively advance EM and Traumatology Sciences in India. As a result, significant synergies and progress were achieved toward establishing EM training programs and building clinical infrastructure through education, grant funding, research, skills development, bidirectional collaborations, and sustained influence on public health policy development. As INDUSEM's mission matures, its efforts will increasingly focus on creating long-term sustainability across clinical, didactic, educational, outreach, health policy, and research domains. In this joint statement, the authors describe the evolution of INDUSEM's institution of INDO-US Summit into the World Academic Congress of EM, with the parallel inception of an India-centric academic enterprise, EMINDIA. [ABSTRACT FROM AUTHOR]

Background: India has launched Ayushman Bharat Digital Mission (ABDM), to provide an integrated digital health infrastructure. The success of digital health systems lies in their ability to achieve universal healthcare and incorporate all levels of disease prevention. The objective of this study was to develop an expert consensus on how Community Medicine (Preventive and Social Medicine) can be integrated into ABDM. Methods: A total of 17 and 15 participants, who were Community Medicine professionals with more than 10 years experience in the Public Health Sector and/or Medical Education in various parts of India, participated in round 1 and 2 of this Delphi study respectively. The study explored three domains: 1. Advantages and challenges of ABDM, and possible solutions; 2. Intersectoral convergence in Unified Health Interface (UHI) and 3. Way ahead in medical education and research. Results: Participants envisaged improved accessibility, affordability, and quality of care due to ABDM. However, awareness generation, reaching out to marginalized populations, human resource constraints, financial sustainability, and data security issues were anticipated challenges. The study identified plausible solutions addressing six broad challenges of ABDM and classified them based on the priority of implementation. Participants listed out nine key roles of Community Medicine professionals in digital health. The Study identified about 95 stakeholders who play direct and indirect roles in public health and can be connected to the general public through the Unified Health Interface of ABDM. Further, the study explored the future of medical education and research in the digital era. Conclusion: The Study contributes to broadening the scope of India's digital health mission, with elements of Community Medicine in its cornerstone. [ABSTRACT FROM AUTHOR]

Introduction: Government runs teaching hospitals to impart a high-quality medical education to budding medicos and paramedical students in training. The experiences these trainees at various tenure positions get then and there shape their worldview for rest of the life and have an indelible impression. The Covid-19 pandemic disrupted all the routines at the hospitals around the world—including ours—and we make an attempt to measure it in one dimension in this study. Materials and Methods: We obtained attendance data of patients at out patient department and in patient department of our hospital. During the pandemic for a certain duration offline (physical) registrations were closed and they were attended only by online ones. Hence that data (actually a part of it) got captured electronically and we analyzed it to get an idea of the traversed course of the scourge. Results: When the pandemic surged during the spring and summer of 2021, our hospital was turned into a Covid facility. Hence average routine attendance of patients got reduced to a significant extent, elective surgeries/interventions and procedures were postponed and this data is reflected in an electronic system, perhaps making a long-lasting effect on the budding trainees. This fact needs to be realized so as to take appropriate action. Conclusion: We need to realize that the effects of the viral communicable disease may be enduring, not only for the infected patients and their families but also for those who learn on those patients. Therefore, the transmissible diseases disabled not only our society, economy, and health care services when they ascended but pedagogy too. Online learning came to rescue but only up to a certain extent and with several caveats and limitations. [ABSTRACT FROM AUTHOR]

Research is the key to advancement in medical science. Medical school can nurture the skill of research right from the under graduation. Research forms an integral part of the medical curriculum in western countries. We attempted the same in our medical school in India. We developed a structured research methodology program, which was implemented in the undergraduate (UG) curriculum in two phases. Phase I focuses on research methodology and Phase II on manuscript writing. With the implementation of a competency-based medical education curriculum (CBME), we have extended the research methodology program with manuscript writing and introduction to systematic reviews, which is being offered as electives to UG medical students in the third professional year. Our experience in training students at an UG level has been immensely satisfying. We hope that this article will help other medical schools to adopt a similar method of training UG medical students in research methodology and scientific medical writing. [ABSTRACT FROM AUTHOR]

