Expanding medical education

WHILE engineering colleges are in the news at the start of every academic year, a quiet transformation is taking place in medical education in the State thanks to Tamil Nadu Dr M.G.R. Medical University. The university has revamped the curriculum for various courses and has changed the examination pattern that was prevalent since 1965. It has introduced not only post-postgraduate courses in sub-specialities such as Palliative Medicine, Breast Diseases, Vitreoretinal Surgery, Oncoradiology, Critical Care in Cardiology, Reconstructive Microsurgery and Burns but also BSc courses in a variety of subjects. We are looking at what the requirement of specialists in sub-specialities will be after 10 years. We have formalised the post-postgraduate sub-specialities. These are one- or two-year courses, Dr Mayil Vahanan Natarajan, the university's Vice-Chancellor, said.

Essentially, these are clinical fellowship programmes in specialities such as medicine, surgery, surgical gastroenterology, cardiothoracic surgery, obstetrics and gynaecology, neurosurgery, ophthalmology, anaesthesia and paediatrics. The eligibility criterion for the courses will be a Doctor of Medicine (MD), Doctorate in Medicine (DM), Master of Chirurgical (MCh), and Diplomate of National Board (DNB) (the degree awarded by the National Board of Medical Examinations).

The university offers BSc degrees in Accident and Emergency Care Technology, Medical Record Science, Dialysis Technology, Cardiac Technology, Radiotherapy Technology, Nuclear Medicine Technology, and so on. These courses will be taught in select hospitals, but the university will frame the syllabus and conduct the examinations.

Until now, our curriculum was a knowledge-based one. We are now moving to a curriculum based on skill, competence and attitude, the Vice-Chancellor said. In the earlier examination pattern, medicos did one long case and three short cases. Under the new curriculum, they have to perform five medical cases. The university has introduced objective structured clinical examination, a model used in health sciences all over the world.

Mayil Vahanan has an MCh in Orthopaedics from Liverpool University, United Kingdom. He spent 36 years in Madras Medical College (MMC) as student, doctor and teacher. He is a Fellow of the Royal College of Surgeons, England. At the MMC, he established a bone bank, an orthopaedic skills laboratory and orthopaedic implant laboratory.

The university has jurisdiction over 380 colleges in the State. In all 27 medical colleges, 18 dental colleges, 128 nursing colleges, 37 pharmacy colleges, 38 physiotherapy institutes and a number of other institutions are affiliated to it. The university admits 21,702 students every year to 1,653 MMB seats in 17 government medical colleges, 85 seats in one government dental college (in Chennai) and 891 seats in 17 self-financing dental colleges.

For the first time, we have introduced the concept of hospitals becoming colleges, Mayil Vahanan said. We frame the syllabus and ask the hospitals to apply for teaching these courses. We inspect the hospitals and permit them to start the courses.

Diploma courses have been introduced in Operation Theatre and Anaesthesia Technology, Accident and Emergency Care Technology, Optometry Technology, Radiology and Imaging Technology, Nursing Aide and Dental Assistance. Those who have passed class X can study these courses in select hospitals.

Postgraduate diploma courses (eligibility is MBBS) are now available in HIV Medicine, Palliative Medicine, Occupational Health, Clinical Immunology, Medical Genetics, Clinical Diabetology, Critical Care in Medicine, Diagnostic Ultrasound and Clinical Laboratory Medicine. Other PG diplomas are in Public Health Entomology, Learning Disability and Diabetes Education. A diploma course in family medicine, through distance education, has been introduced. Four-year BSc courses have been started in Audiology and Speech Language Pathology, Optometry Technology, and Prosthetics and Orthotics.

The university is offering MBA (Hospitals and Health Systems Management), MSc in Medical Sociology, Medical Laboratory Technology, Human Genetics and Clinical Nutrition and a three-year MSc in Medical Physics.

Mayil Vahanan defended the State government's decision to start a medical college in every district. If tertiary medical care is to reach the common man in rural areas, a medical college has to be started in every district, he said.

T.S. Subramanian