The Medical Local authority or council of The indian subcontinent (MCI) plans to conduct a national level entrance examination for everyone to the MBBS course. The MCI reasons its action by stating that it wants to increase the standard of Medical Education in The indian subcontinent.
There cannot be a second opinion that the standard of Medical education in The indian Saeed mdcat subcontinent is far from satisfactory. There is an urgent need to re-evaluate the standards, content and technique of medical education in The indian subcontinent.
Choosing the right 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 The indian subcontinent the selection process for everyone is enabled to appear as the sole determinant of quality. The structure of the institution, the standard of teachers, the accessibility to clinical material, the technique, 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 assessed with regard to its content and importance. The MBBS course is called ‘medical education’ in The indian subcontinent 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 amounts and amounts of books and getting theoretical knowledge with very less practical training. Like every other education in The indian subcontinent, medical education does not help the student to develop practice focused thinking and clinical management methodologies. Students trained in the uk or US are better equipped to handle the patient in a clinic or emergency room even if they may don’t you have read so many books like their Indian counterparts.
The textbooks from Uk are meant for medical students in the uk. The situations are presented like it were in a UK hospital. The American medical books present the American hospital environment and the American patients. As an example the management of injury 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 see the British and American medical textbooks. This might be one reason why they all want to go to The british isles and America!
They are not trained to go to an Indian town and see the patient in a Primary Health Center. They don’t read very much 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 start to use more research on Indian epidemiology and teaching materials based on that.
We hear people talking about training our graduates to ‘international standards’. They insist 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 course load 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 start to use doctors to serve our citizens. You want large numbers of doctors to serve in countryside The indian subcontinent. 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 she has to learn medicine in a language. The best way to learn science or Medicine is to learn in one’s mother tongue. That will make the training process interesting and help to develop research thinking. Every Western 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 our students cannot go abroad and work. That is a dull justification. First of all allow 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 via a short course. Our students also have to do that. Our students may study English as second language in school. Organic beef even add English language teaching in the Medical course load 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 lessons in The indian subcontinent projecting common entrance examination for entering Medical education as the panacea for all this issues will be counterproductive.
Picking a 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 costa rica government institution in earmarked category. There is no barrier of minimum marks for entering many of the private institutions. There is no competitive test for everyone. The only qualifying measure is money. The seats are traded 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, everyone strategies and fee structure of the private institutions to achieve standards. The MCI appears to be not frustrated 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 countryside students entering professional courses from 28% to 64%. Reintroduction of entrance examination will reverse this and harm the countryside students. School education has already been a big business. Abolition of entrance examination helped not only the countryside 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 course load will make cheerful by improving their business. The training revolves for entrance examination will flourish in cities and the rich and urban students will get unnecessary advantage. The countryside students will be marginalized.
The reason why the IITs, National Law Schools and Central Government Medical institutions remain the family room of the students from metropolitan cities is that the entrance examination to everyone these institutions use CBSE syllabus. Again looking at Tamil Nadu experience, one can see that out of the six and a one fourth 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 fraction and exclude large numbers of poor and the starving from the countryside side.
Entrance examination is perceived as an evil in Tamil Nadu. Doctor. Ramadoss who waged a tireless war against entrance examination for over a decade finally convinced nys government to abolish the entrance examination. This became a huge step up empowering the countryside students. Reintroduction of entrance examination will destroy these benefits to countryside students. The MCI should abandon its efforts for CET and work for improving the standard of medical training.