PG medical students may have to serve in district hospitals

New Delhi: All postgraduate medical students will have to serve in district hospitals for at least three months in order to be eligible to appear in the final exam, a Board of Governors (BoG), vested with the powers of the Medical Council of India (MCI), has proposed. Currently, students pursuing undergraduate medical courses are attached to primary health centres or urban health centres for three months as part of a compulsory rotating internship. The BoG has written to the Health Ministry to develop guidelines for implementation of the proposal for postgraduate students in partnership with it and the state governments.

It has also sought that this provision comes into force from the next academic session. "The move is aimed at providing practical experience to future specialists in real-life setting of the country's public health system. Also, this will help address shortage of specialist doctors in district hospitals of rural and remote areas, and help strengthen services at such hospitals," a senior government official said. The note sent to the Union Health Ministry said all postgraduate students shall undertake a rotation in designated district hospitals/health system for a period of three months as a part of the course curriculum.

For postgraduate students of community medicine, the requirement can be posting at primary health centres and field experience in addition to activities at the district hospital. "Satisfactory completion of this rotation shall be an essential condition before the candidate is allowed to appear in the final examination of the respective postgraduate course. The Ministry of Health is requested to develop guidelines for the scheme in partnership with the state government and BoG in three months," it read.

For the purpose of the proposed programme, a district hospital will be defined broadly as a functional public sector or publicly-funded hospital of about 200 beds or more, with facilities for specified specialities, designated by the Centre or state governments. Medical colleges, both government as well as private, will place their post-graduates at the disposal of the government for rotation/posting for the duration of the course.

According to the note, the rotation will be provisionally termed 'District Residency Programme' and the postgraduate student undergoing this posting will be termed as 'District Resident'. Suitable guidelines for this rotation of postgraduate students of subjects such as Community Medicine, Forensic Medicine and pre-para clinical disciplines will be developed in commensurate with their curricula and training needs. "Ensuring training of doctors in varied settings of health system is a well-recognised principle in medical education. This (proposal) exposes the future physicians and specialists to diverse clinical materials.

"District hospitals represent the backbone of the country's secondary level public healthcare providing speciality care. These hospitals are closer to people than most medical colleges, and are a overwhelming source of services for the people, rural and urban alike," a senior government official said. As part of the suggested plan for implementation of the proposal, the BoG said the District Residency Programme may be coordinated by the Directorate General of Health Services and the role will include preparing an annual roster for placement of the batch of postgraduate students. The states with surplus postgraduate students supply may be clustered with supply-deficient states.