Indian Medical Graduate Research Articles

Mediation effect of sleep quality and internet addiction on depression among indian medical graduate students: A cross-sectional study

Introduction: There is a complex interaction between poor sleep quality, Internet addiction (IA), and depression. This study aimed to determine whether sleep quality or IA statistically mediates the association between the other two variables. Materials and Methods: This cross-sectional study was conducted from June 2022 to October 2022 in a medical college in Ajmer, Rajasthan. Data were collected from 400 undergraduate medical students. Data were collected using Depression, Anxiety, and Stress Scale-21, Pittsburgh Sleep Quality Index, and Young's IA tools. Data were analyzed by multivariate logistic regression and the PROCESS program in SPSS 20.0. Results: The mean (standard deviation) age of the students was 20.9 (1.68) years. About 43% of students (n = 174) had depression, 40.3% (n = 161) had poor sleep, and 54% (n = 216) had IA. The age of the students (adjusted odds ratio [aOR] = 1.92), screen time per day (aOR = 1.06), smoking (aOR = 13.20), sleep quality (aOR = 1.16), and IA (aOR = 11.64) were significantly associated with depression. IA mediated 30.55% of the indirect effect of sleep quality on depression, whereas sleep quality mediated 18.18% of the indirect effect of IA on depression. Conclusion: Sleep quality and IA have a differential independent indirect effect on the association between depression and the other variable. Programs and counseling sessions that promote mental health should also address the adverse impact of poor sleep and IA.

Perception of 2nd-year MBBS students for new competency-based curriculum of the Indian medical graduate program

Background: Medical education in India has undergone significant shift recently with the implementation of competency-based medical education (CBME) in August 2019. The results of this study can be a valuable input to the National Medical Commission for curriculum development. Aims and Objectives: The objective of this study was to understand the level of awareness of CBME among students, know their satisfaction with the new learning methods, and get their suggestions. Materials and Methods: A pre-validated questionnaire with ten yes/no questions, eight 5-point Likert scale questions, and seven open-ended questions was used to capture students’ perspectives on CBME. Results: Overall, the students had a positive response. The study also highlights some areas of concern, such as the lack of early clinical exposure experienced by some students and the relatively low participation in reflective writing. Many students considered logbook as a burden as they could not understand its aim. Management of supplementary batches requires reconsiderations. There are differences in opinion about the optimal duration of the phases of MBBS course. Conclusion: Students find the curriculum helpful in their learning and development. The findings suggest that the new curriculum is on the right track, but that there are some areas that need to be improved.

A study to assess students’ performance in theory and practical components of final summative pharmacology examination in Non-CBME and CBME curriculum

Background: Competency-based medical education (CBME) has transformed the MBBS curriculum and aims to emphasize the five roles of an Indian medical graduates: clinician, leader, communicator, life-long learner, and professional. Accordingly, various changes have been made in the curriculum and assessment of Phase II students in pharmacology since 2019. The scores in the theory component have changed from 110 to 200, and those in the practical component have changed from 40 to 100. Aims and Objectives: To assess performance of students in the theory and practical components of the final summative pharmacology examination under the CBME curriculum (Batch 2019–20) with the earlier non-CBME curriculum (Batch 2018–19). Materials and Methods: A record-based observational study was conducted at a medical college in Kolkata. The percentage of marks obtained by students in theory and practical components in the CBME batch and in the non-CBME batch (inter-batch comparison) were compared by using an unpaired Student’s t-test. Further scores in theory and practical components were also compared for each batch (intra-batch comparison). Results: Average marks obtained by the students of the non-CBME batch (n = 250) and CBME batch (n = 242) in the theory exam were 64.36% ± 6.14 and 63.69% ± 6.77, and in the practical exam they were 71.51% ± 8.58 and 71.04% ± 6.54, respectively. There is no statistically significant difference in the theory and practical components between non-CBME and CBME batches. The performance in the practical examination compared to the theory examination was significantly better in both the non-CBME and CBME batches (P < 0.001). Conclusion: Major changes and modifications have been made in the curriculum due to the incorporation of CBME. Over the years, more data can be generated on students’ ability to adapt to the CBME curriculum and improve their learning.

