BMJ - Doctors criticize proposed changes to the undergraduate medical curriculum in India

Proposals to reduce the length of basic medical training in India by six months to just four years have been greeted with criticism by doctors, who say essential components of the syllabus are now optional electives.

The Medical Council of India has proposed the new roadmap, called Vision-2015, to try to stop the fall in standards in medical training that it says has been happening in the past decade. The document recommends reducing the duration of basic academic training in medical school from 4.5 years plus a one year mandatory internship in hospital to four years of medical school plus a one year internship. It breaks down the syllabus into core subjects that are mandatory and electives of six months duration, and proposes that students start clinical training in their first year alongside studying the basic science syllabus.

Vision-2015 also recommends that forensic medicine and toxicology are not taught as subjects in their own right but broken down and taught alongside relevant sections of pharmacology, obstetrics, and surgery. Medical ethics will also fall outside the core syllabus and be taught as an additional elective.

These proposed changes have come under widespread criticism, led by members of forensic medicine and toxicology faculties. Forensic medicine has traditionally been an essential part of the Indian medical curriculum, taught in the second year along with pharmacology, pathology, and microbiology. In protest the faculties of forensic medicine at colleges all over India observed a “black day” on 5 February, when staff all wore black armbands.

India has a severe shortage of forensic experts, which means that most cases of rape and assault are handled by doctors with only basic medical training and no specialist knowledge. SD Nanandkar, head of forensic medicine department at JJ Hospital, Mumbai, was quoted in the Times of India as saying that India had only one fifth of the 6000 forensic experts it needs.

Shailesh Mohite, head of forensic medicine department at BYL Nair Hospital, Mumbai, recently warned that removing forensic medicine and toxicology from the core curriculum will de-skill doctors still further, making the current situation worse.

The Medical Council of India has invited suggestions and feedback from the medical community and policy makers before it publishes the final version of its proposals.

Reference: BMJ 2011;342:d1043