To,
The Board of Governors
Medical Council of India
New Delhi.
Subject: objections and suggestions on MCI Vision Document-2015
Respected Sir,
My objections and suggestions on MCI Vision Document-2015-
Regarding MBBS curriculum in general-
1. 1- Aim must be to produce increased number of quality doctors rather than just increasing the number of doctors by diluting the standards of teaching for the sake of bringing doctor-population ratio at par with the developed nations as envisaged in Vision Document.
2. 2- Duration of course should be increased from 4 ½ years to 5years instead of 4 years as suggested by working group so that quality of medical education does not suffer. Medical knowledge and technology has grown in a torrential manner since last 2-3 decades and this must be incorporated in any future medical curriculum. For that even 5 year duration may be insufficient. Any reduction in the duration of course will be a retrogressive step and not consistent with global standards. It will seriously undermine the reputation of Indian Doctors.
3. 3- Some subjects like Forensic Medicine, ENT, Ophthalmology, Orthopedics, Psychiatry, have been clubbed as non-core or elective subjects, which is not only erroneous but also disgraceful for these specialties. Medico-legal cases (crime, violence, medical negligence), physical trauma cases, ocular diseases and mental diseases affect society at large. A general physician has to face these cases in his day to day practice perhaps more so than a specialist. He has to be fully equipped to deal with them. Division of subjects into core and non-core appears totally hypothetical and retrogressive for these subjects. These subjects should be strengthened by introducing new techniques and knowledge into their syllabus rather than weakening them by classifying them as non-core subjects.
4- Early clinical exposure is a welcome move as also is the idea of integrated teaching across various disciplines.
5. 5- Rural exposure from 3rd year onwards by organizing guided tour to PHCs and CHCs instead of 3 months rural posting during internship as is current practice. Early exposure will stimulate the minds of students to work in the rural areas after completion of their studies.
6. 6- Internship should be strengthened by taking viva-voce/practical examination at the end of posting in each Department and an intern must obtain certain minimum marks in order to get the internship completion certificate.
7. 7- Introduction of exit examination should be considered only after widespread consensus has developed.
Regarding Forensic Medicine & Toxicology
1. 1- FMT is an indispensable subject in UG curriculum. Every medical doctor working in a government hospital be it PHC, CHC or district hospital has to compulsorily do medico-legal work (postmortem, injury report, examination of sexual assault). This is part of his service conditions and one can not escape from it. Even a private practitioner has certain legal obligations in dealing with criminal cases which he can not absolve. Under these circumstances keeping FMT under non-core/elective subject seems elusive.
2. 2- FMT should be upgraded to clinical subject from para-clinical subject and should be taught alongside medicine, surgery, orthopedics, obstetrics and gynaecology and should not be split up among these subjects as one gets the impression from the vision document. There is no comparison between teaching a subject as a separate discipline and teaching it in a piecemeal manner with several disciplines.
3. 3- Data regarding need and shortfall of faculty of Forensic Medicine seems erroneous. As per the faculty database given in MCI website currently there are about 1400 teachers of Forensic Medicine.
4. 4- Teaching hours of FMT should be increased to 200 hours.
5. 5- Every medical college including private medical colleges should have a working mortuary and should be attached with a police station so that medico-legal autopsies can be carried out at college itself rather than taking the students to government authorized mortuary.
6. 6- Histopathology facilities for medico-legal cases must be made mandatory.
7. 7- Poisoning wards/centers should be brought under FMT to strengthen the toxicology as well as to provide practical exposure.
8. 8- Any step taken to dilute the teaching of FMT will have serious repercussion on society at large as it will lead to degradation of quality of medical evidences given by doctors in the court of law due to lack of knowledge.
With regards
Dr. Ashish Jain
Senior Resident
Forensic Medicine & Toxicology
All India Institute of Medical Sciences
New Delhi-110029
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