For the first time in 21 years, the Medical Council of India (MCI) has decided to update the curriculum for the MBBS course. It has been reported that the new syllabus will highlight certain aspects of doctor-patient interactions, focus on addressing mental health issues in patients and will include classes on ethics - all designed to help budding doctors understand various situations they may have to deal with when they start their practice. The revised syllabus is likely to be implemented from the next academic year, 2019.

What are these new changes to the course and why have they been brought in? TNM brings you a quick explainer.  

Ethics

While there are strict rules about maintaining confidentiality with patients, if that information regarding the patient could potentially harm someone else, is the doctor obliged to reveal the same? For example, if a patient is found to have HIV/AIDS, is the doctor ethically required to reveal this information to the patient’s partner? Or are they supposed to uphold patient-doctor confidentiality? These are some of the ethical dilemmas that the MCI’s new Attitude, Ethics, and Communication (AETCOM) course aims to tackle in-depth.

“While students are currently exposed to certain lessons in ethics, we feel that incorporating AETCOM into the medical syllabus will help them to better apply these skills in practice,” stated one official from the MCI.

Whether it is passing on sensitive information or maintaining patient-doctor confidentiality, the MCI plans on exposing students to a course in medical ethics to help them understand how to handle sensitive situations. The MCI also feels that this will help to facilitate and improve communication between patients and doctors.

Communication

Under AETCOM, students will also be given training on how to speak to and approach patients. Whether with regards to the treatment a patient may be receiving or any other issue, several medical educators feel that helping students improve their communication skills will help avoid issues and conflicts.

“(Students) will be trained to effectively communicate with patients and their relatives in a manner respectful of the patient’s preferences, values, beliefs, confidentiality, and privacy,” states the MCI’s new curriculum.

Mental Health

While it has been reported that an increasing number of people are turning to professionals for help to deal with their mental health, several students find themselves unable to handle several situations pertaining to the same.

“It is important that medical students learn to not only recognize symptoms of mental health issues but also about how to approach a patient who might be struggling with the same,” said UP-based psychiatrist Dr Akshay. He, along with many mental health professionals, feel that by exposing students early on in their careers to mental health issues and teach them how to recognize the same, it will help reduce stigma around mental healthcare.

In addition, since the last time the course curriculum was revised (21 years ago), several changes have taken place in the realm of mental health and students should be made aware of these changes. In the older curriculum, forensic studies listed homosexuality, adultery and several other terms under sexual offences, but these stances no longer hold true. The MCI feels it is important to acknowledge these changes and that the syllabus too, is updated to reflect the same.

Public Health

While the current medical curriculum ensures that students have some amount of exposure in the public healthcare sector, it remains a domain that still requires more focus. Rural outreach programs are limited to certain medical schools and several students take upon the same as an option. While students do take Preventive and Social Medicine (also known as Community Medicine) as a subject, the new curriculum aims to improve their public health knowledge and outreach. Furthermore, students will also be trained and given the skills to handle basic public healthcare issues and take preventive steps to address public health issues such as controlling the spread of communicable diseases.

Organ Donation

There still exists some amount of misinformation regarding organ donation and there has been little or no formal education given to medical students about how to broach the topic with the patients or the patient’s family and increase awareness. The new MBBS syllabus will include a subject where students will be taught about the benefits of organ donation and also guide them on how to speak to patients and their family members about organ donations.

“Students are seldom actively taught how to approach, much less counsel, the family members of a deceased patient, so it becomes that much more difficult to get family members to consider organ donation following the passing of a loved one,” explains physician Dr Swetha K from Chennai. “By including it in the curriculum and training students how to counsel people for organ donations, we are encouraging awareness about the same too.”