Medical education in India is in doldrums with no uniformity in the entrance tests or examinations, highly deficient faculty in numbers and skills, lack of initiative to learn or teach and no concern for socio-economic realities of the society, sensitization to the patients’ needs, ethics or skill in the finished product. The emphasis from cramming and remembering facts has to undergo paradigm shift. At the time of admission the essential element in each candidate should be sympathy for any living being in pain or suffering, and urge to help him rather than just scoring high marks or plan a lucrative career. At the time of graduation the candidate should have empathy to the patient’s problems and sensitization to the mode of dealing with the relatives of the sick.
Medical Council of India, the apex body to monitor the standards of medical education has miserably failed to ensure that the medical education provided in medical colleges all across the country is of a sufficiently high standard. So that when medical students graduate, and go out in the community to practice as doctors, they provide safe and effective medical care to their patients. The majority of colleges in private sector have been set up as money minting centres and is run by politicians. They often don’t have the necessary infrastructure – either in the form of beds, equipment, patients or staff etc. On the day of inspection, they will arrange medical teachers on their rolls; and pay people to pretend to be dummy patients . The medical examinations which are designed to test the competence of the doctor are of poor quality. Medical Council of India should now move on and start using simulation technology which deploys virtual patients to test trainee doctors before they are allowed to graduate. They are great testing tools, because they check whether the doctor can apply the knowledge he has acquired to the patients he will see in real life. A common medical exit graduating examination, which utilizes virtual patients will serve as a platform which can be used to test medical students across the country. The MCI will be able to track the performance of all the medical students of individual medical colleges, and red flag those whose students continue to perform miserably, so that they can be shut down before create too much harm by churning out too many incompetent doctors. There will be much less corruption, because everyone will be held to the same standards. The MCI will have access to dashboards to compare which colleges are doing well, and where the students are persistently failing.
Endorsing a Parliamentary Standing Committee report of March 2016 that medical education and profession in the country is at its ‘lowest ebb’ and suffering from ‘ system failure’ due to corruption and decay, the Supreme Court has used its rare powers under the Constitution to set up a three-member committee, headed by a former Chief Justice of India, to oversee the functioning of the Medical Council of India (MCI) for at least a year. The judgment referred to the parliamentary panel report, which described the MCI as an ‘ossified and opaque body’ unable to cope with the ‘humongous’ task of managing medical education in over 400 colleges across the country. Unethical practices have brought down “Quality of medical education, the right type of health professionals were not able to meet the basic health needs of the country. Products coming out of medical colleges are ill-prepared to serve in poor resource settings like Primary Health Centres. Graduates lacked competence in performing basic health care tasks. The Supreme Court said the Justice Lodha committee “will have the authority to oversee all statutory functions under the MCI Act. The Committee will be free to issue appropriate remedial directions”.
Common Medical Entrance test
In a historic ruling last month, Supreme Court also abolished validity of separate entrance test in different states for undergraduate and postgraduate medical education. The Supreme Court ruled in favor of petitioners who requested the court to quash separate medical entrances by various government and private institutions. They also sighted that there was potential for corruption and deserving students were not able to take an opportunity if they could not pay large sums as donations. The Supreme Court established the constitutional validity of NEET (National Eligibility Entrance Test).
While it is laudable for the apex court to step in to improve standards of medical education and healthcare, it may be a dangerous trend to pass on executive functions to judicial domain in each sphere of life. After all judges also come from the same society, where other professionals take training and excel in their respective fields.
Standard prescription format
MCI-affiliated doctors are expected to start using the new format from April onwards. This standard hard copy format is very much required for prescribing medicines in the interest of patient safety. The format also offers the physician to write generic medicines based on the efficacy, affordability and availability of drugs. As per the new guidelines, allopathic doctors must write prescriptions legibly and in capital letters as well as furnish a complete and detailed prescription. The comprehensive format includes the doctor’s full name, his/her qualification, patient’s details, name of the generic medicine or its equivalent along with the dosage, strength, dosage form and instruction, name and address of medical store with pharmacist’s name and date of dispensing, as well as the doctor’s signature and stamp. In several countries, printed prescriptions are mandatory because they are not only legible, but also constitute a database of medication that the patient has taken over the years.