Table of Contents  
COMMENTARY
Year : 2016  |  Volume : 9  |  Issue : 6  |  Page : 706-707  

Medical internship: Is it a "one year paid leave" for postgraduate entrance examination preparation?


Department of Pharmacology, M.P. Shah Medical College, Jamnagar, Gujarat, India

Date of Web Publication16-Nov-2016

Correspondence Address:
Anupama Sukhlecha
Department of Pharmacology, M.P. Shah Medical College, Jamnagar, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.194186

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How to cite this article:
Sukhlecha A. Medical internship: Is it a "one year paid leave" for postgraduate entrance examination preparation?. Med J DY Patil Univ 2016;9:706-7

How to cite this URL:
Sukhlecha A. Medical internship: Is it a "one year paid leave" for postgraduate entrance examination preparation?. Med J DY Patil Univ [serial online] 2016 [cited 2024 Mar 28];9:706-7. Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2016/9/6/706/194186


  Prevailing Situation Top


The Medical Council of India (MCI) describes internship as "a phase of training wherein a graduate is expected to conduct actual practice of medical and health care and acquire skills under supervision so that he/she may become capable of functioning independently." [1] Unfortunately, this valuable period is misused to prepare for postgraduate (PG) entrance examinations. The entrance preparation involves attending year-long coaching classes at an external location. Periphery postings (which involve actual community-based health care) are totally neglected and considered as the time to involve in the intensive preparation for PG entrance. An article mentions of interns getting leave as and when asked for, overlooking the rule that they are allowed only 12 leaves per year. [2] There are also a set of interns who do not prepare for PG examinations but still take long leaves for other reasons such as tying the knot, preparing for civil services examinations, and long excursions.


  Expectation from an Intern Top


An intern is expected to help clinicians with history taking, writing discharges, follow-up notes, learn basic skills such as administering injections, collecting blood, inserting intravenous cannula, Ryle's tube, urinary catheters, and conducting normal delivery. These interns need to be supervised by a senior so that they learn the correct diagnosis and treatment. [3] The transition period from medical student to doctor is influenced by his/her personal attributes, medical proficiency, and the support provided in the hospital environment. [4]


  Consequences Top


The interns who qualify in the PG entrance examination and take admissions in the clinical PG courses manage to learn clinical skills pertaining to their specialty but those who do not qualify are at the worst place. Willingly or unwillingly, they take up jobs at primary health centers (PHCs). At PHCs, such untrained doctors are hardly in a position to manage diseases with skill. Here, they may not get the opportunity to learn skills under senior doctors, as in larger hospitals. They may not look up to nursing or supporting staff to teach them clinical skills at PHCs (due to ego issues). As a result, their status remains as mere clerks, or to say - "puppets" with string in the hands of supporting staff at PHCs.


  Possible Solutions Top


Patients look upon doctors as their saviors. In actual clinics, a doctor does not get multiple-choice in treatment. Hence, exclusive preparation of multiple-choice questions will not help in real settings. The college authorities should become strict and not give ward posting completion certificates until interns have learned basic clinical skills and management of common diseases pertaining to Indian set up. At New South Wales University, a "Preparation for Internship" (PRINT) course was developed to facilitate medical students' transition to internship. [5] The PRINT course was effective in improving students' perceptions of their capability in procedural skills and administrative tasks. There can be similar such courses in Indian set up also. Interns could also take up small research projects during their ward postings based or field work to learn practical aspects of medicine.

Students learn theory of drugs in paraclinical years, but actual therapeutics is introduced in the final year. When they learn applied aspects, they would have forgotten pathophysiology of those diseases. Hence, there is a need to integrate preclinical, paraclinical, and clinical years vertically as well as horizontally. Knowing the correct dose, route, and time of administration of drug to patients is as important as knowing about the drug. If an intern takes round with a consultant and his team, writes prescription and administers drugs to patients, as advised by the consultant, he/she will automatically learn the skills.

The need is to produce competent Indian Medical Graduates. "Vision 2015" of MCI has mentioned about a "foundation course" for new entrants to MBBS. There is also a mention of compulsory licensure examination to prove their competence before awarding MBBS degrees. [6] This examination should be conducted by an external team as there could be chances of bias with internal team. Skill learning should be given credit points that need to be added to PG entrance examination score. This will definitely improve intern attendance in clinics.

 
  References Top

1.
Medical Council of India. Salient Features of Regulations on Graduate Medical Education. New Delhi: MCI; 1997. Available from: http://www.mciindia.org/RulesandRegulations/GraduateMedicalEducationRegulations1997.aspx. [Last accessed on 2016 Jul 15].  Back to cited text no. 1
    
2.
Giri PA, Parhar GS. Internship: A transition from a medical student to a doctor. Int J Biomed Adv Res 2012;3:753-5.  Back to cited text no. 2
    
3.
Singhal A, Bansal S. Is internship what it′s meant to be? Stud BMJ 2007;15:45-88.  Back to cited text no. 3
    
4.
Brennan N, Corrigan O, Allard J, Archer J, Barnes R, Bleakley A, et al. The transition from medical student to junior doctor: Today′s experiences of tomorrow′s doctors. Med Educ 2010;44:449-58.  Back to cited text no. 4
    
5.
Scicluna HA, Grimm MC, Jones PD, Pilotto LS, McNeil HP. Improving the transition from medical school to internship - Evaluation of a preparation for internship course. BMC Med Educ 2014;14:23.  Back to cited text no. 5
    
6.
Medical Council of India (MCI). Vision 2015. Available from: http://www.mciindia.org/tools/announcement/MCI_booklet.pdf. [Last accessed on 2016 Jul 15].  Back to cited text no. 6
    



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