India has a rising burden of cancer with an estimated 70% of the cancers caused by modifiable and preventable risk factors. This review was conducted to document the status, analyse the situation and propose the way forward for cancer prevention in India. A desk review of the online databases and reports from the government websites was conducted. The ongoing initiatives including cancer registries, medical and health education and training, and community-based programmes were analysed. This review was done from July 2019 to February 2021. Cancers of the breast, cervix, and lip and oral cavity are the three most common malignancies, with distinct regional variations in India and account for 34% of the 1.15 million cancer cases diagnosed annually. The major initiatives were focused initially on cancer treatment and prevention was added nearly a decade ago. Even with those, the scope and coverage of cancer prevention and treatment services has remained in hospitals and urban settings. India needs to build upon the ongoing approach which seems to be focused on "tracking the cancer, teaching the future and helping the masses" by implementing non-vertical primary healthcare cancer prevention and control approach. Cancer prevention should be made an integral part of the health interventions, rapidly extended to primary healthcare services and facilities, linked with specialised treatment facilities, as India aims for universal health coverage. The opportunity provided by the Ayushman Bharat Programme launched in 2018 should be leveraged for rapid expansion and effective coverage of cancer prevention and treatment interventions in India. [ABSTRACT FROM AUTHOR]

A medical postgraduate course in the field of Laboratory Medicine for the Bachelor of Medicine and Bachelor of Surgery (MBBS) degree holders has existed for more than two decades in India, initiated and offered by the All India Institute of Medical Sciences, New Delhi, which was created under the special Act of Parliament of India 1956. This course has recently been included in the draft of National Medical Commission's Post Graduate Regulation 2021 list of medical courses, and the foundation guidelines have been laid for other medical colleges and teaching hospitals across the country to start this course. This article, written purely in academic interest, describes the past, present and future of this postgraduate training program in India with an aim to answer several doubts regarding this unique and holistic course with a view to providing a direction to those who are willing to become a laboratory physician through this post-graduation. [ABSTRACT FROM AUTHOR]

The need for training in Occupational Medicine in India is well known. The majority of company doctors cannot leave their work and join a residence program. The question which course delivery mode - residential or blended or distance education — is appropriate to teach working company doctors is therefore an urgent one. Adult education: Adults learners — in contrast to young students — have a lot prior experiences and knowledge which they want to use. They have tight personal schedules and are very practical and goal-oriented. They usually have a fulltime work. Adults need more guides than lecturers. Immediate use, practice by doing and discussion groups are the most powerful tools in teaching. Lecturing seems to be the most ineffective teaching method. Distance education is widely used already in teaching occupational health & safety and occupational medicine (OS H) in other countries. Almost 100% of all post-graduate teaching in occupational medicine is done by distance education in the UK. A "blended" course model seems appropriate for Occupational Medicine teaching. It has contact phases and self-learning phases The Indian Association of Occupational Health could play a leading role in expending high quality teaching in Occupational Medicine. These activities would contribute to the Government's goals to strengthen Occupational Health in India. This article discusses distance education and online-teaching as one viable way to deliver high quality training in Occupational Medicine to working company doctors in India. [ABSTRACT FROM AUTHOR]

Background: Competency-based medical education (CBME) has been the mandate by regulatory bodies of medical education in India, and implementation is an evolving process. This study aimed to identify and propose a set of entrustable professional activities (EPAs) for a master's degree in psychiatry. An attempt has been made to present it in the form of a portfolio. Methodology: Faculty experts in psychiatry went through phases of review to select appropriate EPAs for postgraduate residents from divergent thinking to development of portfolio. Results: One hundred and sixty-seven EPAs were identified and are presented. These were divided according to expertise required. Of these, 54% were considered vital, 30% essential, and 16% desirable. Conclusion: It is envisaged that the use of EPAs and portfolios will be instrumental in implementation and success of CBME in psychiatry. It is expected that medical universities will incorporate them in their curricula. It is also expected that data will be generated to identify challenges, which shall guide future refinement of the EPAs. [ABSTRACT FROM AUTHOR]

