Thread by @anilbhatortho

My perspectives on our #Indian #Postgraduate #education

Once upon a time was an era of multiple entrance exams, quota systems, paper leaks,obnoxious capitation fee etc which have been largely controlled with more transparent systems now. /1

I won’t deny that they don’t exist in their own mutant ways even now. But It’s much better than two decades ago.
Coming to the students per se, we know that internship has almost become a formality now except in few colleges./2

Very few institutions implement it well or, if there is a compulsion of manpower shortage, then interns are forced to work . Otherwise I know many colleges allow them to sign off n go for their PG prep . The fall out of this is seen when they join the post graduation. /3

Basically we get first year “interns” who are deficient in their patient care skills of routine procedures & also communication skills.We can’t blame them as the whole system is geared towards ‘getting a pg seat’. The next major deficiency is the duration of PG course in India /4

Most countries have a rigorous 6 year postgraduation programs which include foundation years & fellowship as part of training towards becoming a consultant. Here, we are officially eligible to become a “consultant”in 3 years. There is no structured program after 3 years. /5

With ever changing knowledge n technologies in many subjects , 3 years is too short a period to even get an complete overview of many subjects. However, all of us have come through this system & already there is enough frustration of medical edu being such a long drawn process /6

After passing the options are many : join as a senior resident, or a junior to a consultant, start your own practice, do a fellowship if you have an opportunity, a govt job or many myriad ways to start working . Hence the level of skill sets are completely different /7

What happens in the world arena is we are looked down upon for the inadequate training we get as PGs until a time when we start doing really well in our practice. This may take many years to achieve. It becomes an on job training rather than competency achieved practice / 8

Young pass out postgraduates run around in circles without good mentors and opportunities. Sometimes, they get caught in corporate culture very early to achieve success, make mistakes due to peer pressure and undergo early burn out in some cases /9

My above statements are based on being a teacher for the last 20 years & interacting with many postgraduates of mine , listening to their stories and travails . They may be different in someone else’s experience & I would be glad to hear out them / 10

Some solutions :
1. Internship needs to be overhauled to make it meaningful 2. Competency based curriculum for PGs with mentorship driven teaching.The effort has to be from both sides
3.Increase in postgraduate years based on world standards to be acceptably skilled /11

4. Foundation program for PGs to prepare them for soft skills & research can be added
5. Fellowship training can be centralised by a national body to give equal opportunities
Some of these might help in sending out a holistic“consultant” to serve the society in a better way /12

My above thread is borne out of frustration seeing many of my own students struggling so much in their initial years of practice and , the system we have in place which requires a major overhaul . It has happened for MBBS education. Hope it happens for post graduation too 🙏🏼 / 13

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