Abstract

The aim of medical training is to train graduates to efficiently take care of the health and medical needs of the community. The present system is a subject-centric and time-bound method, with very little scope for feedback. Most of the evaluation is summative. The teaching-learning and evaluation methods focus more on knowledge but less on attitude and skills. Therefore medical graduates may have extraordinary knowledge but very little skills and attitude. They may also have deficiency in soft skills related to communication and doctors-patient relationship, ethics and professionalism. Competency Based Medical Education (CBME) is gaining worldwide momentum. The MCI has described the basic competencies required of an Indian Medical Graduate (IMG) and designed a competency based module on attitudes and communication. Acceptance of a competency based approach would result in a paradigm shift in the approach to medical education. Over the years a discernible gap between medical training, health care delivered and societal health needs is visible. Medical Schools are constantly facing the question “Are we producing graduates who are competent to cater to the health needs of the society”. To attempt to correct this anomaly, it is befitting that we re-trace and work our way backwards by first defining the expected roles of physician and also clearly state the characters and abilities of medical professionals graduating from medical schools that enable them to perform these roles well. The curricula then need to be altered such that these outcomes are steered by appropriate assessment methods. There lies the origin of CBME. The objective of medical training is to produce “doctor of first contact”. The Indian Medical Education System has been revolving around the educational/learning objective of the traditional curriculum. The objectives encompass knowledge base with some references to procedural skills and behaviour to be developed during the course of training. In accordance with this, assessment methods also were traditionally designed to measure knowledge attained and specific skills rather than the ability of the graduate in delivering judicious and contextual health care in authentic settings. Efforts to make “competencies” as the chief driving force of training and curricular planning has gained momentum since the turn of the century.