Tethering Medical Education to Technology Achieving the 1: 1000 ratio
December 2015

Tethering Medical Education to Technology Achieving the 1: 1000 ratio

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healthWhile shortages of doctors and paramedical staff are perennial, the need to inculcate adequate skills in the faculty of medical colleges and the field doctors is acute. The current estimated doctor population ratio in India is 1:1700 as compared to a world average of 1.5:1000. The MCI has set a target of 1:1000 by the year 2031. For achieving this target and considering the number of existing medical colleges in the country, it was noted that the present intake by medical colleges in India and the critical mass of doctors have to be rationally enhanced. Aamir H Kaki of Elets News Network (ENN) looks into the reforms needed in medical education in India and how technology can serve as a significant tool in transforming the sector

Despite being the highest number of medical colleges in the world, the doctor to patients ratio in India is abysmally low, pegged at 1:1000. However, the immense growth has occurred in the past two decades in response to increasing health needs of the country. The major challenge for regulatory bodies like the Medical Council of India (MCI) has been to balance the need for more medical colleges as well as maintaining and improving the quality standards. The globalisation of education and health care and the country’s potential as a destination of choice for quality education and health care has brought the issue into sharper focus.

The MCI’s Vision 2015 draft committee has proposed wide-ranging reforms. It cites three main reasons for India’s healthcare woes:

  • Shortage of physicians (both generalists and specialists);
  • Inequitable distribution of resources and manpower; and,
  • Deficiencies in the quality of medical education.

The report has proposed reforms such as curricular reform, emphasis on primary healthcare and family medicine, and strengthening medical institutions by investing in technology.

To systematically address the issues and develop strategies to strengthen the medical education and health care system, curricular reforms are needed so that Indian Medical Graduates match or better the international standards.

Under the draft, there will be a Curriculum Implementation Support Programme, which will assist the teaching faculty of the medical colleges to implement these changes at their own medical colleges. It is also envisaged that the tools of information and communication technology will be harnessed to enhance teaching and learning.

health11:1000 by 2031

While shortages of doctors and paramedical staff are perennial, the need to inculcate adequate skills in the faculty of medical colleges and the field doctors is acute. The current estimated doctor population ratio in India is 1:1700 as compared to a world average of 1.5:1000. The MCI has set a target of 1:1000 by the year 2031. For achieving this target and considering the number of existing medical colleges in the country, it was noted that the present intake by medical colleges in India and the critical mass of doctors have to be rationally enhanced. While improving the numbers will be important, maintenance and improvement in the quality of the doctors with humane content is paramount. Increasing the numbers of doctors alone, without proper and adequate knowledge and skill will not prove beneficial to the healthcare system.

To meet the set target will take a long time, however, experts believe that the technology can serve as a tool to bridge the gap. As Rahul Narang, Chief Technology Officer, Lybrate puts in, “Most of the countries in Asia-Pacific region are grappling with the issue of shortage of doctors. In India specifically, the doctor-patient ratio is skewed with one doctor available for every 1700 people, unlike in European countries.

Use of IT in the healthcare domain can help bridge the shortage of doctors in the country and spread their reach beyond their local area of practice.”

Technology: Transforming the Medical System

The application of IT and computerbased technology in healthcare and medical education system is both rewarding and challenging. The introduction of different material based learning aides including computer-based softwares, cloud computing, internet and telecommunications has the potential of changing the face of medical education and healthcare delivery system.

The introduction of different material based learning aides including computerbased softwares, cloud computing, internet and telecommunications has the potential of changing the face of medical education and healthcare delivery system

health3In recent years, extensive development and growth of IT has made vast changes in medical education system in India at both the teaching level as well as research level. The availability of internet services across every corner of India made data transfer easy, time saving and convenient.

As Dr Harish Pillai, CEO, Aster Medcity & Cluster Head Kerala stated, “India is on the cutting edge when it comes to healthcare technology. We can do more in the area of research and development. Typically, most of the hospitals in our country focus more on clinical excellence that is not how a good institution works. A good institution need to have a fair balance of clinical excellence, academics and research, which is needed to retain the talent. We, all in the private sector in India, need the right ecosystem.”

The use of IT is slowly progressing in Indian medical education system and is on the rise. It is projected to grow by leaps and bounds in the coming years. Several health and medical experts feel that the new mobile and cloud-enabled applications imply a lot of backend infrastructure readiness from IT – right from secured access, wireless connectivity, proper bandwidth utilisation, to providing security to devices and data.

