AYUSH Minister Shripad Yesso Naik helmed, Group of Ministers (GoM) on health suggested reducing the course duration of MBBS along with internship to 4.5 years. They also proposed to include a 2 years rural posting to be mandatory before awarding MBBS degree.
The panel of ministers put forward these recommendations with reference to ‘changing circumstances’. Additionally, the 2 years rural posting will increase the availability of doctors with MBBS (Bachelor of Medicine and Surgery) degrees even in rural areas.
The GoM comprises Union Ministers Jitendra Singh, Rattan Lal Kataria, Debasree Chaudhuri and Ashwini Kumar Choubey. COVID-19 crisis is the chief reason to accelerate these moves for reconditioning health policies in India.
Apart from government-funded health insurance systems, other aspects like availability of reliable sources, staff, infrastructure and to top it all, a transparent system is necessary to exercise an efficient healthcare sector as a lasting solution.
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The GoM recommended 4.5 years of new MBBS course duration to have a curriculum that focuses on qualitative development of skills and scrapping “quantitative knowledge gathering”. This will require a complete revision of the MBBS curriculum to include recent disease profile in the country and subsequent ground realities.
The focus panning towards qualitative skilling from quantitative knowledge will allow assessing medicos on practical clinical skills. So far, students were burdened with profuse information that was irrelevant for their future endeavours.
Read: MBBS Syllabus
GoM Recommends Three Models to Cut MBBS Course Duration in India
Currently, the MBBS course is of 4.5 years and 1 year of internship. Meanwhile, in 2019, MCI had cut down the 54-month MBBS course to 50 months.
The first model of GoM suggests MBBS courses will be completed in 4.5 years that is 4 years of study and 6 months of internship.
The report reads, “The first year may include teachings in basic sciences and health courses involving anatomy, physiology and biochemistry. The next one-and-half year, the students may be exposed to broader specialities like medicine, surgery, paediatrics and anesthesiology. And during the last one-and-half year, they may be exclusively posted to the pre-assigned specialities like OBG, surgery, paediatrics, internal medicine or other required specialities.”
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GoM’s second model suggests capping MBBS course duration to 4 years, allotting 2 years of speciality or super speciality PG Courses. Final year MBBS students will have to appear for a common exit exam, NEXT (National Exit Exam as already proposed by the government) as a gateway to PG courses.
The report on this reads, “The students, without wasting any time on completion of the bachelor course, can join the speciality course depending upon choice and merit in the common exit exam. This option may be limited to meritorious students only, who pass the exit exam with a high score, the others passing out as normal physicians.”
The third model of GoM suggests a 6-years integrated MBBS-MD program with the facility to opt for specialization in the fourth year.
The report on this reads, “This is a variation of model 2, wherein the initial entrance exam itself may be made a basis for entry to the 6 years course (4 years MBBS and 2 years PG). An integrated programme would provide not just doctors but specialists with adequate clinical experience acquired over 6 years. In this model also, there would not be an internship.”
Overall the report speaks of bringing forth a curriculum with proportionate inclusions of specific disease knowledge and society’s common problems.
Rural Posting for Medicos
The panel suggested a mandatory 2 years rural posting for increasing medical officers in these areas. The report reveals there is a huge deficiency of doctors in remote areas for obvious reasons.
Physicians prefer posting in cities as there are fewer facilities for accommodation and recreational activities in villages. Moreover, the current policy does not mandate rural posting. Also, MBBS graduates have built a tendency to switch to private jobs to earn big by practising in cities.
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As of now, new regulations will focus on providing better facilities for doctors posted in villages. Report states, “To make this mandatory posting less harsh for the graduates, the one-year internship period can be combined with an additional one-year rural posting for meeting the above criteria.”
Most significantly a hardship allowance is required to be levied to cover deficiencies in rural postings. In order to encourage doctors to serve in rural areas, state governments need to adopt flexible measures and add extra credits for rural services during PG admissions.
The GoM even pointed out, “prejudice of AYUSH being a non-scientific field can be overcome by integrating it in the MBBS curriculum”.
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