Reorienting Medical Education in India - Absolutely Essential

摘要

SIR, — The whole objective of expansion of PG program in India should focus on achieving the final objective of MBBS seats= PG seats. We have now 80,000MBBS seats, and the available PG seats now is only 25,000. Remaining 55000 MBBS doctors can be transformed into family doctors every year starting from 2025 onwards, if we start acting now. The long-term objective must be to get 80% of all doctors working as family doctors. Increasing the number of other specialists without building a strong base for modern medicine, and without a referral system is the root cause of all unhealthy trends in India, including bridge course and the hurry to train doctors of other stream in surgery. Background and the Issues : Heavy disease burden (due to lack of social determinants of health and wellness) and lack of good primary care in the periphery overloads the existing treatment facilities. There is no one to supervise and take charge of health and wellness scientifically and to make early diagnosis and provide decentralized disease care management. Since all patients are forced to go to tertiary care, even for their primary care, and are forced to engage multiple doctors belonging to single system specialties- without person centered care, there is a huge artificially increased need for more and more single system specialists and emergency medicine specialists. Thus, we wrongly perceive the need for more specialist doctors and more medical colleges. In reality we have enough doctors, enough MBBS seats, but we failed to produce doctors for our country, by mistake they were all being transformed only into single system specialists, ignoring all the priorities including family medicine. Specialist doctors in turn promote the centralized disease care machinery.