Prof A K Agarwal
Professor, School of Health Sciences,  IGNOU

It is very crucial to bridge the gap in the context of medical education, where many of the emerging and demanding courses are not present in the conventional courses currently.

In a conversation with Divya Chawla and Sangita Ghosh De of eHEALTH, Prof A K Agarwal of Indira Gandhi National Open University (IGNOU) shares his insights about the need of the modernisation of medical courses in India.

What is your perspective on the state of medical education in India vis-a-vis the global scenario?

Medical education in India is at the crossroads now. There have been very little research and innovation in socialising medical education in our country. Therefore, when the MBBS graduates pass out of the medical colleges they are not having enough interaction with the community and as such very less connected to the social structure. When posted to serve the community, they are far away from the ground realities. This creates a huge gap between the education of a doctor and his perfection in service towards his patients, as the aspiration of a medical graduate grows higher after he becomes a graduate in medicine. Besides, he is being educated in the age old British model existing in India in medical education which is yet to get an updation since the independence of the country. As per the expectation, the medical graduates are also supposed to understand the civic-social problems in the country, while working closely with the communities that vary widely in different states in India. When we say this, we mean that even if there are excellent teachers, brilliant students and lots of opportunities in India in medical education, there has been very little done to make it appropriate for the present situation and for the future scenario as well. Here we need an up-to-date technology supported course and atleast one year orientation programme, included in the MBBS course, in socialising with the community, where the trainee doctor can go to the rural area and stay with the community in understanding the problems and its solutions related to healthcare. This would also solve the problem of scarcity of healthcare professionals in rural and semi-urban areas in our country. We take this cue from our neighbouring countries as it is very much happening in other Asian countries as well as in the US and UK.   

What is the importance of Open University and Distance Learning system in medical education? How can it bring about a transformation in medical courses in the country?

It is very crucial in the context of medical education as we know that many emerging and demanding courses are not present in the conventional courses currently. The School of Health Sciences in IGNOU was initiated in the year of 1992. Before that nobody even thought of offering special learning programmes as short term courses to the doctors. Now the introduction of the new module courses in IGNOU is a very recent development during the last one and a half decade. Open university and distance learning system is the need of the hour now because through conventional courses we will not be able to reach out to the grass root levels. As our analysis says that conventional medical education does not have integrated short term courses in terms of RCH, diabetes for elderly, essential surgeries, counsellings for adolescent healthcare problems etc. But these courses are very much required, if included right after the graduation, in our healthcare support system. But through open and distance learning system short term certificate or diploma courses in integrated medicine and surgical needs can be developed, while reaching out to more and more aspirants to meet the needs of our society. Besides, the format of the courses would allow us to open a vast network of study centres in hospitals and medical colleges and train a large number of manpower in much shorter time.

What can be the optimal structure of a regulatory body for bringing about proper quality and regulations in the medical education system in India?

As per the newspaper reports which says that the recent body of MCI (Medical Council of India) got dismantled, a new governing body of six members, who are eminent personalities in the field of medicine and medical education, has been constituted to take over the current functionalities of MCI as per the direction of the government. The body is also entitled to bring about the radical changes in the curriculum, modifying the course structure of the medical education in India, and overall addressing the issues related to the modernisation of the course to make it more community and student friendly. 

Open and distance learning has a vital role to play as it is more reachable and effective in much lesser time to a wider network of aspirants in the community.

Please highlight the journey and achievements of School of Health Sciences (SOHS), IGNOU ever since its inception.

Since the inception of the institution in 1992, the school has a BSc in Nursing programme approved by the National Council of Nursing, which is very successful and in demand right from its beginning. Courses in health sciences started much later in 1996 with the PGDMCH certificate courses and then moved onwards to subsequently develop the PG Diploma in Health and Hospital Management and then one year PG Diploma programme in Rural Surgery. This was an integrated course designed towards incorporating all the essential life and limb saving surgeries in rural hospitals in collaboration with Association of Rural Surgeons in India. But it did not run successfully as the programme was introduced after MS in General Surgery, MD in Obstetrics and Gynaecology (Obs & Gynea), MS in Orthopaedics or MS in ENT Surgery at PG level. Now we have realised that it should have been developed after MBBS so that the fresh graduates can become multi skilled surgeons and go back to rural areas, where at least 70% population lives and they urge for the life and limb saving surgery. After the almost failure of the first programme now we are planning to relaunch the programme after the MBBS course to make it successful. We have also introduced a six months programme in Biomedical waste management in association with WHO for South East Asian countries.  

How does SOHS aim to achieve the gap between the availability versus requirement of adequately skilled manpower in the health sector?

We are trying to address the needs of the people through the integrated short term special courses at the earliest. We are now looking forward for more and more enrollment in these programmes so that we can train maximum professional in minimum time period. Our next step is to open  maximum study centres in medical colleges and hospitals and train as much people as we can. It is not just for the rural areas but also for the semi urban areas besides the slum and shanty areas of capital towns and metros even.    

What are the new courses you are planning to introduce under the school?

We are trying to develop more innovative programmes that could meet the need of the hour. We are going to start a PG Diploma in HIV Medicine, PG Diploma in Diabetes, one year PG Programme in Dialysis Medicine, and Lifestyle Diseases. The Dialysis Medicine programme is really essential as the rate of the occurrence of the disease is increasing day by day. It is found that 200 persons per one lakh of population are affected annually in chronic renal infection and therefore, the failure of the organ. In the rural and suburban areas there is a dearth of enough kidney specialist that results in lack of proper diagnosis and treatment of the disease in time. We are now planing to increase the number of seats in the PG Diploma in Clinical Cardiology, while adding new study centres to the existing list as well. Besides, we are looking into developing courses more in Ayurveda and Acupuncture. Opportunities also lie in the areas of paramedical courses to train more and more skilled technical persons in medical domain. The demanding courses are BSc and MSc in Opthalmic Technology, BSc (Hons) in Medical Laboratory Technology, BSC (Hons) in Imaging Radiology besides having courses in managing medical records, acupuncture and many such related to health and hospital management. We also want to develop a web portal and create a network to mutually share information and contents about the developments and experiences of the medical professionals across India and also can update them on the developments at the other ends.  

How do you perceive the future of medical education in India, especially in the open and distance learning format?

If updated and modified with the reformation and the changes for the best, medical education in India has a very bright future ahead. In the process of advancement and modernisation, the format of open and distance learning has a vital role to play as it is more reachable and effective in much lesser time to a wider network of aspirants in the community. It will also enhance the opportunity in bridging the gap between the dire needs at the moment in the society and the medical domain in terms of higher numbers of healthcare professionals.  

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