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Tribune Special
Shorter MBBS course on the cards
MCI recommends 5-yr course instead of 5.5
Aditi Tandon
Tribune News Service

New Delhi, January 2
Medical students would have study MBBS for only five years instead of 5.5 years if the government accepts the recommendations of the Medical Council of India-constituted panel on undergraduate medical reform in India.

The eight-member UG working group in its Vision 2015 Document for Health has proposed major restructuring of the MBBS course saying the current training was not focused on providing healthcare to the needy and disadvantaged and lacked the development of clinical competency of the students.

Noting that discipline based curriculum and lack of integration between basic and laboratory science and clinical medicine was not producing “basic doctors” - need of the hour - the panel has recommended a 4+1 model of MBBS training (4 years MBBS course teaching + 1 year internship, including six months of electives) instead of the existing 4.5 years teaching plus one year internship model.

“It’s important to remove redundancy in the curriculum. The time saved can lead to shorter duration and more time for electives, professionalism and ethics,” the panel has said, proposing clinical teaching from the first year instead of second year onwards as is the present practice. The panel has proposed to make medical ethics and professionalism course a mandatory part of MBBS curriculum and recommended introduction of family medicine course in the fourth year with focus on NRHM and other criticalities with health-related Millennium Development Goals in mind.

“The clinical training would start in first year with a foundation course focusing on communication, basic clinical skills and professionalism. Professionalism and ethics will be a mandatory to MBBS curriculum and will be integrated throughout the course. The foundation courses will be taken during the first and second year and rest will be taught with the clinical subjects,” states the committee. The MCI has sought feedback on the panel’s UG reform proposals by January 17.

For clinical training, the group has mooted clerkship/student doctor model of postings and mandatory secondary hospital exposure by linking each medical hospital to local health systems like community or primary health centres.

In the clerkship method, students would be posted to respective departments as clerks or sub-interns to learn history, examination, procedural skills and management of patients’ common ambulatory and emergency conditions. Students work under the supervision of the registrar and consultant both in the out-patient and in-patient setting and emergency setting.

“Learning is by practical involvement in the process of care of patients,” states the committee report, further prescribing a mandatory skill set in which every intern would require certification before he gets his licensure degree to practice medicine.

Called Level 1 skills, each medical hospital would have to have expertise to impart these skills, namely basic surgical skills, basic life support skills, procedural skills, normal labour management and conduct of delivery. These will be compulsory to clinical training of all undergraduates.

Overall medical teaching would comprise 6400 hours through four years of medical course (eight semesters instead of the current nine) as follows - Year 1 (Anatomy, Physiology and Biochemistry), Year 2 (Pathology, Microbiology and Pharmacology); Year 2 (Forensic medicine), Year 3 and 4 (ENT and Ophthalmology, STD and Dermatology, Orthopedics, Accident and Emergency Medicine, Radiology, Anaesthesia, Psychiatry and elective options); Year 4 (Medicine, Surgery, Obstetrics and Gynaecology, Pediatrics, Family Medicine and Community health). Each semester will comprise 800 teaching hours.