MCI Vision 2015 - A Radical change in medical education

The Medical Council of India ( MCI) has released a much-awaited reform document that proposes major changes to the existing MBBS curriculum, which they think is not good enough to produce competent doctors. Academicians have said this is the first time in decades that the country with the highest number of medical colleges in the world has taken a step towards changing the face of its medical education.

Some of the proposed changes-reducing the duration of the course from four and a half to four years-has already created flutter in the medical community. However, doing away with examinations in the first three years of the MBBS course is being considered the most crucial reform If implemented, students may have to appear for an exam only at the end of four years and another after the completion of a one-year internship.

The MCI's Undergraduate Education Working Group has asked medical colleges and stake holders from across the country to provide feedback and suggest further changes to the proposal by January 17, after which the final draft of the policy will be formulated.

Following two rounds of discussions that were held this week, medical teachers from the KEM and Nair Hospitals concluded that certain changes were "too drastic". They felt that some ideas, like exposing students to clinical knowledge more than para or pre-clinical, or in others words allowing them to handle patients right from the first year of the course, is unrealistic. Currently, their first brush with patients comes only after they are two years into the course.

The dean of KEM Hospital, Dr Sanjay Oak, said, "We don't think students should be allowed to handle patients that early. They should deal with patients only after end of the third year," he added. Oak observed that the reforms, though welcome, are too drastic and cannot be employed at one go.

The proposed changes have also left students who are currently pursuing MBBS unimpressed. A student of the GS Medical College, which is affiliated to the KEM Hospital, said it would be tough for them memorize and remember all subjects at one go. "It is impossible for students to study or remember subjects right from first year to fourth year," he said. Oak added that while the manner of evaluation is open to debate, one can't completely scrap examinations.

The new curriculum stresses on helping students hone skills required to handle cases of rape, suicide, assault and injury. It has also been suggested that students be taught subjects like gynaecology and forensic medicine in tandem. As a part of clinical training, there will be a foundation course to focus on communication, basic clinical skills and professionalism.

A paradigm shift could be the introduction of more relevant subjects like ethics and legal medicine, genetics, HIV medicine, Assisted Reproductive Technology as electives, for which students will devote six months of the curriculum.

Dean of Nair hospital, Dr Ravi Rananavare, said that while the introduction of professionalism and ethics in the course are welcome, the reforms in totality would have to be widely debated. "As for examination, they should be having some alternative pattern," he said.

Proposed changes to the MBBS curriculum

* The duration of MBBS course will be 4 years now instead of four-and-half

* One year internship after the course remains unchanged

* Students have to study electives for six months within the four-year timeline

* Only two exams- one at the end of four years and another after completing internship

* Clinical exposure or rather direct brush with patients to begin from first year

* A mandatory set of skills will be set for students and only after certification of those skills can they get license to practice

* Each medical colleges to be linked to a local hospital including community health centres, taluk hospitals and primary health centres that will act as their training ground

* Contemporary approach to education such as skills lab, e-learning, m-learning and simulation

* Flexibility in curriculum

* Additional requirement of teaching faculty

Subject---------Current Need-----Current shortfall---Projected Need--------Total additional need


Anatomy---- -----2000--------------1000-----------------2000----------------------3000


Physiology--------2000---------------1000----------------2000----------------------3000


Biochemistry -----2000---------------600------------------2000---------------------2600


Pharmacology----2000---------------600-----------------2000----------------------2600


Pathology----------2000----------------600---------------2000------------------------2600


Microbiology-------1600 ---------------500----------------1600---------------------2100


Forensic med------2000----------------1500--------------2000---------------------3500


Community med---2400---------------500----------------2400--------------------2900


Medicine--------------2000-------------200----------------2000---------------------2200


Surgery--------------- 2000-------------200----------------2000---------------------2200


Obstetrics & Gynae--1600-----------160---------------1600---------------------1760


Psychiatry-------------800-------------80------------------800----------------------960


Dermatology----------800-------------80-------------------800--------------------960


Anesthesia -----------1600------------160----------------1600-------------------1760


ENT---------------------800--------------80------------------800--------------------1760


Ophthalmology ------80---------------800----------------960-------------------800


Orthopaedics---------1600-------------160---------------1600-----------------1760


Radiology--------------1000------------100---------------1000-----------------1100


TOTAL------------------29,400---------6340-----------29,160----------------35,740