Abhijit Gupta, Founder and CEO, Praxify Technologies informed, “From struggling to get decent broadband bandwidth to set up heavy resource driven server infrastructures, India has come a long way in the past two decades. With the advent of cloud and mobility, and the growing demand of ubiquitous access, IT has started playing a strong role of an enabler in the medical infrastructure today.”

Technology will be a game changer in the manner in which medical education, training and healthcare services will be delivered in India. The private sector will be the major driving force behind technology adoption in this vital segment. Due to the increasing convergence of technology and healthcare, there is a huge opportunity for providers to improve the experience and operate more efficiently due to augmented association and information sharing among providers. There are lot of players in the market providing innovative technological solutions to ease the medical education, research, healthcare services and overall health outcomes.

The innovative digital solution such as Ovid – a research platform which enables healthcare institutions to access world renowned journals, eBooks, databases and many other resources electronically – by Wolters Kluwer, is transforming the healthcare and medical education system. Shireesh Sahai, CEO – India, Wolters Kluwer said, “In a hospital setup, professionals need multiple solutions to enhance their knowledge and give best possible treatment to their patients. Our solutions enable healthcare professionals from any tier such as specialist, primary care physicians, nurses, pharmacists, researchers and medical students to deliver better health outcomes. Our leading innovative digital solutions which are used by healthcare professionals across the globe are UpToDate, Ovid, Lexicomp, Provation, 5 minute consult, Nursing solutions, Healthcare Communication and many more.”

In MCI’s Vision 2015, the following modifications have been made in the existing curricula to accommodate the aspirations of the defined goals and competencies:

  • Newer learning experiences through introduction of foundation courses placed at crucial junctures, clerkships/student doctor clinical mode of teaching and electives;
  • Early clinical exposure starting from the first year of the MBBS course;  Alignment and integration (horizontal and vertical) of instruction;
  • Integration of principles of Family Medicine;
  • Emphasis on clinical exposure at secondary care level;
  • Competency based learning;
  • Greater emphasis on self-directed learning;
  • Integration of ethics, attitudes and professionalism into all phases of learning;
  • Encouragement of learner centric approaches;  Ensure confidence in core competencies so as to practice independently;
  • Assessment of newer learning experiences, competencies, integrated learning and subject specific content;
  • Acquisition and certification of essential skills.

The ever-changing scenario of technology in every sphere is forcing the stakeholders to keep abreast of the changes and to take proper measure to upgrade themselves. Even the healthcare and medical education is not untouched with it. Several developed countries around the world are taking several measures to make the medical experts abreast of the latest trends and developments. There is a real need for governments across India to adopt the continuing medical education model, and make it mandatory for doctors to take regular tests to keep themselves updated.

Robin Raina, CEO Ebix Inc said, “Globally, some governments have made it mandatory for doctors to obtain continuing education credits. This means if you are a practicing doctor, it is mandatory for you to keep abreast of the latest trends in your field. Ebix offers continuing medical education solutions to practicing doctors to help them obtain credits. Typically, these are three hour online tests approved by top medical bodies like Harvard Medical School and Johns Hopkins, which can be taken thrice a year. In India too, a few states like Jammu and Kashmir have started adopting this model.”

The innovative digital solution such as Ovid – a research platform which enables healthcare institutions to access world renowned journals, eBooks, databases and many other resources electronically – by Wolters Kluwer, is transforming the healthcare and medical education system

health4The Path Ahead

There is a need to set up faculty development institutes that will equip and empower teachers in medical education for discharging their professional responsibilities. The objective of a good medical education should be to produce general practitioners, specialists, teachers and research workers. The factors governing this are the curriculum, medium of instruction, duration of course, admission qualifications, the examination system, teachersstudents relationship, prospects of teachers and students, etc. Besides, it may be mentioned that the medical education should fit in with the needs of the country and the conditions prevailing there.

The dependence on technology in the medical education and healthcare industry cannot be overstated, and as a result of the recent development of brilliant innovations, medical experts and healthcare practitioners can continue to find ways to improve their learning and practice – from imparting education and training to better diagnosis, surgical procedures, and improved patient care.

Whatever the final shape of the mechanism, it owes it to the citizens to create some basic changes in medical education and healthcare system. Policy makers, physicians and those who teach physicians have to open their eyes to the opportunities, realities, and responsibilities available in the vital segment of medical education and healthcare. We need a holistic, radical surgery to restructure the entire medical education system in India.

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