CHALLENGES AND ISSUES IN MEDICAL EDUCATION IN INDIA

Abstract

One of the largest in the world, the Indian medical education system produces several physicians who emigrate to the United States, the United Kingdom, and many other nations. Accordingly, the standard of these doctors has a wide global influence. Medical schools in India have proliferated exponentially in the last 25 years, doubling to a current number of 258 since 1980. The Medical Council of India (MCI) accreditation stresses facilities and resource documentation and does not provide self-study. The number of schools is decided by each state; the allocation of "payment seats" generating income in private medical schools, coupled with elevated emigration, which motivate an increase in the output of physicians. The selection of students is almost entirely based on entrance examination results, with a lower cutoff score for underrepresented minorities. For over 30 years, curriculum reform has been proposed, calling for the curriculum to be more important to the needs of the community.  Revised guidelines from the MCI in 1997 supported these changes. Under the aegis of medical schools in India, the internship year (the fifth year, based on rotating clinical experiences) has suffered from a lack of supervision and minimal assessment; it is also used primarily as a time to prepare for residency entrance exams. In addition to better faculty development initiatives, the authors advocate broader use of the in-depth accreditation process used by the National Accreditation and Evaluation Board, currently available to just 10 percent of medical schools, as well as curriculum improvements, student selection, and internship assessment.