Teaching should be preferred over research in peripheral medical institutions

The main purpose of medical education is to ensure that medical students acquire sufficient knowledge, skills, and professional efficiency that prepares them to provide good health education, and good health care or enhance existing medical knowledge, depending on the aptitude and conditions available to them in the future. This entails proficiency both in teaching and research. The teaching enhances the development of students while research advances new knowledge. Therefore, linking teaching and research is essential to both teachers and students. There are many ways of linking research to teaching; the most important of these is to set specific teaching and research goals. However, the problem comes when some teachers have no inclination or may not have time to do research due to a poor teacher–student ratio. Most of the peripheral medical colleges have a very poor teacher–student ratio as compared to one that was recommended by the Mudalier Committee in 1962.[1,2] Therefore, research should not be forced to teachers, particularly if they do not have any aptitude for it or they do not have time to pursue such activities. Contrary to this, if they have a good interest and aptitude for teaching, students taught by them excel in all fields of their later life such as teaching, patient care, research, and interpersonal relationship. Recently, the National Medical Council of India has recommended an introductory course in medical education technology[3–5] and basic research in biomedical research as mandatory for promotion. Not only that, this body has also made it mandatory that one should also publish a requisite number of research articles in indexed journals for their promotion.[6] For this reason, teachers who were already under pressure to complete the course were forced to do research, on the cost of teaching. As a result, the quality of producing good Indian Medical Graduates is defeated. Not only that, forced research has adulterated the already existing good scientific data with false-positive results. Not only that, the number of predatory scientific journals has started worldwide purely for business purposes. They started charging exorbitantly, and poor teachers have no option but to pay it. To conclude, teaching and patient care should be given more weightage over research, particularly in peripheral medical colleges, for the following reasons: Teacher–student ratio is very poor, institutions are not well equipped with research facilities, all teachers are forced to do research whether they have an aptitude for it or not. As a result, medical teaching and patient care are on a decline.

Competency-based medical education for Indian Medical Graduates: where do we stand?

Competency-based medical education for Indian Medical Graduates: where do we stand?

IMPOSTOR PHENOMENON AND IT'S ASSOCIATION WITH MENTAL WELLBEING OF INDIAN MEDICAL GRADUATES OF INDIA.

The impostor phenomenon is a condition where a person despite of being competent doubt his or her own capabilities. This condition can be seen in any stage of life however it is very commonly seen among the students who are in the active phase of learning and study there are various social demographic and psychological factors associated with it. It has been seen that impostor phenomena is more commonly seen in females as compare to the males and also affect their mental well-being in the long run. A person with impostor phenomenon can never accept the fact how competent he or she is and will always think whatever they have achieved is because of luck or some supernatural forces. This study has been devised to focus on prevalence of impostor phenomenon among medical students of academic year 2019 and 2018 and to know about its association with their mental well-being. With the development of new research modalities and ever expanding medical science, medical students in a developing country like India are under a constant pressure to somehow complete their syllabus, get updated with new advancements and meet the expectations ,the modern society has for the doctors. This greatly affect their psychological and psychiatric well-being trapping them into a vicious cycle of depression, anxiety and stress. Having frequent experiences of impostor phenomenon predisposes or makes a person more vulnerable to conditions like stated above. The aim of our study is to assess the impostor phenomena in the nal and pre-nal year medical student in north-western India and correlating it with their mental well-being based upon an assessment for depression, Anxiety and stress.

A Critical Appraisal of the New Competency-Based Medical Undergraduate Curriculum in Biochemistry.

The online version contains supplementary material available at 10.1007/s12291-022-01088-y.

Learning Circle Communities- An Experience with Medical Postgraduates

Online Communities of Practice (OCoP) or Learning Circle Communities, especially amid pandemics have a significant role to play in professional development. One of the long–term goal of Indian medical Graduate is lifelong learning, so oCoP is an opportunity to shape professional’s attitudes and behavior and also to increase efficiency at work. For this, improving collaboration with colleagues by increasing the interpersonal connections is of utmost importance. Etienne Wenger defines Communities of Practice as “Group of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. Membership therefore implies a commitment to the domain, and therefore a shared competence that distinguishes members from other people. They value their collective competence and learn from each other. In pursuing their interest in their domain, members engage in joint activities and discussion, help each other, and share information.

