Summary:
The conversational transcripts highlight the challenges facing medical education in India, including a shortage of qualified faculty in pre-clinical and para-clinical bench subjects as majority of the residency hopefuls clearly show a preference for the bedside. The conversing participants try to illustrate solutions in front of the NMC to this current impasse of students not choosing pre and para clinical bench subjects for their post graduation asking NMC to reformulate these courses into patient centered bench to bedside learning courses offering MD general medicine degree for each such pre and para clinical discipline and also mentioning the pre or para clinical subject in bracket in the degree of MD general medicine and while they do their bedside training in MD general medicine, ensure that they also work in the lab bench of their bracketed pre para specialty, also for their thesis that would typically involve data capture both from their chosen lab bench as well as patient data from their general medicine bedside. They further postulate that eventually these courses could serve to fill the current translational research gap and this variety of an MD general medicine degree can obtain better brand value than a degree of the current MD general medicine!
Additional suggestions include reforming medical education and incentivizing doctors to pursue careers in teaching and research through the so called pre and paraclinical bench disciplines. However, concerns about job security and competition among doctors are also raised.
Key Words
Medical Education Reform, Faculty Shortage, General Medicine, Incentivizing Doctors, Competition and Job Security.
News report: quoted from the link above:
"Even as the government claims to have increased the number of medical education seats in the country, these medical colleges and institutes face a severe student enrollment crisis in post-graduate courses such as anatomy, physiology, biochemistry, pharmacology, forensics, microbiology and pathology, according to an official aware of the matter on condition of anonymity.
This has led to a faculty shortage for these courses since students are not keen on pursuing them.
In this scenario, the National Medical Commission (NMC) is mulling a two-pronged strategy to bridge the gap in demand for these courses.
First, NMC will open a third of the vacant faculty posts to non-medical teachers with a doctorate in the subject and a Bachelor’s and Master’s from the science stream. The other part of the plan is to make these courses more attractive for students through incentives and the inclusion of clinical activities."
[22/02, 10:06]rb: The easiest solution in front of the NMC to this current impasse of students not choosing pre and para clinical subjects for their post graduation is to ask all these courses to be reformulated into patient centered learning courses offering MD general medicine degree for each and also mentioning the pre or para clinical subject in bracket and while they do their MD general medicine, ensure that they also work in the lab bench of their bracketed pre para specialty (also for their thesis) other than the general medicine bedside.
Eventually this translational research gap filling MD general medicine degree will obtain better brand value than a degree of just MD general medicine?
[22/02, 11:16]ad: There is a branch called laboratory medicine already. So why MD medicine should be a pre para branch?
[22/02, 11:16]ad: The reason there are no takers for pre para subjects is because of the limited job opportunities for them. Instead if the teq makes nonmedicos not eligible to be faculty in medical education , then many doctors will take up pre para clinical courses. These courses are very important for future practice. If non medicos teach them, then the patient care perspective may be lost. So keep the specialities pure. Each has its own importance and method
[22/02, 11:23]dmz: True, when non allopathic doctors are practicing allopathy, why not allow the allopathic graduates to enroll as MD in General medicine and allow them to practice as MD General Medicine along with their basic pre Para branch, which will make them available for teaching as well as patient care.
[22/02, 13:23]dmk: NMC removes circulars promoting Non MBBS faculty for teaching in 1st year MBBS subjects. Why should MBBS risk their future taking nonclinical branches and competing for jobs? Then NMC complains of acute shortage of MBBS MD in non clinical subjects.
[22/02, 14:06]dn: Nailed it 👌👌👌
[22/02, 20:21]ad: So how to make the teaching attractive to MBBS? How to make the colleges understand that it is worth investing in Medicos to teach 1st and 2nd MBBS subjects?
[22/02, 20:23]yt: Giving higher salary
Allowing them to enroll in pg course without fees and giving good stipend
Promise of promotion as soon as they complete the course and SR ship
Free good quality accomodation
[22/02, 20:35]dmz: and why would private college do it?
[22/02, 20:36]ad: To get reliable good quality teachers for a long term
[22/02, 20:37]dmz: do u think private college owners think this way?
[22/02, 20:38]ad: Nmc should make them think this way
[22/02, 20:39]dmz : it has made the norms more relaxing
[22/02, 20:39]dmz: Can't we all see that?
