lmproving the delivery of medical education in rural medical colleges

Saurabh RamBihariLal SHRIVASTAVA,Prateek Saurabh SHRIVASTAVA

Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

ABSTRACT

It is a fact that in most of the rural settings, especially in low- and middle-income nations, the access to health care services and facilities is quite difficult. The primary reason for origin of this problem lies in the fact that a major proportion of medical professionals are not willing to serve in rural areas. This is in turn can be linked with the obvious geographical disparity in distribution of medical colleges in both rural and urban settings,with most of them being present in urban locations. In order to accomplish the vision to create a cadre of competent medical professionals,who are fit to work in the capacity of a primary health care physician, it is an indispensable requirement to sensitize and give adequate number of learning experiences pertaining to rural medical education. The process of planning and execution of rural medical education needs careful and systematic consideration, otherwise we will find ourselves short in achieving the intended learning outcomes. To conclude, rural medical education is an important aspect of the medical training. It is high time that all the stakeholders join their hands and work together to improve the competence level of medical students and play our part in the making of a community health physician.

Keywords: Curriculum, medical education, rural

INTRODUCTION

It is a fact that in most of the rural settings, especially in low- and middle-income nations, the access to health care services and facilities is quite difficult. In fact, the rural segments of population are exposed to multiple challenges and barriers to avail health care in contrast to the people living in urban areas. The primary reason for origin of this problem lies in the fact that a major proportion of medical professionals are not willing to serve in rural areas.[1]This is in turn can be linked with the obvious geographical disparity in distribution of medical colleges in both rural and urban settings, with most of them being present in urban locations. The presence of medical colleges in urban areas generally deprives the medical students from the opportunity to assume the role of a community physician owing to the limited or nil exposure during the training period to health care delivery system in rural area or primary health care level.[1]

SCOPE AND SIGNIFICANCE OF RURAL MEDICAL EDUCATION

In order to accomplish the vision to create a cadre of competent medical professionals, who are fit to work in the capacity of a primary health care physician, it is an indispensable requirement to sensitize and give adequate number of learning experiences pertaining to rural medical education.[1,2]Considering the need to expose the students to rural medical education and o bridge the existing gaps,slowly, but definitely steps have been taken to improve the existing scenario. These measures include initiation of new medical colleges in rural areas and relaxing the regulatory norms for the same.[1,2]

Moreover, the findings of a review revealed that more than 95% of the newly produced medical graduates preferred to render services in rural settings, as they were trained in a medical college located in a rural area.[3]In addition, medical colleges distributed across different geographical region have launched initiative to post medical students in rural settings as a part of the training requirement.[2-4]It is a must that the component of imparting rural medical education should be included as one of the integral aspects of the medical curriculum to ensure better implementation. In both of the constituent medical colleges of the Sri Balaji Vidyapeeth,Puducherry, as a part of the early clinical exposure, the newly joined medical students are posted in the field practice area of the medical college to give them insights about the lifestyle, livelihood pattern, available health care & welfare services, and simultaneously also giving them exposure about quantitative and qualitative research methodology.

IDENTIFIED CHALLENGES AND SOLUTIONS

The process of planning and execution of rural medical education needs careful and systematic consideration,otherwise we will find ourselves short in achieving the intended learning outcomes.[4-6]The challenges can range from being administrative (like resources available,infrastructure required to impart training in rural settings,etc.), the quality of teaching offered, conveyance facilities,accommodation arrangements, and lack of internet /network connectivity. In essence, most of these issues can be sorted out via adequate dialogue between the involved parties and giving reassurance to the government authorities that the students can be employed to manage the clinical work.[4]

The quality of imparted teaching can be improved by either having a linkage with a local practitioner or by ensuring that a teacher is available in rotation in those settings where students are posted.[5,6]Moreover, most of the logistic concerns can be resolved by persistent dedication from the administrators and managers.[1,5]For better outcome, the entire program targeting rural medical education should be designed after taking inputs from different stakeholders and should be improved subsequently via inputs from the members of the Curriculum Committee. The description pertaining to the term of students to be posted, time span of posting, range of educational opportunities, etc., should be clearly defined.[4,5]

It has been emphasized that the students fare well in those setting wherein they are posted for variable periods distributed across the entire training frame.[3-5]Under all circumstances, it is a must that the program should be periodically evaluated on different aspects in the form of feedback from different stakeholders and follow it up with corrective measures.[5,6]

CONCLUSION

To conclude, rural medical education is an important aspect of the medical training. It is high time that all the stakeholders join their hands and work together to improve the competence level of medical students and play our part in the making of a community health physician.

Financial support and sponsorship

Nil.

Con flicts of interest

There are no conflicts of interest.