Increase in the Number of MBBS Seats through the Scheme of One Medical College per District

India currently hosts the largest medical education system in the world with 650 medical colleges and 98613 MBBS (undergraduate) training seats. The reasons for Indian Medical Graduate's international migration and internal distribution within India have been multifactorial. There are push factors (with India) as well as pull factors (international host countries). Almost the same reasons are implied to the distribution and availability of the medical workforce geographically within India. To address the regional disparities in medical education and the availability of human resources in health, the policy of establishing one medical college in each district in India was initiated. Impressive progress has been achieved so far. However, the policymakers must look at it critically to be able to steer this project towards meeting the public health objectives of the country in the coming century. The discussion must include arguments on the type of doctor India needs. Indian can no longer afford the policy of having many cardiologists as compared to miniscule number of trained family physicians. All specialist system is being perused at the cost of a generalist health system. This paper critically looks at the district medical college scheme and exponential growth in the number of medical seats in India. Statistical success alone cannot address the public health needs and medical care of the Indian population. The creation of the National Medical Commission (NMC) has eased the criteria for recognition of new medical colleges; however, several limitations of the Medical Council of India are being carried forward within the functioning of NMC. Unless, there is a focus on creating employment and retaining medical graduates within the health system, it is worthless producing millions of them.

A Comparative Study of Case-Based Learning vs. Traditional Teaching Method in Pathology in Indian Medical Graduates

Background: There has been a substantial shift in the educational curriculum in Indian medical institutes with a more experiential approach toward teaching. One such method is case-based learning (CBL). Objectives: This study aimed to compare CBL with traditional method and gain students’ and teachers’ feedback. Methods: This was a cross-sectional study conducted in the Pathology Department among second-year bachelor of medicine and bachelor of surgery (MBBS) students. The students were divided into two groups of 75 students: group A was given anemia cases, and group B was given jaundice cases. After covering theory lectures on these topics, the students were given pre-test multiple-choice questions (MCQs). This was followed by this was followed by subdividing students into five groups and conducting three CBL sessions. This was followed by post-CBL test. Data were compared using paired t-test and analyzed using SPSS software version 16. Results: Out of 150, 110 students attended the pre-and post-CBL test and completed the feedback form. There was a significant improvement (P < 0.001) in the mean scores of students in both groups A and B from 8.31 and 7.54 to 13.44 and 12.71, respectively. Regarding the student feedback, it was revealed that 87% of the students agreed with the usefulness of CBL in better understanding of the topic and retention in memory. They also acclaimed that it encouraged their critical thinking and decision-making qualities. Among the faculties, all of them agreed with the incorporation of CBL in the routine curriculum. Conclusions: CBL improves students’ logical, analytical and clinical skills, which helps bridge the gap between theoretical knowledge and clinical skills. Rather than replacing, it serves better as an adjunct to the traditional lectures.

National exit test: The medical faculty perspective—A pilot study

Background Implementation of the exit examination for medical graduates in India has been debated for many years. The national exit test (NEXT), under the construct of the National Medical Commission Act, would serve two purposes: first, it will be a common exit/licentiate examination for all Indian medical graduates, and second, it will be a test for postgraduate selections for all specialties. There has been no research or evidence on stakeholders’ opinion on this test. We aimed to assess the perspective of medical faculties, nationwide, regarding the implementation of NEXT. Methods We conducted a nationwide, cross-sectional, questionnaire-based pilot survey. The Google survey form with close- and open-ended questions was forwarded via email and WhatsApp to various groups. Results Two hundred and forty-five medical teachers participated, of which 35.9% were from Gujarat, 44.9% were working in government colleges, 91.43% had MD/MS as the highest professional degree, 50% had >15 years of experience and were from different medical specialties. The majority felt that the NEXT examination was a positive step, 82.5% suggested that a national selection/testing authority should conduct it, 36.3% suggested having the test after internship while 32.7% expected some weightage for each year of the medical programme, and 84.1% agreed that all the learning domains should be assessed by various strategies. Discussion Faculties welcomed the NEXT examination under a national testing authority. The necessity of this examination is to have uniform standards and quality for medical graduates irrespective of their institutes. Assessment of all the domains will make the Indian medical graduate more competent for the job or residency programmes.

