OPINIONS

Indian Medical Education — A Story of Negligence and Decline

Sunday, July 9, 2017

by Ankit Raj

“The only thing more expensive than education is ignorance.” — Benjamin Franklin

Ankit Raj

Ankit Raj

Perhaps, there is not a more suitable quote describing the current state of medical education in India. India has an astounding 426 recognized medical colleges imparting training to 53,455 medical students at any given time. Yet, the country has a dismal ratio of 7 physicians per 10,000 population and its major health indicators show it as one of the worst performing nations. India also has a unique and troublesome feature of brain-drain where medical graduates from India migrate to western nations looking for better pay, career opportunities and lifestyle.

Of these 426 medical colleges offering MBBS (Bachelor of Medicine & Bachelor of Surgery) course, majority are private. Except for a handful of exceptionally excellent colleges, private medical colleges in India are infamous for charging capitation fees wherein medical seats are exchanged for a lofty sum of money. These medical colleges function on negligible to basic infrastructure, ghost faculty and vacant wards and OPDs (outdoor patient departments). One can imagine the quality of doctors churning out of these corrupted institutions. Since most of these private medical colleges act as cash cows for political heavyweights, the government has also not done anything significant to adequately address their quality issue. The story is not very sunny in government medical colleges too. Again, other than a few extraordinary performing institutes like AIIMS and PGIMER, most of the government medical colleges are short on infrastructure, facilities and faculty.

Outdated syllabus and encouragement of rote-learning only add fuel to the fire. Medical science needs to be constantly updated to maintain its relevancy and efficiency. But medical education in India follows out-of-date regulations and teaching methodology. Medical students are evaluated on their theoretical knowledge and the ability to rote-learn maximum amount of facts through short and long answers written in response to exam question papers. Their clinical acumen and communication skills are hardly evaluated. Again, there is no special emphasis on research. Research projects by medical students are given no extra credits or support and in some places are even discouraged and frowned upon. Teaching methodology is also of colonial era and is heavily relied upon didactic lectures. There is not much emphasis on the use of modern communication tools and there is no separate training for teaching and innovations. Due to very limited number of residency seats and government reservation policies, medical students start preparing for postgraduate entrance exams right from the second or third year by attending coaching classes (mugging schools), all the while ignoring their clinical duties and bedside learning.

It is high time that India conducts a ‘Flexner reform’ of its own. Research and innovation should be encouraged at student level along with the incorporation of modern teaching and training methodology and tools. The government also needs to crack down on medical colleges working without an infrastructure and either shut them down or revamp them with modern standards. Medical education should transition from singular rote learning to a more holistic approach that can benefit the nation in long run.

The writer, Ankit Raj, is a Final Year MBBS student at Kasturba Medical College, Manipal.

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6 Comments »

Comment by Dr Soham D Bhaduri
2017-07-09 16:20:25

Good to read your piece Ankit. Nice to find someone restate eloquently what I’ve myself fervently crusaded for. The biggest blemish in Indian medical education today is the unduely heavy reliance on theoretical instruction and assessment which does not jibe well with logic. I could palpate these deficits in our education system as well as you could when I was in MBBS, and have penned numerous articles on it both in this portal and elsewhere. You may want to peruse few of them. Find one below:

http://www.indiamedicaltimes.com/2016/03/06/opinion-its-time-to-revamp-medical-education-in-india/

We want others like you to come to the fore and raise cudgels.

 
Comment by Ankit Raj
2017-07-10 17:54:05

Thank you sir. I am a long time follower of your blog and writing. Totally agree with your observation on theory and practical assessment in India, we are still decades behind other countries like USA, S. Korea. Also, government would rather focus on trivial issues like exit exams than actually try to change the system. Hope to create some ripple effect in future!

 
Comment by Dr.Ashok Jahnavi Prasad
2017-07-11 01:27:55

My compliments on your bold article!

Having worked in 11 different countries myself, I can state that the hallmark of a medical school in a developed country is continuous revision of medical curriculum in which medical students regularly provide input. Innovative suggestions are welcomed and routinely debated in a robust manner. I observed a very major overhaul of medical curriculum when I was in Sweden just before my relocation to India.

Rote learning has no place in a discipline like medicine.

I have myself penned several columns on the deficiencies in the medical curriculum . But it is easier to be vocal after retirement ( as in my case) than when you are still a medical student.That is what makes your endeavour laudable. I sincerely hope more medical students routinely petition the MCI and the government!

 
Comment by Ankit Raj
2017-08-02 15:57:37

Absolutely agree with your opinion sir. Thank you!

 
Comment by Dr Ramesh Vardhan
2017-08-03 12:06:48

Country needs More and more young, honest and Active Medicos like Ankit Raj. Unfortunately it is hard to find someone like him. Most of the students are interested in getting a piece of paper called MBBS degree certificate by hook or crook with out having enough knowledge and skills to help the poor and needy patients our country. They pick up Dirty tricks of referring the patients for unnecessary investigations and other Hospitals for cuts and commissions or look for the MEDICAL Representative for FREE food, free drink and the trips to travel in the name of conference. And next door chemist/ MEDICAL SHOP fellow Will Dispensing the drugs of his choice to rip the patients. Because such Greedy practiceniers our HEALTH CARE services at the bottom level in the world scenario. So sad , it’s really Bad.

 
Comment by Dr K.Gowrinath
2017-08-06 10:12:03

Indian medical education was based upon both clinical experience and theoritical knowledge. Books were written out of research and past clinical experience. In India, the MCI has been changing the norms and regulations of medical education allegedly for the benefit of private medical college managements and not for the medical students.When I studied, the student teacher ratio was less for both undergraduate and post graduate medical education. It was easy for the teacher to remember and distribute the clinical work in wards. Now the number of PG students to be guided by the professor has been increased increasing the responsibility of teachers. Only a lighted candle can light other candles. Those without any research experience and with years of clinical work and routine teaching are made to guide research in the department.The result is substandard dissertation work and increase in unethical practices in medical colleges.There was a situation when the post graduate lamented that his professor never guided and corrected his dissertation and simply signed whatever he wrote resulting in rejection by the evaluator. There must be must read and must know topics to get more knowledge about the current common medical diseases and essential procedures.Intramuscular injections and Intravenous cannulation by interns has become unusual in private medical colleges now.Nobody can blame MCI for that.In India there are enough number of rules and regulations but there is no effort to monitor and no punishment for violation.There must be a separate department for research and academic activities in each medical college to advise and guide the medical students.

 
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