‘Learn & Serve’: Spending 3 months in district hospital must for post graduate medicos now | India News

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MUMBAI: Post graduate medicos across the nation will now have to mandatorily spend at least three months in a district hospital as a part of their course curriculum. The idea is to expose them to rural health care services and “learn and serve”. The ‘Post-Graduate Medical Education Regulations of 2023’, which was released by the National Medical Commission (NMC) in a Gazette, however, failed to define ‘work hours’ for resident doctors, a demand from associations across the country.Instead, it has mentioned that doctors have to work for ‘reasonable working hours’ and that they will be provided ‘reasonable time for rest’ in a day.
The regulations, released on Thursday and effective from January 1, 2024, states that the District Residency Programme (DRP) will be imparted for MD/MS students admitted from 2021. Already in force in Maharashtra and other states, since a resolution was passed in 2021, the programme has now been included in the PG education regulations and will be implemented across India in the third/ fourth or the fifth semester of their PG-ship.
“During this rotation, the resident doctor will be posted with the concerned/allied speciality team/unit/ sections/services at the district health system/ district hospital. The clinical responsibilities assigned to the residents would include serving in outpatient, inpatient, casualty, and other areas pertaining to their speciality and encompass night duties,” said the regulation, a draft that was out earlier and now finalised after expert comments poured in. The NMC has also included a clause on providing honorarium for the DRP, but has kept it optional for states.
Former head of the Directorate of Medical Education and Research Dr Pravin Shingare said, “The fact that this is a part of the course is a good move. This will give students the much-needed experience and ensure quality healthcare in districts. Also, the earlier clause of mandatorily offering pre-clinical and para-clinical courses to offer clinical subjects has been done away with for those wanting to start new PG colleges.”
The Federation of Resident Doctors’ Association (FORDA), though have welcomed some of the guidelines, has said that the Commission failed to properly define work hours and rest hours, which has been the major bone of contention for resident doctors across the country. “The guidelines mention ‘reasonable work hours and reasonable rest hours in a day’ for resident doctors, leaving a lot of scope for subjectivity,” said president of Forda, Dr Aviral Mathur, adding that they had conveyed this to the authority in the past.
“Also the guidelines leaves the responsibility of providing accommodation, transport and other basic amenities, even for DRP, with the respective state governments, when the Commission could have specified the requirements. Some of the aspects in the new guidelines are ambiguous too,” he said.
Mental health of young doctors, which has been one of the major concerns off late, has not been addressed in the guidelines too, said Mathur. There should have been some statutory body in every college, which can tackle mental health issues, he added.
Former dean of KEM Hospital, Dr Avinash Supe, said that most of the previous amendments have been consolidated and updated in the new guidelines. Provisions on NEET-PG and NExT have been added in the new document. “Guidelines for district residency programme have been made uniform across the country. They have also added the e-logbook system. Basic cardiac life support and advance life support course have to be conducted by the institution. Instead of having both presentation and published paper, the guidelines gives students an option to choose one,” said Dr Supe, adding that a section for disabilities have been included too.
In case of stipends, a contentious issue as there is a huge chasm between what is paid to resident doctors in public and private hospitals, Brijesh Sutaria, a parent representative, lauded the clause that directs colleges to pay uniform stipend to PG medicos of private colleges as that paid to their peers in government hospitals. But another parent representative Sudha Shenoy was quick to rebut the same when she said, “it was fine on paper” but private institutes were not adhering to the norms. Ruiee Kapoor echoed Shenoy’s views and added, “While the gazette is out, there has to be systems set in place that ensure the written word is followed. In case of stipends, students’ pass books can be checked. There are instances where stipend is deposited in the account but there cash withdrawal to be paid back to the college.”

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