How the ailing medical education can be healed

There are no standardised national platforms for certifying knowledge and skills of doctors in India.

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Quality speaks and attracts — be it of material things, or human beings. Qualified doctors, certified specialists, dexterous surgeons and astute physicians are always in great demand. How to find such doctors?

There are no standardised national platforms for certifying knowledge and skills of doctors in India. Can’t we conceive and create such a platform? This thought formed the basis of the National Exit Examination (NEXT), conceived way back in 2010 along with its twin brother, the National Eligibility-cum-Entrance Test (NEET).

If the raw material is good (students entering through NEET) and the finished product passes quality standards (NEXT), a standardised medical resource will be available: the Indian Medical Graduate.

Every quality product is produced after carefully laying down specifications, standardising manufacturing practices and passing through quality standards, say, Euro-VI or ISO. Doctors qualifying NEXT would be like that.

Today, we spend all effort on the process without properly defining or assessing the product.

Of course, the NEXT has to be thoroughly worked out, unlike the current proposed format in NMC. In the ‘Vision 2015’ document for Medical Education, the exit exam was proposed to be done in two equal parts: one of theory, soon after final MBBS exam, and the other, practical, to assess the clinical skills at the end of the internship.

This approach will ensure that besides the knowledge, the medical graduates learn clinical skills during the internship, and not merely hole up in a den to mug multiple choice questions. NEXT could also serve well as a licentiate examination: To give permission to practice medicine independently. Such an exam is common in many countries like the US or Canada. All those who score above a given percentage, say, 30% should be considered as eligible to practise medicine in India.

NEXT has met with resistance. It is stated that it is an additional burden on students. It is not. It is said NEXT could deprive a medical passout of practicing medicine. No, NEXT doesn’t do that. It only sets a national standard. One can reduce this minimum to 20-25%, if the country so wants.

As a society, we have the right to demand ethically qualified, skilled and adequate number of doctors. Systems hindering this basic need must be abandoned to bring a new era where the world says with pride: ‘Trained in India’. Make Indian doctors a ‘brand’ and send them to serve the world.

Dr S K Sarin is the director of Institute of Liver and Biliary Sciences and former chairman of the Board of Governors of the Medical Council of India.

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