22/02, 20:36]ad: To get reliable good quality teachers for a long term
[23/02, 09:49]rb: Define reliable good quality teachers! 😅
[22/02, 11:16]ad: There is a branch called laboratory medicine already. So why MD medicine should be a pre para branch?
[23/02, 10:01]rb: Because NMC is trying to address the requirements of the primary beneficiaries of medical education and not the requirements of the secondary beneficiaries (students and faculty).
The requirements of the secondary beneficiaries will be fulfilled automatically once the primary beneficiary requirements are fulfilled.
Laboratory Medicine is not the same as the translational General medicine degree proposed above, which as already indicated above includes regular General Medicine bedside training along with bench-side training that will produce a much more robust degree than either plain MD general medicine or plain MD Laboratory medicine so much so that within a few years it will be at the top of the Neet/next charts coveted by the neet/next toppers.
🙂🙏
Primary beneficiaries of medical education include all humans (for now) because even most doctors become patients on their deathbeds!
[23/02, 11:09]ad: Then there will be an issue about competition between your newly qualified so called general medicine people and the existing general medicine qualified people.
Back to square one: as between non medico and medico teachers
[23/02, 11:12]ad: All holders of mbbs degree can have their clinics according to their training in MBBS. Why modify and dilute the general medicine subject?
[23/02, 12:16]rb: Not really back to square one because all these translational MDs will compete to provide patient care as opposed to the current crop who haven't been allowed to train to provide care!
A healthy competition between physicians competing to provide care will be good for the primary beneficiaries of medical education.
Will the current MD general medicine degree get extinct? Not as long as there remains a role of a generalist. Those who study AI know very well how much more difficult it's to create AGI (artificial general intelligence) than AI! Generalism will be the last human bastion to fall to the onslaught of AI!
Here's a past lecture about Generalism in medicine delivered in jipmer👇
[23/02, 12:36]ad: I worked at Jipmer long ago. At that time anatomy department was advanced. They were doing karyotyping for our suspected chromosomal anomaly cases. They never asked to be called md general medicine.
Actually there is nothing general about general medicine. It is a complex specialty that requires many critical thinking skills
[23/02, 12:54]rb: Well generalism and generalist competences are advanced traits as elucidated in that lecture linked earlier and there are plenty of literature supporting the above statement that generalism is not easy for the general mass to follow!
Generalism can only be practiced by special people!
The other more descriptive name for the general medicine department could have been "The department of optimizing clinical complexity covering internal and external medicine" but that would have been a mouthful and hence back to calling it "general medicine"
More here 👇
23/02, 12:06]dmk: Yes Sir but right now at present the condition is such that there is so much acute shortage of Anatomists that there are 2 mbbs md faculty in new gmc for 100 students. And actually full time just 1 for 150 students in private medical college here......
[23/02, 12:09]rb: As soon as these new General Medicine MD anatomists begin their PGs they will fill that shortage.
Here's a thematic analysis of the conversational transcripts:
Coding
1. *Medical Education Reform*: Discussions around reforming medical education to address shortages in certain specialties.
2. *Faculty Shortage*: Concerns about the lack of qualified faculty in pre-clinical and para-clinical subjects.
3. *General Medicine*: Debates about the role and definition of General Medicine, including its relationship to other specialties.
4. *Incentivizing Doctors*: Suggestions for incentivizing doctors to pursue careers in teaching and research.
5. *Competition and Job Security*: Concerns about the potential impact of reforms on job security and competition among doctors.
Categorization
1. *Challenges in Medical Education*: Faculty shortage, lack of interest in pre-clinical and para-clinical subjects.
2. *Proposed Solutions*: Reforming medical education, incentivizing doctors, creating new degree programs.
3. *Implications and Concerns*: Job security, competition, impact on existing degree programs.
Learning Insights
1. There is a need for innovative solutions to address the shortage of qualified faculty in pre-clinical and para-clinical subjects.
2. Reforming medical education to make it more attractive and relevant to the needs of the healthcare system is crucial.
3. Incentivizing doctors to pursue careers in teaching and research is essential to address the faculty shortage.
4. There are concerns about the potential impact of reforms on job security and competition among doctors.
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