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18.2.11

Experts question fusing basic subjects

Basic science subjects like anatomy, physiology and biochemistry are said to be the foundation of entire medical science and hence must be taught within the widest possible spectrum. Also these subjects should be given more duration compared to all others.

But the new Vision 2015 document of Medical Council of India ( MCI) is proposing not just cutting the teaching duration of these subjects in the first year by six months but also suggesting that they be taught through an integrated approach, both horizontal and vertical integration. Most medical teachers TOI spoke to see this suggestion as irrational and impractical.

Former dean and professor of orthopaedics at Government Medical College and Hospital Dr Vikram Marwah says that unless the students understand these subjects thoroughly they cannot be undergo higher teaching. "Unfortunately, we are squeezing these subjects. Reducing teaching or learning will serve no purpose. Until the students know the position and function of entire human body, how can you proceed further into special subjects? Human body is a complex machine and functions as system. If students don't understand the system in totality they will never be clear about basics of clinical medicine," he says.

Medical teachers say that horizontal integration is a good option but to some extent there is already scope for this in present form of teaching. Vertical expansion is, however, being opposed in almost all quarters. Dr Bhalchandra Murhar, professor and head of biochemistry, GMC Yavatmal, categorically states that purely integrated teaching is just not possible, especially in basic subjects. "There are some identified areas in anatomy, physiology and biochemistry which can be taught simultaneously. But a vertical integration model cannot be a replacement to the existing teaching pattern," he says.

Almost every teacher says that due to invariable delay in admission process which goes on till late September, students are already left with just about 6-8 months of teaching-learning process. "Vertical integration will make this completely irrelevant," said Prof A H Kale, head physiology, GMCH in city. "Even before the students get used to handling human body, understanding the working of different systems, they are pushed to higher subjects. Horizontal integration is already there," he adds.

Dr Meena Meshram, professor and anatomy head at GMCH, too has the same opinion. "I have not read the vision myself. But whatever I gather from my colleagues, vertical integration is a totally impractical idea," she said.

Dr P Dixit, president of Maharashtra State Medical Teachers Association, though says that integrated teaching will improve quality of medical education; he does not see much logic in the proposed format of integration. Vision 2015 proposes to give 80% importance to pre-clinical side and 20% to clinical side in the first year. This is apparently fine but the vertical integration will not work in second year MBBS with subjects like pathology, microbiology, pharmacy and forensic medicine. All these subjects, especially forensic medicine, are very vast and cannot be taught properly in new model, he adds.

Another form of integration being opposed by most teachers is the switching over of teaching of some subjects by teachers of other subjects. At present, forensic medicine is taught completely by the subject teacher. New vision proposes to shift some aspects like rape and sexual assault to gynaecology and physical injury to surgery.

"Gynaecology as well as surgery teachers are already overburdened with treatment of patients. Shifting additional responsibility on them would increase their load. It will also affect the medico legal quality of cases needing expert opinion," says Dr Manish Shirigiriwar, associate professor of forensic medicine at Indira Gandhi Government Medical College.
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