Need of Research Oriented Approach in Medical Education in India

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Mar 31, 2016 - little or no understanding of modern technologies for research. In ... in medicine and biomedicine into medical education and research to make ...
Asian Journal of Bio-Medical Research E-ISSN: 2454-6275

Editorial

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Need of Research Oriented Approach in Medical Education in India Submission: 05-03-2016

Revision: 16-03-2016

Unlike other countries, though India has successfully sent a spacecraft (Mangalyaan) to Mars in their first attempt. But the country still waits to produce any path-breaking research or acclaimed scientists for the last several decades. And it is presumed that India might not be able to produce one in the near future unless some rigorous changes in policies are implemented. Even though since independence, there has been drastic rise of expenditure fueled towards research and development in our country the figures shows that it was about 20 crores spent in 1960s which went to about 8500 crores in the year 2004. In the year 2014 approximately $40 billion representing about 0.9% of gross domestic product (GDP),1 which is though shortage of the Indian government target of 2% of GDP which was set in 2010, and further it is being spent in number of institutions. However the publication record has been rather disappointing. The number of scientific articles from India included in Science Citation Index fell from 14,983 in 1980 to 12,127 in 2000.2 The Medical Research is in worse shape. Even though it is considered as an integral part of Medical education, it gets the lowest priority in budget allocation and in national agenda regarding the importance of Medical Research.3 As per the detailed ICMR survey reports, the number of scientific articles published by the educational institutions from the period of 1990–1994, has dropped down and almost 20–30 % of Medical education institutions could not even publish a single article accounting to the decline in scientific articles.4 The situation has been very alarming as the number of new medical college have been increasing dramatically without keeping the set goals of Medical research in their respective institutions. The infrastructure for conducting research has been given the least priority in most of the medical colleges.

Publication: 31-03-2016

number of medical colleges has increased but the quality of medical education has seriously suffered a setback. There is a gross shortage of resources, both finances and trained skill manpower. In most of the medical colleges, even the minimum supportive laboratory infrastructure is lacking, thus the students are barely exposed to the expanding areas of medicine and biomedicine with little or no understanding of modern technologies for research. In such atmosphere most of the medical teachers lack the confidence in writing research proposals and project/s, though the funding agencies have major programs for medical sciences, they are virtually very few who obtain research grants. Way back from the Bhore committee (1943), strategies have been adopted to improve the health manpower development with special emphasis in the service sector,6 hardly any attention has been paid to develop medical research. No special task force has been commissioned to address the critical issue of integrating the outcome of advances in medicine and biomedicine into medical education and research to make the students globally competitive. With the pro-active activities of ICMR, there are several indicators to show that there is a bright future of Medical Research and Medicine continues to attract the best brains across India.

There are number of reasons which can explain the poor state of medical research in India. When we look back at the time of independence (1947), India has just countable number of medical colleges and the number of students embarking to medical education was also very less. Now seventy years later we find the number of medical colleges have come up like a mushroom growth and the numbers have increased almost 20 folds, adding to it the annual intake of students in medical college across India.

ICMR promotes biomedical research in the country through intramural (by its own institutes) and extramural (grants given to projects to non-ICMR institutes through non-biased transparent rigorous review process). The extramural research grants also supports in setting up centers for advanced research in different research areas around existing expertise and infrastructure in selected departments of Medical colleges and Universities. The area of thrust in the area of research related to Bio-Medical importance includes nanomedicine, stem cell, oncogenes, immunogenetics, Rec-DNA technology, etc. ICMR also raises human resource development for biomedical research via Research fellowship (Junior and senior research fellowships and research associateships, short-term visiting fellowship, short term research studentships, travel grants for participation in conference abroad. These ventures by ICMR inculcate, familiarize and raise awareness of importance of research in Medical colleges and Universities. The students are benefitted as they familiarize themselves with research methodologies and techniques.

As per the report of the Steering Committee on health for the 12th five-year plan (2012–2017), currently India produces 30,000 doctors, 18,000 specialists, 30,000 AYUSH graduates, 54,000 nurses, 15,000 ANMs and 36,000 pharmacists annually.5 There are 355 medical colleges in India and mostly concentrated in four states 41.69% (148/355) of Andhra Pradesh, Karnataka, Kerala and Tamilnadu. Of 44,300 annual admissions of medical students 19,410 students are admitted in the colleges of these four states. Nevertheless we find the

There is also an initiative by ICMR on re-printingas an anthology of ‘Citation Classics’- the already published scientific article acclaimed by ICMR, as a tribute to the authors who created new knowledge for improving our understanding about many areas of human health, most relevant to the people of India. This move from ICMR have given impact to Medical research and have developed the culture and motivation of establishing a research laboratory in their very own institutes and design good research proposal.