In the last two decades, India has seen a massive rise in the number of medical schools. As a result, numerous issues, including the availability of qualified teachers, have made medical education in India challenging. Faculty development (FD) has gained significant attention because of its importance in educational capacity building. FD programs help faculty become more aware of their professional responsibilities. Medical education units can play a vital role in FD and thus improve the quality of medical training by training the teachers. The National Teacher Training Centre (NTTC), Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, was the first center established by the Ministry of Health and Family Welfare, Government of India in 1975, with the assistance of the World Health Organization, to promote the training of health professionals in educational science and technology, including educational planning and research. This article describes the profile of activities of NTTC, which is functioning under the aegis of the Department of Medical Education (DME), JIPMER, and lists the outcomes that contributed to the success of DME with particular reference to the last decade. The establishment of DME is seen to affect the medical school positively. [ABSTRACT FROM AUTHOR]

At least half of the world's population still do not have full coverage of essential health services and the available health-care services are also not equitably distributed, the rural areas being the generally underserved ones. Several factors influence attraction and retention of doctors in rural areas which are related to international and national contexts, work-related factors, environmental and living conditions, and individual or personal factors which includes family and social support, in addition to personal aspirations. Innovative strategies have been worked out and implemented to address these problems and fill the gaps in the areas of educational, regulatory, financial and professional and personal support. This review discusses the educational strategies which are targeted at all levels viz. selection of candidates for admission, and subsequent undergraduate, internship, and postgraduate teaching and training that can be oriented toward rural health and health-care services. [ABSTRACT FROM AUTHOR]

Background: Current undergraduate medical academic curriculum does not emphasize on evaluation and management of dementia. The knowledge and attitude of medical students towards patients with dementia in India has not been ascertained previously. Objective: We aimed to assess the knowledge and attitude of final year medical students about dementia and Alzheimer's disease. We also aimed to assess if a dedicated sensitization cum teaching session by a group of interns doctors guided by a neurologist could help improve students' knowledge and awareness towards dementia or not. Methods and Materials: 82 consenting final year medical students answered questionnaires of Alzheimer Disease Knowledge Scale (ADKS) and Dementia Attitude Scale (DAS) at a baseline level. A sensitization cum teaching session by intern doctors was conducted to enhance students' knowledge about dementia. A post sensitization reassessment of students was done to assess impact of the session. Results: The ADKS score was 57% at baseline which was increased to 71% post sensitization program. The mean DAS score was 3.2 at baseline which was reported to be 3.4 after sensitization program. Students reported significant improvement in their knowledge level but did not show the same improvement in their attitude and comfort level in caring for dementia after the sensitization program. Students were still not comfortable dealing with patients with dementia. Conclusion: Medical students lack significant knowledge and training about dementia. Patient contact and practical training for basic assessment and care of dementia needs to be incorporated in the current academic curriculum. Dedicated sensitization sessions on dementia care can help improve the gap. Practical exposure to management of patients with dementia would be required to enhance the comfort level and attitude of students towards dementia. [ABSTRACT FROM AUTHOR]

The article focuses on the development of the psychiatry curriculum as a major subject at All India Institute of Medical Sciences, Rishikesh (AIIMS-Rishikesh). Topics discussed include the process of expert consultation under the Indian Psychiatric Society (IPS) followed by AIIMS-Rishikesh, number of hours of theoretical teaching and clinical skills posting in psychiatry in the undergraduate curriculum, and importance of the integration of the curriculum with other subjects.

