Letter by Dr.M.K.Mohanty

Sub: Modified UG Curriculum 2010(VISION-2015)

We conducted a meeting in the Department of Forensic Medicine at Sri Venkateswaraa Medical College, Puducherry in presence of all the teaching faculties of Forensic Medicine regarding curricular reform in UG Medical education (Vision 2015).

We are thankful to the MCI for its Vision- 2015 in which the goal of curriculum has given due importance to Forensic Medicine along with Family Medicine and Medical Education etc. It has rightly thought to introduce teaching Forensic Medicine in integration with other clinical subjects which increases its practical application, which was done never before.

But we found there are some lacunae and ambiguity which will affect the subject and have been highlighted in the following points

1. As per Vision -2015, page no. 15, - students will be expose to the patients or clinical subjects and professionalism and ethics to be taught from first year(i:e through out the MBBS course). Where as in page no 13 it has mentioned Forensic Medicine in Group C and year 2. It has not been made clear when actually the subject will be taught and exam held.

2. As per page 15, Forensic Medicine will be taught along with other subjects, then it is very unlikely that the students will understand the legal aspects of the subject as a single entity. This is because usually students are exam oriented.(Subjects like Anaesthesia, Dermatology, Psychiatry, Radiology etc are studied by the students for exam purpose only and forgotten thereafter.) Forgetting Forensic Medicine during Medical Practice will land them in legal problem which can affect their career. Vertical integration of Forensic Medicine with clinical subjects will be useful only if it is included under year 4(instead of year 2).

3. Another aim of this curriculum is to produce “BASIC DOCTORS”. In India majority of Medico-Legal works are done by them and not by Medico-Legal Experts. Making the subject elective will not immune the basic doctors for not performing Medico-Legal works. So the subject must be taught comprehensively in the core group

4. Nowhere it was mentioned when autopsy procedure will be taught to the students. After passing MBBS every basic doctors is expected to perform Medico-Legal Autopsy from day one. For proper training in Medico-Legal Autopsy each Medical College should be linked to respective jurisdiction Police Station for receiving cases to perform Autopsy. (Similar to the provision in Vision- 2015 mentioning that each Medical College will be linked to local health system for better training)
Performing Autopsy should be made compulsory for getting letter of permission (LOP) for which the management of the all Private Medical College should obtain permission from respective State Government.

5. As per page 9 of vision 2015, doctors are not going to rural areas because they do not feel equipped with adequate skill and competency. Another aspect is that they do not feel competent and skilled enough to handle Medico-Legal issues (like Medico-legal Autopsy etc) and lack of proper infrastructure in rural areas which refrain them to join peripheral health centres. This can be sorted out by making compulsory internship posting (instead of elective) in a centre performing Medico-Legal Autopsy to gain hand on experience and write Medico-Legal Autopsy report under expert guidance.

6. As per page-11 , table 3 , it has projected that current need in teaching staff in Forensic Medicine is 2000 and current shortfall is 1500. Where as at present total no. of Medical colleges in India is 330. If we calculate staff requirement considering 150 student batch per college (staff requirement Prof.: Assoc Prof.:Asst Prof. = 1:1:1, total no: 3/Medical College) 330 X 3 = 990 is requirement for the whole nation. So projecting a shortfall of 1500 and thereafter 3500 , which is highest shortfall among all medical subject appears ambiguous. This improper projection may be the reason for which the present requirement of staff has been reduced to Prof.: Assoc Prof.:Asst Prof. = 1:1:1.

7. As mentioned in page 15, “Legal experts can be called for Medico-Legal issues”. But legal experts (lawyer) are non-medical person; how is it possible that a non-medical person can advice on Medico-Legal issues? Rather a post of Medico-Legal Expert can be created in the Hospital to deal with the clinical Medico-Legal cases.

8. Instead of teaching Toxicology integrated with Pharmacology, a separate Toxicology ward should be set up constituting a General Physician, Forensic Medicine Experts along with Pharmacology to deals with poisoning and drug overdose cases and management of Medico-legal issues relating to it. The hospital should set up a Analytical Toxicological Lab attached to the Toxicology Ward which will help in rapid diagnosis of suspected poisoning cases. This lab would also be helpful for Pharmacology department for drug estimation.

9. We also found the honourable members of panel forming under graduate working group-2010 are mostly from clinical departments. In the proposal Forensic Medicine and Ethics was highlighted more than any other subjects. But it fails to provide a clear vision on this subject. Forensic Medicine expert may be included in the panel to give expert guidance.

Concluded the meeting, our panel formed above list of suggestions which IAFM/SIMLA/KAMLS/others can include (if found useful) in its letter drafted to MCI regarding curricular reform in Undergraduate Medical Education 2010.(Vision-2015)


Thanking you.

Dr Manoj Kumar Mohanty

Prof & I/C HOD
SVMCH & RC, Ariyur
Puducherry