The Medical Council of India (MCI) plans to conduct a national level entrance examination for admission to the MBBS course. The MCI reasons its action by stating that it wants to reduce the standard of Medical Education in India.
There cannot be a second opinion that the standard of Medical education in India is far from Saeed mdcat satisfactory. There is an urgent need to re-evaluate the standards, content and methods of medical education in India.
Selecting the best students for training may be one prerequisite to achieve standards. But it remains a small step up achieving quality training. Unfortunately for every other professional education in India the selection process for admission is made to appear as the sole determinant of quality. The infrastructure of the institution, the grade of teachers, the availability of clinical material, the methods, research potential and uniformity of standards throughout the country does not attract attention and debate. This is unfortunate considering the big difference in the standards of education in several parts of our country and between institutions within the states.
Our medical education needs to be evaluated with regard to its content and relevance. The MBBS course is called ‘medical education’ in India whereas it is called Medical Training all over the world. There is a sea of difference between the word ‘education’ and ‘training’. The Indian medical education involves studying databases and databases of books and getting theoretical knowledge with very less practical training. Like every other education in India, medical education does not help the student to develop practice oriented thinking and clinical management methodologies. Students trained in the uk or US are better equipped to handle an individual in a clinic or emergency room even if they may not need read so many books like their Indian counterparts.
The textbooks from British isles are meant for medical trainees in the uk. The situations are presented that it were in a UK hospital. The American medical books present the American hospital environment and the American patients. For example the management of strain care is presented in American textbooks with the American ambulance service and emergency room scenario in the mind. That’s not the situation in our country. Western textbooks give more importance to metabolic diseases and congenital diseases which constitute a major disease burden in their countries. Our students look at the British and American medical textbooks. This might be one reason why they all want to go to Britain and America!
They are not trained to go to an Indian small town and see an individual in a Primary Health Center. They just don’t read a lot about malaria and skin infections which are so common in our country. They neither have books which give them inclusive knowledge about the Indian clinical scenario nor get the proper training for Indian clinical practice. We need more research on Indian epidemiology and teaching materials based on that.
We hear people talking about training our graduates to ‘international standards’. They insist that our professionals should be able to go to any country in the world and survive. The percentage of Indian medical graduates going abroad will be less than one percent. Should we be designing our medical program to help these less than 1% to achieve their personal goals? No country in the world should plan its education programs to train their students to go abroad. We need doctors to serve our citizens. We wish large numbers of doctors to serve in out of the way India. It is insane to talk about ‘international standards’ when what we need is a true ‘Indian standard’.
Another big handicap for the Indian student is that he has to learn medicine in a foreign language. The best way to learn science or Medicine is to learn in one’s mother tongue. That will make the learning process interesting and help to develop research thinking. Every European, whether German, Spanish, French or European studies Medicine in their mother tongue. China, The japanese and even a small country like Thailand provide medical education in their mother tongue. It is a possibility. It is practical. The only opposition would be that our students cannot go abroad and work. That is a paralysed pretext. First of all let the medical graduates not go to abroad at all, leaving our country. If they want to go to another country speaking a different language for training they have to do exactly what the Chinese, the japanese and the Russians are doing. Graduates of these countries if they wish to go abroad they have to learn English, German or French or whatever language by having a short course. Our students also ought to that. Our students may study English as second language in school. Once in a while even add English language teaching in the Medical program as an option. So there cannot be any excuses for not teaching Medicine in their respective mother tongues in all the states.
When so much needs to be done to improve the standard of Medical trained in India projecting common entrance examination for entering Medical education as the panacea for all this issues will be counterproductive.
The selection of candidates to the MBBS course is an important step up improving the standard of education. The selection process needs to be regularized. The private medical institutions and the so-called ‘deemed to be universities’ have a free run in the selection. A student who has failed in the matriculation examination and passed in the second attempt can also purchase a seat in these institutions. Most of the students entering some of these institutions have secured more than ten marks less than the lowest mark of a student entering the government institution in arranged category. There is no barrier of minimum marks for entering many of the private institutions. There is no competitive test for admission. The only criterion is money. The seats are sold in open auction. This is of grave concern when you talk about maintaining the standard of medical education. We need to regularize the selection process, admission strategies and fee structure of the private institutions to achieve standards. The MCI appears to be not troubled about these issues for unknown reasons.
The Tamil Nadu experience has clearly shown the harms of the entrance examinations. Abolition of entrance examination has increased the percentage of out of the way students entering professional courses from 28% to 64%. Reintroduction of entrance examination will reverse this and harm the out of the way students. School education is already a big business. Abolition of entrance examination helped not only the out of the way students and also students from government high schools to enter professional colleges. If CET is introduced the private schools offering training for entrance examination along with the regular program will make merry by improving their business. The training organisations for entrance examination will flourish in cities and the rich and urban students will get undue advantage. The out of the way students will be marginalized.
The reason why the IITs, National Law Schools and Central Government Medical institutions remain the family den of the students from metropolitan cities is that the entrance examination to all or any these institutions are based on CBSE syllabus. Again looking at Tamil Nadu experience, one can see that out of the six and a fraction lakh students studying twelfth standard about five lakh are state syllabus students, about one and a half lakh are from matriculation syllabus. Only six thousand and odd students study CBSE syllabus. The CET will obviously be based on the CBSE syllabus which is more voluminous than other syllabuses. This will benefit a microscopic tossing and exclude large numbers of poor and the lacking from the out of the way side.
Entrance examination is perceived as an evil in Tamil Nadu. Dr. Ramadoss who waged a tireless war against entrance examination for over a decade finally convinced the state government to abolish the entrance examination. This is a huge step up empowering the out of the way students. Reintroduction of entrance examination will destroy these benefits to out of the way students. The MCI should abandon its efforts for CET and work for improving the standard of medical training.