Implementation of Competency-Based Medical Education in 2019 has brought significant changes in the delivery of medical education in India. Attitude, ethics, and communication module has been introduced in to focus on the much-overlooked soft skill aspects and real-life scenarios that will be encountered during future medical practice. The present study has used thematic analysis to understand the effect of this newly implemented module on undergraduates. Qualitative data analysis of thematic type was performed for gaining in-depth perceptions. Analysis revealed that students observed the importance of various roles and their hard work involved in hospital functioning. Students felt they would practice attributes of collaborative work, enhanced communication, and respect for all support systems in future practice. Students perceived the module positively and got to know the facets of under-recognized roles of health-care workers other than medical professions, whose role is crucial for delivering quality health-care services. [ABSTRACT FROM AUTHOR]

Benefits of Faculty Development Program Teaching skills will be improved with oriented and motivated faculty members, new teaching learning methods can be incorporated for more interactive teaching, and Specific Learning Objectives in respective departments will be easier to formulate. Introduction National Medical Commission (NMC) has started new Competency-Based Medical Education since 2019 academic year in all medical institutions throughout our country. [Extracted from the article]

The recommendation of a Rural Indemnity Bond after MBBS aims to address the rural-urban disparity in the Indian healthcare system. It is a radical reform in medical education curriculum and generates searching questions: How to affect the attitudes of medical graduates? Are there other successful models we can learn from? Do the healthcare challenges need a more integrated action? A policy enforcing the shunting of doctors needs to take the apprehensions of all the stakeholders into consideration. The broader issue of Rural Health Iniquity, that plagues the country requires interventions at multiple levels with a properly financed healthcare system at its foundation. [ABSTRACT FROM AUTHOR]

After decades of administrative hibernation, the Medical Council of India (MCI), now National Medical Commission (NMC), started deliberating on reforms in medical education a few years back. The MCI/NMC introduced vertical corrective actions, yet there is a need for horizontal integration, and these measures require adequate guidance on implementation strategies. All postgraduate medical students must conduct a research project as a "Thesis." This crucial opportunity to instill scientific thinking is excellent, along with patient care and clinical training. This opportunity has a long-term impact on clinical practice and research and development in medicine if implemented well. To enforce this step, the Board of Governor introduced a compulsory course in basic research methods for all postgraduate medical students, but alas, without adequate deliberations on implementation and complementary mechanisms. This critical review provides a brief history of the evolution of medicine and medical education in India and reforms in medical education. Further, it presents a balanced critique of the process, intending to brainstorm in improving the process and achieving the expected outcome from this course. Albeit many relevant issues need attention, this article will focus mainly on ways to leverage infrastructure optimally to imbibe scientific thinking in medical students of India with cursory deliberation of the relevant issues. [ABSTRACT FROM AUTHOR]

Background: Previously, we had a course in epidemiology for medical undergraduates that was based on traditional lecture methods with no formal formative assessment (FA). We found poor uptake of our course in terms of learning and attendance by students. Objective: The objective was to assess the effect of improved course (interactive lectures and formal FA) in epidemiology on student learning and attendance. Materials and Methods: It was a triangulation type of mixed-methods program evaluation, where both quantitative (quasi-experimental design) and qualitative (open-ended responses) analysis was done. This study was carried out in the department of community medicine in a tertiary care teaching hospital, Puducherry. We improved the quality of the course material, interaction in lectures and included formal structured FA in the last course. Kirkpatrick's framework was used for the course evaluation. We compared the performance of three batches to check the effect of our revisions on students' learning and their attendance. Results: Student's learning outcome was measured using end-of-course assessment scores (Level-2). The percentage of students successfully completing the course improved from 39% to 81% and attendance status of ≥90% improved from 50% to 57%. Learner's immediate reactions (Level-1) were captured using open-ended questions, and content analysis was done. Students appreciated the course material, FAs, and in-class activity. Conclusions: Little improvement in a traditional epidemiology course for undergraduates in the form of interactive lectures and formative feedback and providing the student with course material led to significant gains in students' knowledge and attendance. [ABSTRACT FROM AUTHOR]

