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Amid opposition from a section of postgraduate medical students, the Health Department appears keen on going ahead with the National Medical Commission’s compulsory three-month district residency programme for postgraduate students at district hospitals.
In a circular issued a few weeks ago, the Director of Medical Education asked the deans of the government medical colleges to establish a committee under the academic cell to coordinate and monitor the implementation of the programme, nominate a nodal officer and submit details.
In the communication, the Directorate noted that the National Medical Commission mandated that all MD/MS students undergo the programme in rotation for three months at district hospitals or in the district health system as a part of the curriculum for the third or fourth or fifth semester. This was an essential requirement for them to appear in the final examinations. Candidates admitted during the academic year 2021-22 have to undergo the programme from the third or fourth or fifth semester, which is from February next.
The Tamil Nadu Medical Officers Association (TNMOA) has opposed the programme and urged the State government not to implement it. It said shortage of doctors at district and peripheral hospitals in various parts of the country, especially in north India, was the reason for the proposal. But this was not the case in a State like Tamil Nadu. The TNMOA noted that the postgraduate curriculum should be aimed at training doctors at medical college hospitals in a particular speciality during which they would see a lot more cases and do complex procedures. There could not be a gap in this specialised training with their posting at district hospitals where facilities are less than at a tertiary care centre. This would jeopardise the specialist training that the postgraduate students undergo. TNMOA said the programme had been imposed on all States. Instead, the States should have been given an opportunity to decide whether to implement it or not according to the prevailing situation.
Kiran Kumar P.S., secretary, legal wing, TNMOA, said, “In Tamil Nadu, we have already had enough exposure working at government hospitals and primary health centres, and know in depth about the district health systems and how they work. The National Medical Commission claims that this is to make postgraduate students aware of the functioning of the district health systems. Making it compulsory for appearing in the final examinations is a major issue. States have no say whatsoever.”
A postgraduate student said some colleges started collecting basic detailssuch as date of joining and native district, while committees have been formed at some other colleges. “Some postgraduate students of departments that have long working hours and a heavy workload are welcoming the programme as they think it will give them a break from the routine, while the rest are opposing it,” he said.
If the programme is implemented in Tamil Nadu that has progressed in social and health infrastructure in the past four decades, it will be a regressive step, felt P. Saminathan, president of the Service Doctors and Post Graduates Association. “Service postgraduates already have experience of serving in a rural area for three years. The National Medical Commission saying that the programme is for giving hands-on experience to the postgraduates in rural healthcare is a big misnomer as it will lead to a deficit of three months in the skills upgrade period,” he said. An official said the programme would be implemented in rotation at the end of the first year.
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