Foundation course – A fundamental requirement for Indian medical graduates as per graduate medical regulations

A foundation course for newly joined Indian medical graduates is essential for their induction into the medical profession. They learn about various soft skills and other nuances, which will help them adapt to the new professional learning environment. In our institute, the course is conducted based on the Graduate Medical Education Regulations of the National Medical Commission (NMC) of 2019. The process of organization, planning, and execution of the foundation course is described in a step-wise manner. The student activities are planned in various large groups and small groups under each module put forth by the NMC. The modules include the orientation module, skills module, field visit to community health center module, professional development and ethics module, enhancement of language and computer skills module, and sports and extra-curricular activities module.

A narrative review on the experience of “Family Adoption Programme” in a tertiary care institute

Family Adoption Programme (FAP) aims to provide an experiential learning opportunity to Indian medical graduates towards community-based health care and thereby equity in health. FAP is recommended as a part of curriculum of Community Medicine subject and should begin from first professional year with competencies being spread in ascending manner for entire MBBS training program. The family adoption should preferably include villages not covered under PHCs/RHTC adopted by the medical college. Medical students may be divided into teams and each team may be allotted visits with five families per student. A brief sensitization session on the needs and competencies of Family Adoption Programme (FAP) as recommended by the National Medical Council of India was conducted which was followed by sensitization of the students to the FAP document prepared by the department along with hands on practice. Then the students along with their team members visited nearby three villages (Tenmathur, Endal and Kolakudi) for their first family adoption visit. During the visit, they interacted with the family and details were documented, the mentors refined the corrections of the document, and then the students were made to present their families in the power point presentation with their reflective experience of the first family adoption programme visit.

Implementation of Self-Directed Learning in Physiology for Phase 1 Undergraduate Medical Students.

One of the primary roles played by Indian medical graduates is that of a lifelong learner. To this end, students must acquire the habit of self-directed learning (SDL). Lack of SDL skills among undergraduate medical students is a concern; hence, this study was designed to introduce SDL in physiology to phase 1 undergraduate medical students and assess its effectiveness through student and faculty perceptions. The project commenced after obtaining clearance from the institutional ethics committee. The faculty members and students were sensitized on SDL. A feedback questionnaire was framed and the topics for SDL were selected. SDL was implemented for six topics. The effectiveness of the sessions was evaluated by administering the feedback questionnaire to the students and recording perceptions of the students and faculty on SDL. The data were subjected to quantitative and qualitative analysis. A total of 96 phase 1 students participated in the study. A majority of the students felt that after SDL sessions, they were more prepared and aware of their learning strengths and had started taking ownership of their learning. However, some students felt that the activity was not useful in improving their analytical skills. Both the students and the faculty were fairly satisfied with this teaching learning innovation. SDL was successfully implemented for phase 1 medical students. Both the students and faculty were satisfied with the SDL strategy. SDL has been shown to make students independent learners who are aware of their learning goals and capable of evaluating their learning.

Competency-Based Medical Education for The Indian Medical Graduate: Implementation & Assessment in Ophthalmology

Competency-based medical education (CBME) curriculum has been implemented by National Medical Council from 2019 for the Indian Medical Graduates (IMG). This competency-based curriculum focuses on skill acquisition with incorporation of soft skills related to attitude, communication and ethics. Widespread adoption of a competency-based approach would mean a paradigm shift in the current approach to medical education.

Web-Based Educational Resources for Indian Medical Graduates

Background: Nowadays, students have a vast knowledge of multimedia. Social media is an online platform that allows community building through collaboration. Objectives: The present study aimed to understand the use of web-based resources for educational purposes by medical students. Methods: This cross-sectional survey was conducted for three months on the students, interns, and residents of a tertiary care hospital and Government Medical College, Surat, India. Informed consent was taken from the participants, and a pre-approved questionnaire was delivered to all of them for data collection. The data were entered using the Google spreadsheet and were expressed using descriptive statistics. Results: Out of the study population consisting of 900 individuals, 646 filled the questionnaires and were finally evaluated. Out of 646, 430 individuals were medical students, 335 were female, and 303 were male. The majority (91.9%) of the responders were exposed to computer education in their schools. We found that 549 (86.4%) people were aware of the free internet access provided to them in the college library. Almost 97% (617) of the responders had mobile phones with internet access, and 80.1% connected to the internet more than once a day. The results of this study showed that 94.4% of the participants accepted that they used internet-based media to enhance their academic knowledge, while 66.5% agreed that internet resources are giving much unreliable information. Moreover, 55.8% of the responders were associated with the academic e-learning groups. Only 55 (8.7%) respondents had received formal training for online literature search. Conclusions: The emergence of various social media applications and web-based resources provides us with more collaborative approaches to medical education. However, implementing new technologies also creates new challenges and opportunities for students and faculties. Training concerning internet search and web-based resources is important to enhance their e-learning skills.