Purpose: In 2020, in response to the emergence and global spread of the disease COVID-19, caused by a new variant of coronavirus 2019-nCoV, the government of India ordered a nationwide lockdown for 21 days, which was then extended to a total of over 50 days. The aim of this study is to assess the effect of the lockdown on ophthalmic training programs across India.Methods: An online survey was sent across to trainee ophthalmologists across India through various social media platforms.Results: In all, 716 trainees responded; the average age was 29.1 years. Results showed that majority of the respondents were enrolled in residency programs (95.6%; 685/716) and the others were in fellowship programs. About 24.6% (176/716) of the trainees had been deployed on 'COVID-19 screening' duties. Nearly 80.7% (578/716) of the trainees felt that the COVID-19 lockdown had negatively impacted their surgical training. Furthermore, 54.8% (392/716) of the trainees perceived an increase in stress levels during the COVID-19 lockdown and 77.4% (554/716) reported that their family members had expressed an increased concern for their safety and wellbeing since the lockdown began. In all, 75.7% (542/716) of the respondents felt that online classes and webinars were useful during the lockdown period.Conclusion: Our survey showed that majority ophthalmology trainees across the country felt that the COVID-19 lockdown adversely affected their learning, especially surgical training. While most found online classes and webinars useful, the trainees' perceived stress levels were higher than normal during the lockdown. Training hospitals should take cognizance of this and reassure trainees; formulate guidelines to augment training to compensate for the lost time as well as mitigate the stress levels upon resumption of regular hospital services and training. Going ahead, permanent changes such as virtual classrooms and simulation-based training should be considered. [ABSTRACT FROM AUTHOR]

Introduction: Faculty development to implement competency-based medical education (CBME) is urgently needed as the Medical Council of India has implemented the competency-based curriculum this year onwards. Objectives: To evaluate a 2-day faculty development workshop in terms of: (a) increase in knowledge about CBME terminology and concepts, (b) self-reported capacity to develop and implement a competency-based module in their respective disciplines, and (c) satisfaction of the participants. Methodology: A single arm interventional study using mixed methods was carried out in which faculty members were purposively identified and requested to volunteer for a two-day faculty development workshop on the development and implementation of CBME. The workshop was evaluated (open-ended and Likert scored items) by the participants for self-reported gain in knowledge, gain in their confidence to develop and implement CBME, and level of satisfaction with respect to the components of the workshop. Quantitative data was analyzed by Wilcoxon signed rank test and Kruskal–Wallis test. Qualitative data was analyzed by doing content analysis and emerging themes have been presented. Results: Eleven faculty members attended a capacity building workshop for developing and implementing a competency-based curriculum for medical undergraduates. There was a significant improvement in their self-reported knowledge and attitude regarding the competency-based curriculum. New concepts learned fell into four domains: modification of the existing curriculum toward competency-based curriculum, knowledge of CBME, teaching-learning and assessment methods, and beneficial to the students. The participants were highly satisfied with the workshop in its current form. Conclusion: A two-day faculty development workshop can increase the knowledge and understanding of competency-based medical education and can be an important first step in the journey to more specialized training. [ABSTRACT FROM AUTHOR]

Medical education in India is expected to undergo a significant reform after the introduction of the National Medical Commission Act. Single, nationwide National Exit Test (NEXT) is an essential provision under this act, which will be implemented during the next three years. It aims to bring about uniformity in the minimum standard of final MBBS examination, quality control in the licentiate examination and elimination of multiple entrance examinations for admission in postgraduate courses. Since the NEXT has multiple and varied objectives, we suggest a three-step scheme for the conduct of NEXT. Step I (Part A and B) will be equivalent to present-day first and second professional MBBS examinations and step II will act as the final professional MBBS and licentiate examination. Step III will form the basis for admission to the different PG courses. The written exam of Step I and II will consist of structured long, short and multiple choice type questions, whereas practical or clinical examination will consist of structured instruments with lesser inter-rater variability (viz., OSCE, OSPE, OSLER, etc.). This opinion piece is a result of in-depth discussions among major stakeholders such as MBBS students, resident doctors, and faculty of AIIMS, New Delhi. The suggested three-step plan is probably the most feasible way to ensure that the three modalities (final year MBBS, licentiate examination, and PG entrance competitive) are assessed in a valid, reliable, and acceptable manner. Due consideration is given to the fact that an assessment process has a significant impact on learning and teaching. The government may consider these suggestions while formulating the regulations of the NMC Act. [ABSTRACT FROM AUTHOR]

