Health Education in India
Medical education in global context has evolved over a period of time and so in India. With changing community needs, educational advancements and technological revolutions, we need to update the method of imparting knowledge and skills to the students. Major components of hidden curriculum like communication skills, attitude, empathy, altruism, professionalism, humanities etc need to be uncovered and delivered in a more systematic way. Ever increasing demand of doctors in the country has forced to establish new medical colleges across the country but the quality of Indian Medical Graduates produced out of them needs a lot to think and work upon. Reforms in curriculum Medical Council of India is planning to bring should be taken seriously and all efforts should be made to bring them to reality. In order to bring a competent Indian Medical Graduate in par with global standards should be the mantra of every medical education institution.
Healthcare education encompasses the formal training received by the medical and allied healthcare staff in medical colleges. However, we often stop at that. Healthcare education in India is largely synonymous to medical training and educating the people to help them take informed decision often slips away: Making the people aware of their health needs and risks, payment options to reduce their out-of-pocket medical expense, etc. are some of the aspects on which even a well-educated, city-bred person may need some help. India must utilise the access its community health workers (Anganwadi and Accredited Social Health Activist (ASHA) workers) enjoy to inform and assure people of the options they have, failing which even the best technology and most efficient staff will fall short of making an impact.
The medical education in India can be traced back to the era of Charaka and Sushrutha who had their own doctrines in treating and teaching indigenous system of Medicine in ancient India. The formal training of Indians in Medical Science has started at the time of British rule in India where initial emphasis was given to establish the medical schools that provide instructions to students in native languages. Medical Colleges in Madras, Bombay, and Calcutta were established with the objective to afford better means of instruction in Medicine and Surgery to the Indo-British and native youths, entering the medical branch of the service in the presidency. Later on, several institutions to train Indian youths in indigenous system of medicine such as Ayurveda, Unani, Homeopathy, and Siddha were established throughout the country. Keeping in mind, the potential readers of this article, I would henceforth concentrate on medical education pertaining to allopathic medicine.
Even after the independence, the medical education in India did not come out of colonial yoke. Most of our medical schools still felt comfortable with western mode of instruction rather than tailoring the curriculum to the local needs. In the mid-1970s, the Shrivastav Committee advocated reorientation of medical education by national priorities and needs.In 1986, the Bajaj Committee called for the establishment of an educational commission for health sciences. It also noted that medical school faculty, though efficient in their clinical specialties, were deficient as educators. In order to meet the societal need of doctors, larger number of government and private medical colleges were established across the country. These medical colleges have been successful in creating the doctors who could cure the diseases but failed to provide comprehensive health care which includes, preventive, promotive, curative, and rehabilitative services to the people who are in need of the health-care services. Over a period of time, medical education in India has turned out to be a business sector, with competitive pricing for the providing basic and specialized certification. Establishment of Medical Council of India (MCI) as a statutory body to the maintenance of uniform standards of medical education, both undergraduate and postgraduate were one of the welcome steps to ensure check on basic minimum requirements for the establishment and running of undergraduate and postgraduate programs in Medicine. There is also a strong criticism that the statutory body itself hinders the flexibility of offering medical education in the country through its stringent rules and regulations.
The state of medical education in India is at crossroads. It represents a scenario marked by rhetoric wishful thinking rather than concrete steps in right direction. Sticking on to the age-old curricula, which was developed more than 100 years ago, which compartmentalizes the medical disciplines rather than giving holistic understanding of the subject is the root cause for these problems. Every academician and governing authorities in all possible academic forums advocate the need for bringing rampant curriculum reforms in medical education by tailoring it to the current day needs and demands, but when it comes to action, we are still at ground zero.
Apart from curriculum, we still believe that the role of medical teacher is like a “sage on the stage rather than guide by the side.” We often want our students to sit in the class like the rat which is a passive and motivation-free recipient of stimuli and listen to the lectures of an elated faculty member for hours together and feel scared to interact with him. There is a need that this scene is classrooms should change in such a way that the teacher should act as a facilitator and allow students to learn by themselves through active involvement based on the principle of cooperative learning. Thus, the classrooms should become the platforms for two-way sharing of ideas and thoughts between teachers and students with larger scope for healthy debate and dialogues. I can imagine this setting like a lively, noisy, bubbly, energetic classroom rather than an asylum of pin drop silence.