Sunday, May 30, 2010

Postgraduate Education in India - Time to Change

While the Medical council of India is being purged and hopefully for the better, time has come to revisit how our MBBS doctors are trained for specialties. It may be prudent here to look at some other models to realize that over the years, countries who in 50s and 60s were following the model we still follow, have evolved and changed their systems of imparting post graduate courses.

As I am a surgeon, my discussions will use surgical higher education as a template, which of course can and should be applied to other specialties.

Today, I will list some issues and hope readers will join in to augment this list as well as discus the various issues!

In India, after completing internship, a doctor can be immediately admitted to post graduate training in surgery, which lasts for three years. In the western world, after internship, a doctor joins as a medical officer or what was traditionally called a house job. This is for a minimum of 2 years. During these two years, entrance exams are taken to join advanced training in surgery, which will last for a minimum of 4 years. Only about 10 % of doctors will complete this in 6 years years time. Average will take 8 years.

After being awarded the fellowship (MS in India), senior residency is a must. If one has to go and become a general surgeon, one year of senior residency is essential, though two to three years in preferred. Then only one can become a consultant to practice independently! In India one can immediately start practicing independently after getting the MS. Only who join teaching hospitals have to joining as senior residents for three years, but this is different from state to state and university to university.

Essentially, what is highlighted in the above discussion, is that period of training has a relevance in imparting higher education. There are other issues like who controls this training, the syllabus and the content of training. Standards of examination, research and training are other issues. Criteria for selection is also another issue of contention. All these issues will be discussed in the following blogs.

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