Background: Qualitative studies on students' perspectives about stress in medical education are sparse but nonetheless potentially relevant. Aim: The aim of the study was to assess the proportion of students who considered medical education to be excessively stressful and to elicit students' perspectives about ways to reduce stress in medical education. Materials and Methods: All medical undergraduate students of the college were asked about various aspects of stress in medical training using a self-rated questionnaire. Qualitative answers about the ways of reducing stress were also obtained using the questionnaire. Results: Medical education was considered to be excessively stressful by 265 (55.1%) students. The most common themes expressed for reducing the stress of medical education included those of "less frequent exams," "more spare time," and "slowing the pace of study or reducing syllabuses." Conclusion: Majority of students considered medical training to be stressful and curricular overload is an important reason for the same. [ABSTRACT FROM AUTHOR]

The article focuses on the strategies employed to improve medical education quality in India. Topics discussed include the key role of faculty development programs in improving medical education quality, requirement for faculty members to participate in revised basic course workshop and Curriculum Implementation Support Program (CISP) under the Medical Council of India rollout plan, and importance of encouraging research in medical education.

Imparting a positive attitude toward social determinants of health among medical students has remained a challenge in medical education. This pedagogical exercise attempted to use a toxic tour with participant photography technique to impart environmental health education as part of the community medicine curriculum for medical students. In collaboration with a local environmental health nongovernmental organization, faculty from two medical colleges took a set of 13 medical students to Ennore thermal power plants as a part of a toxic tour to view the air and water pollution caused due to the operation of the power plants. The students were instructed to capture photographs of the environmental hazards using their mobile phone cameras and share them on a social media platform. Immediately after the tour, the students discussed their experiences with the faculty. Two weeks after the toxic tour, the students engaged in a focus group discussion in which they discussed their experiences, advantages, and disadvantages of the toxic tour and participant photography method and their attitudes toward environmental health. This pedagogical exercise led to the active engagement of the students with the environmental hazards in the area. They shared 70 photographs on the social media platform. In reflection, students described that they found the method very useful to actively engage with the environment, look for and find the hazards, revisit, and reflect on the photos, and use the photos to share the knowledge and experience. They also demonstrated a positive social determinants and public health attitude during the discussions. Participant photography technique during a toxic tour can impart affective domain of learning related to environmental health among medical students. [ABSTRACT FROM AUTHOR]

The Indian medical education system has been able to pull through a major turnaround and has been successfully able to double the numbers of MBBS graduate (modern medicine training) positions during recent decades. With more than 479 medical schools, India has reached the capacity of an annual intake of 67,218 MBBS students at medical colleges regulated by the Medical Council of India. Additionally, India produces medical graduates in the “traditional Indian system of medicine,” regulated through Central Council for Indian Medicine. Considering the number of registered medical practitioners of both modern medicine (MBBS) and traditional medicine (AYUSH), India has already achieved the World Health Organization recommended doctor to population ratio of 1:1,000 the “Golden Finishing Line” in the year 2018 by most conservative estimates. It is indeed a matter of jubilation and celebration! Now, the time has come to critically analyze the whole premise of doctor–population ratio and its value. Public health experts and policy makers now need to move forward from the fixation and excuse of scarcity of doctors. There is an urgent need to focus on augmenting the fiscal capacity as well as development of infrastructure both in public and private health sectors toward addressing pressing healthcare needs of the growing population. It is also an opportunity to call for change in the public health discourse in India in the background of aspirations of attaining sustainable development goals by 2030. [ABSTRACT FROM AUTHOR]

