1. What are the challenges and issues in medical education today?
There are many issues related to medical education. We have very good medical schools in our country but the number of such good institutions is very limited. Along with the increasing population the numbers of various diseases are going up. We are not producing good trained doctors in our country as compared to the west or the developing economies.
The government is opening medical schools away from metros and into the districts but the faculty is not ready to go there because of the limited facilities available in those districts, the problems they would have to face in quality of life, education of their children etc. If the districts are improved, the medical schools will come up more rapidly and will get more easily established. We have very good doctors but the number is very small as compared to the population of the country. The government is making efforts but still a lot needs to be done.
2. How do you like to fix these issues?
The pattern of teaching has not changed much during the last 50 years. It is very surprising that we never thought that the content, the training, the way of evaluation and the way of examination should change in medical education. We have never thought that MCQ type of questions should also be included in this curriculum and there should be evaluations every 2-3 months. The knowledge should be given but it should be seen whether the same is being converted into real skills and whether he be able to practice this knowledge when he is exposed to the ground realities of treating patients independently.
Secondly all the students coming to medical schools want to become specialists or super specialists although it is not our overall requirement. The government and the Medical Council of India have to think on our need for family physicians. Family physicians are the most important people for the community of 4000-10000 patients. A large number of family physicians should be produced by our medical curriculum.
3. How has specialisation and super specialisation affected healthcare ?
The concept of super specialisation came in 1980’s and with that a large number of doctors shifted to cardiology, nephrology, endocrinology etc. The seats of MD in medicine and MS in general surgery are much more than the seats of super specialists. The number of doctors who have done MD in medicine is large in our country. These doctors should be given much more importance as they know the overall medicine needed by the patients who come in with more than one problem. The general physicians are the people who should be given special training to bridge the gap between super specialists and specialists.