Medical education in India needs comprehensive reform

There exists a significant gap between theoretical knowledge and practical skills

65-Dr-Randeep-Guleria Dr Randeep Guleria | Sanjay Ahlawat

Guest Column/ Dr Randeep Guleria, chairman of Institute of Internal Medicine & Respiratory and Sleep Medicine and director of medical education at Medanta

Medical education in India has come a long way, producing competent health care professionals who serve the nation with utmost dedication. Globally, Indian doctors have always been known for their comprehensive training, especially in clinical medicine. However, the landscape of medical science and technology is evolving at an unprecedented pace, and it is crucial for Indian medical education to keep up with it. There is a need for a comprehensive reform of the curriculum to ensure that it aligns with contemporary health care needs.

Collaborating with companies that specialise in health care technology can provide access to the latest tools and resources for students and educators. These partnerships can also facilitate internships, guest lectures and research opportunities, ensuring that students receive practical exposure to emerging technologies.

To begin with, there now exists a significant gap between theoretical knowledge and practical skills among medical graduates. The limited emphasis on practical training during medical education results in a proficiency gap, making it challenging for graduates to apply their knowledge effectively in real-world health care settings. Most examinations after graduation are based on theoretical skills and do not test practical clinical skills of a candidate. Students, therefore, focus on rote knowledge and join coaching classes rather than spend time in wards, learning clinical skills and the art of medicine.

Another limitation of the current curriculum is the disproportionate focus on specialised areas of medicine, neglecting the importance of primary care. The health care needs of the population require a stronger emphasis on primary care, which can be achieved through curriculum reform. Moreover, ethics, communication skills and a focus on research-based learning are essential for health care professionals. Unfortunately, the current curriculum does not provide adequate training in these areas. Building strong ethical foundations and effective communication skills are vital for empathetic and patient-centred care.

Moving away from a lecture-based approach, a competency-based curriculum focuses on practical skills and evidence-based medicine. This approach ensures that medical graduates possess necessary skills and knowledge to excel in their professional practice. The National Medical Council has initiated a competency-based curriculum for training, but it is not effectively implemented in medical colleges. Promoting inter-professional collaboration is another effective practice that needs to be integrated into the curriculum. Today’s health care system requires professionals from various disciplines to work together seamlessly. Incorporating collaborative experiences and interdisciplinary projects during medical education will prepare graduates to thrive in team-based health care environments. As science advances, there is a need to look at elective training options in medical schools. Students should have the liberty to choose an elective course, like humanities, traditional medicine, biotechnology, and entrepreneurship.

The biggest challenge in the future is that as technology becomes increasingly intertwined with medicine, it is essential for future doctors and health care professionals to understand and harness these technologies. Technological advancements have revolutionised the way health care is delivered across the globe. Artificial intelligence, telemedicine and digital health are just a few examples of the remarkable progress made in recent years. These technologies have brought significant changes in patient care, diagnostics and treatment methods. For instance, artificial intelligence can assist in the early detection of diseases, predict patient outcomes, and even support surgical procedures. Telemedicine, which was very successful during the pandemic, allows patients to access health care remotely, ensuring timely diagnosis and treatment, especially in rural areas. Digital health facilitates the use of health care apps and wearables, empowering individuals to actively monitor and manage their health. While technology has transformed health care globally, the current medical education curriculum in India does not adequately address these advancements. The curriculum often lacks integration with emerging technologies and practical applications of these technologies in health care. Consequently, medical graduates may not be adequately prepared to tackle future health care challenges. Therefore, medical education in India needs to embrace the new technologies that are transforming health care worldwide.

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Integrating technology into medical education can also help optimise health care delivery. A multidisciplinary approach to teaching is essential to integrate technology and medical sciences effectively. Encouraging collaboration between different disciplines, such as medicine, engineering and data science, can help students gain insights into how technology can be applied in health care. By fostering collaboration among experts from various domains, medical education can create a comprehensive learning environment. Active learning methodologies, such as problem-based learning and case studies, can be utilised to enhance technological competency among medical students. By actively engaging with real-world scenarios and using technology in educational settings, students can develop proficiency in utilising digital tools and innovative solutions for patient care. Practical exposure through internships and hands-on training should also be emphasised to familiarise students with the latest medical technologies.

However, implementing curricular reforms in medical education is not without its challenges. Factors such as resistance to change, limited resources and faculty training may pose hurdles. With careful planning and collaboration, these challenges can be overcome. For instance, strong partnerships between academia and the health care industry can help bridge the gap between theory and practice. Collaborating with companies that specialise in health care technology can provide access to the latest tools and resources for students and educators. These partnerships can also facilitate internships, guest lectures and research opportunities, ensuring that students receive practical exposure to emerging technologies.

Also, providing faculty training programmes on emerging technologies can equip educators with the necessary knowledge and skills to incorporate these technologies effectively. Faculty members play a crucial role in shaping the curriculum and delivering education. Continuous professional development can ensure that faculty members remain up-to-date with the latest advancements, promoting ongoing curriculum development.

It is imperative to implement the upgradation of infrastructure, which is essential to support the integration of new technologies in medical education. This includes providing access to high-speed internet, ensuring computer labs are equipped with state-of-the-art hardware and software, and creating simulation centres to facilitate hands-on learning. Investments in infrastructure will create an environment conducive to harnessing the potential of emerging technologies in medical education.

In conclusion, the need for curriculum reform in Indian medical education is evident. By acknowledging the challenges and limitations, embracing emerging trends and technology, and following best practices, Indian medical education can transform its curriculum to produce tomorrow’s health care leaders. Through a comprehensive reform that incorporates modern advancements, practical training, interdisciplinary collaboration, and global perspectives, Indian medical education can equip future health care professionals with the competence and compassion needed to address the evolving health care needs of the nation.