The trials and trepidations of an emerging department, uncertainties of its survival midway through its course, the innovative ideas that initiated its development, a regimental discipline, addition of newer technological advances with changing times, and its blossoming as the one of the best departments in the region, mark the origin and development of the Department of Neurosurgery at Andhra Medical College (AMC) and King George Hospital (KGH) Visakhapatnam. AMC and KGH are getting ready to celebrate their centenary in 2023. This history of the department is derived from the knowledge of the immense effort and academic discipline that was required to bring it to its current stature. Dr. Sunkara Balaparameswara Rao (SBP Rao) established the Neurosurgical Unit at the AMC and the KGH, Visakhapatnam on 2nd April 1956. He has had the unique privilege of witnessing the entire history of the department, from the inception till today, which represents 60 years of continuous progress of the department after its establishment. He also took a very active role in organizing its Diamond Jubilee function held on 23rd September 2016. The first author of this article has also had the privilege of witnessing and being a part of the history of the department during the past half a century. This is a narration of what may be better termed 'the (hi) story of 60 years of Neurosurgery at AMC and KGH', Visakhapatnam, India. [ABSTRACT FROM AUTHOR]

Background: Infertility is a neglected service component in the public health-care system in India. Objectives: This study aims to assess the availability and practices on prevention and management services for infertility in the district health system. Methodology: A cross-sectional survey of selected health facilities and the staff from 12 district hospitals (DHs), 24 community health centers (CHCs), 48 primary health centers (PHCs), and 48 subcenters was conducted using qualitative and quantitative methods. Interviewed staff included 26 gynecologists; 91 medical officers; 91 auxiliary nurse midwife; 67 laboratory technicians; and 84 accredited social health activist workers. Results: The findings indicate that adequate staff was in place at more than 70% of health facilities, but none of the staff had received any in-service training on infertility management. Most of the DHs had basic infrastructural and diagnostic facilities. However, the majority of the CHCs and PHCs had inadequate physical and diagnostic facilities related to infertility management. Semen examination service was not available at 94% of PHCs and 79% of CHCs. Advanced laboratory services were available in <42% at DHs and 8% at CHCs. Diagnostic laparoscopy and hysteroscopy were available in 25% and 8% of DHs, respectively. Ovulation induction with clomiphene was practiced at 83% and with gonadotropins at 33% of DHs. Conclusion: The district health infrastructure in India has a potential to provide basic services for infertility. With some policy decisions, resource inputs and capacity strengthening, it is possible to provide advanced services for infertility in the district health system. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to assess the attitude and perceptions of residents regarding Pediatric Ophthalmology and Strabismus (POS) subspecialty training. We also explored the possible barriers and solutions to promoting POS in India.Methods: A questionnaire consisting of 20 items, with a 5-point Likert scale, was provided to all postgraduate residents of Ophthalmology in the year 2013-2014. Semistructured interview of a selected panel of experts was carried out to understand the challenges, barriers, and opportunities for developing POS subspecialty in India. The data collected were coded and statistically analyzed using standard methods for quantitative and qualitative data.Results: Out of 81 residents, 69 responded (85.2%). The mean age of the respondents was 27.5 ± 1.23 years. Forty eight (69.0%) residents reported that there was no structured surgical teaching and systematic periodic posting in this subspecialty during their residency program. Residents who stated difficulty to understand the subject were 59%. Pursuing POS as a career choice was indicated by 21.0%. Major attracting attributes of POS fellowship were intellectual stimulation (69.7%) and independent operative skills (57.5%). Dissuading factors were difficulty to handle children (54.5%) and stress factor (48.4%). Expert views were grouped under four domains, such as doctor-patient ratio, infrastructure, training opportunities, utilization, and accessibility to POS services.Conclusion: The study has provided useful insights into the preferential behavior among trainee resident doctors and reasons for not choosing POS as a possible choice of future fellowships. [ABSTRACT FROM AUTHOR]

The academician forms the backbone of any medical college, hospital or university and shoulders the quadruple responsibilities of patient care, teaching, administration and research. Of these, research, though long and difficult, is extremely fulfilling. Academicians often carry out research that is based on observations in practice or in response to their patient's needs. These are called as "Investigator-initiated studies" and these may not have the funding support of the pharmaceutical industry. Hence, the investigator must make sure that he/she complies with the country's regulatory requirements. In the past decade, several changes have dotted the regulatory landscape in the country and have changed the way in which academic research is carried out. The present article outlines regulatory requirements for academic research giving their historical evolution, the key bodies in India that govern or oversee research, along with "must know" and "good to know" facets for the conduct of clinical research in the country. [ABSTRACT FROM AUTHOR]