Preparing future Indian medical graduates for emergencies at the Foundation Course: Do the knowledge and self-confidence increase after basic cardiac life support training?

ABSTRACTBackground and Aims:Medical professionals must be able to perform life-saving skills like cardiopulmonary resuscitation (CPR) during emergency situations, even outside the hospital. The foundation course for the first-year medical students includes first aid and CPR training. This quasi-experimental study was conducted to assess the effectiveness of basic cardiac life support (BCLS) training based on Indian guidelines, on the self-confidence and knowledge regarding CPR of first-year medical students.Methods:This study was conducted during the foundation course for first-year medical students. The training included a common lecture for all the students followed by a 4 day long practical training in groups of 45–46 students, each day. BCLS training was carried out in three skill stations – airway, chest compressions and full sequence CPR. Students’ skills were recorded real time on a skill assessment manikin after completion of the hands-on training. The students were asked to fill a questionnaire regarding knowledge and self-confidence, before and after the training. The outcome measures were the difference in knowledge and self-confidence with regard to CPR before and after the training.Results:Out of the 199 students, 181 were included in the analysis. There was significant improvement in the knowledge score (pre-test – 1.46 versus post-test – 8.27, P < 0.001). The overall confidence regarding first aid skills, BCLS knowledge and self-confidence for performing BCLS improved significantly.Conclusion:There is improvement in knowledge and self-confidence regarding CPR and the students develop an acceptable level of skills after the training.

Competency Based Medical Education: An Overview and Application in Pathology

Introduction: The Competency-based curriculum is the turning point in medical education and holds much potential in the current trends of medical transformation in India. It provides an outcome-based approach with the integration of knowledge, skills, attitude, values, and ethics. In comparison to the older curriculum, it differs in clarity, cohesion and has a comprehensive approach.&#x0D; Methods: The study aims to discuss and evaluate in detail the process and establishment of a competency-based medical curriculum in the pathology department and highlights the ups and downs of the experience. It was set up following the guidelines provided by NMC under competency-based undergraduate curriculum for the Indian medical graduate, state university guidelines references from the internet, and peer review from other institutions.&#x0D; Results: The new curriculum has bought many positive changes and requires a radical change in the approach of faculty, institution, and students.&#x0D; Discussion: General preparedness, outgoing and flexible attitude, consistency, and long-term commitment to a transformation from being a facilitator will be the prime needs to make the new “Indian medical graduate.”

The Concept of Self-Directed Learning: Implications for Practice in the Undergraduate Curriculum

Self-directed learning (SDL) is a modality where learners are expected to take responsibility for their own learning, diagnose gaps in their learning, frame their own goals and resources for learning, implement appropriate learning strategies and evaluate learning outcomes. Flexibility and creativity in designing assignments for students to work individually or collaboratively are the keys to promoting SDL. The recent competency-based curriculum document from the National Medical Commission does not elaborate the concept or implementation of SDL, leaving it open to individual interpretation. We, herein, discuss the concept of SDL, address common misconceptions surrounding SDL, and elucidate strategies by which SDL skills can be inculcated in medical students using pre-existing opportunities in the curriculum. Flipped classrooms, reciprocal teaching, technology-enhanced methods, problem-based learning, and group projects are excellent ways of promoting SDL. SDL requires efforts and policies both at the teachers' level and at the institutional level; and is an important input to achieve the goal of being a lifelong learner by the Indian medical graduate.

Competency-based Medical Education curriculum for Indian Medical Graduates, will Really be Impactful?

Competency-based Medical Education curriculum for Indian Medical Graduates, will Really be Impactful?