Secondary hospital rotation of postgraduate trainees: A pilot study

Abstract

Postgraduate (PG) training in general medicine requires reorientation to meet the healthcare needs of India. In this pilot study, we designed a secondary hospital (SH) posting for medicine PGs to sensitize them to the practice of medicine and challenges in a rural SH setting. PG trainees in general medicine were sent for a 2-week rotation to select SHs. A faculty coordinator from the teaching hospital facilitated the programme. The SH faculty used qualitative tools to assess the performance of the trainees. The trainees also evaluated the programme using open- and close-ended questionnaires. Eighteen PG trainees in general medicine were posted to six rural SHs. Data analysis showed that the training exposure provided sensitization to the challenges of medical practice in such settings and the need to be multicompetent. Seventeen (94%) trainees felt that they gained insight into the issues that are specific for practice at an SH and >80% expressed confidence about the knowledge and skills gained during that exposure to enhance medical practice in a resource-limited setting. They were also sensitized to various issues of secondary care including skills of multi-competence, the ability to handle a wide variety of cases with limited investigations, a cost-effective approach, decision-making on referrals, procedural competence and flexibility to adapt to new situations. A short SH posting can positively sensitize PGs to the practice of medicine and challenges in secondary care settings.