Asian Journal of Bio-Medical Research  |  Jan-Mar 2016  |  Vol 2  |  Issue 1

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Arun Kumar, Editorial

Now it is the time to rethink and make research training as an integral part of MBBS curriculum by introducing a short duration research training program as a part of MBBS syllabus. Ideally this research training should be conducted once the students begin their internship phase so that they do not face additional burden and stress during their regular professional examination. Furthermore, those who are really interested in research can get benefitted. As in foreign Universities, where there is an integrated MD/ PhD programme which is offered by more than hundred of medical schools in USA, similar curriculum should be adopted in India too. Though it has some promising results but still has a long way to go. MD/PhD course is about three to four years additional incubation period compared to MD course. The implications would be losing seniority and promotions as the recruitment is at the lowest level of the ladder and promotion is mostly by seniority. So it all depends on the mind set of students whether they would be willing to pursue this integrated MD-PhD course. Secondly, they would remain junior to their batch-mates. The other vital issue is lack of resources to conduct high class research. But there are well- equipped and abundant funded institutes such as AIIMS, New Delhi and CMC, Vellore to provide a platform for the young aspirants who are highly motivated in the field of scientific research. Also the medical colleges located in and around the life sciences research Institutes like Indian Institute of Science Bangalore, National Institute of Nutrition Hyderabad, Bose Institute Kolkata, Central food technological research institute Mysore, Central drug research institute Lucknow, etc can join hands with the medical colleges for collaborative research with faculty exchange programs. This would create interest among medical students, the importance of research and would drive them forward to initiate with some good research proposals.

Though it might take several years to establish the research oriented educational programs for both undergraduate and post graduate levels in Indian medical schools, nevertheless government should initiate some short term crash courses frequently at the state and national level to ignite the zeal of research amongst the students. Though seven decades after independence, medical research, still remains in words with not much action. If we have to emerge as a global leader than we must emphasize on indigenous generation of new concept and knowledge rather than importing thought process from the research based on abroad. The challenges are many but the special task force must act with new strategies for implementing research and generation of thoughts process among our youngsters. Since we are moving in twenty-first century, the time to act is now.

Dr. Arun Kumar Editor in Chief, Asian J Bio-Medical Research Professor and Head, Department of Biochemistry Coordinator, Medical Education Unit Gouri Devi Institute of Medical Sciences and Hospital G.T.Road, Rajbandh, Durgapur, India, Pin- 713212 [email protected]

Dibyendu Gangopadhyay Department of Microbiology Member, Medical Education Unit Gouri Devi Institute of Medical Sciences and Hospital G.T.Road, Rajbandh, Durgapur, India, Pin- 713212 [email protected]

In India, there are several funding agencies Department of Science and Technology (DST), Department of Atomic Energy (DAE), Department of Biotechnology (DBT), Opportunities for Young scientists, Indian Council of Medical Research (ICMR), Research Promotion Scheme, Defence Research Development Organization (DRDO), Indian National Science Academy (INSA), etc which releases grants for research.

References

There are special efforts been taken to strengthen research training at MD/MS level. Students have to undergo rigorous clinical training along with the write up of their thesis /dissertation as an essential component of the course. Unfortunately, majority of the MD/MS thesis are of poor quality, most based comparative and hospital based investigative studies.

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To improve the quality of research, steps like introduction of compulsory research training courses as a part of MD/MS course with a free access to the laboratory of the research institutes. There should be implementation of schemes such as ‘No Promotion without Research’, ‘Publish or Perish’. This would drive the senior faculties to embark into research projects and establishment of research laboratories in their very own medical college and it would pave way for the junior faculties and students further by creating an ambience for doing research. Also at regular period of time, there should be regular workshops on research methodologies, data interpretation/ analysis, Scientific writing arranged by in-house expertise or invited resources.

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https://www.cia.gov/library/publications/the-world-factbook/fields/2116.html Jayaraman KS. India’s scientists agonize over fall in publication rate. Nature 2002;419:100 doi:10.1038/419100b Deo M G. Undergraduate medical students’ research in India. J Postgrad Med 2008; 54:176-179. http://www.scribd.com/doc/121081283/Financing-and-Delivery-of-HealthServices-NCMCH#scribd http://planningcommission.nic.in/aboutus/committee/strgrp12/str_ health0203.pdf Roy S and Nandan D. Development towards achieving health/Reproductive health for all and millennium development goals: A critical appraisal for strengthening action Programmes (Part I). Health and Population Perspectives and Issues 2007;30(2):71-93.

URN: pmi:jr:0019ajbr.v2i1.9646 How to Cite this Article: Kumar, Arun; Gangopadhyay, Dibyendu. Need of Research Oriented Approach in Medical Education in India. Asian Journal of Bio-Medical Research (ISSN:2454-6275), [S.l.], v. 2, n. 1, mar. 2016. ISSN 2454-6275. Available at: .

Author Contribution:  AK - Manuscript preparation, review of literature and final approval DG - Manuscript editing Source of Support:  Nil; Conflict of Interest:  None declared.

Asian Journal of Bio-Medical Research  |  Jan-Mar 2016  |  Vol 2  |  Issue 1