The Department of Neurosurgery started functioning at the Postgraduate Institute of Medical Education and Research, Chandigarh in 1962 with the joining of Dr. Gulati. The department provides neurosurgical services primarily to the people of Chandigarh, Punjab, Haryana, Himachal Pradesh, Jammu and Kashmir as well as the neighbouring areas of Rajasthan, Uttar Pradesh and Uttarakhand. The infrastructure and subspecialties have been developed over the last 5 decades by the dedicated and tireless efforts of the faculty and residents. We attempt to chronicle the contributions of those who have served the department in the past. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the significance of performance of students in written and viva-voce components of final summative pharmacology examination in Bachelor of Medicine, Bachelor of Surgery (MBBS) curriculum in India. The result of the study suggests the significant association between written and viva-voce marks of students. It notes that the result interprets the knowledge and competence of students in MBBS curriculum.

The article focuses on the importance of Psychiatry in the undergraduate medical education curriculum in India. Psychiatry education is an important training aspect for all undergraduate medical students to equip them with the knowledge and information in managing mental illness problems. Several policy making bodies also require the inclusion of Psychiatry education as an examination subject, as well as the training of the nonpsychiatrists on the subject.

High quality publications, patient care and educational standard have made Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India a favored destination for the patients and medical students, for getting treatment and education, respectively. The current article traces the history and milestone of the Department of Neurology, SGPGIMS, Lucknow and summarizes its achievements and facilities. The uniqueness of the department lies in being sensitive to the expectation of the patients, students and its faculty's own aspirations in research, keeping the patient as the center of focus. [ABSTRACT FROM AUTHOR]

Government Medical College, Calicut, Kerala - the first medical college in India to start Doctor of Medicine (MD) in family medicine as a postgraduate course. This was in the year 2012. Till date, this is the only medical college to have MD Family Medicine program in India. The college was allowed two MD Family Medicine seats per year by the Medical Council of India, and this is a 3 year course. The first batch of MD Family Medicine students has passed out from the Government Medical College, Calicut in July 2015. In this article, the author, who has been working as an assistant professor in the Department of Family Medicine, ever since the department started in the year 2012, shares her experiences in setting up the department, its functioning and the achievement of bringing out the first batch of successful MD Family Medicine specialists. Another laurel, of which the institution is proud of, is that they were able to incorporate family medicine teaching program in the MBBS curriculum. A brief introduction about Government Medical College, Calicut, is also given. [ABSTRACT FROM AUTHOR]

Background: Biased results from poorly reported trials can mislead decision-making in health care at all levels, from treatment decisions for the individual patient to formulation of national public health policies.Objective: To evaluate the quality of reporting of randomized controlled trials (RCTs) in ten Indian dental journals over the period 2011-2012.Materials and Methods: This study included all RCTs published as full-text articles reported in ten Indian dental journals over the period from 2011 to 2012. The relevant trials were identified by searching Medline. Hand searching of the journals was also carried out by three of the authors to check if any potential trial was missing. Each article was assessed against the Consolidated Standards of Reporting Trials criteria tool, as described by Schulz et al. (2010).Results: The mean number of criteria present per article was 12.2 (standard deviation [SD] =2.2) and only 5 of 106 articles got total possible score. Most of the articles (69%) did not mention about justification for sample size calculation, 89% of the articles did not mention about allocation concealment, 86% of the articles did not mention about funding and 63% of the articles did not mention about limitations of the study.Conclusion: The quality of reporting of Randomized clinical trials in ten Indian academic journals was poor. [ABSTRACT FROM AUTHOR]

India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2nd National Conference on Family Medicine and Primary Care 2015 (FMPC) brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care), the unfinished agenda of National Health Policy 2002, remains a priority area of implementation. [ABSTRACT FROM AUTHOR]