MCI, PLEASE OBLIGE

When we were students, we had to learn medicine, surgery, obstetrics and gynecology, ophthalmology, ear-nose-throat diseases, orthopediacs and paediatrics as separate clinical subjects. Psychiatry was dealt with in 1-2 lectures, 15 days in the second year and about 15 days of posting in internship. The medicine paper was supposed to have a question on Psychiatry which was usually a short note on one of five favourite topics (which unfortunately did not include depression).

This was 15 years ago. Now when I meet my classmates, irrespective of speciality or area of practice or even if some of them have switched their professions- all my classmates rue the lack of special training in Psychiatry. Most of my non- psychiatry colleagues have told me how a significant portion of their practice is actually psychological intervention or psychiatric treatment. One family physician joked to me that he will have very minimal practice left if he begins to refer patients with psychological problems to Psychiatrists instead of treating them himself! Considering all these experiences, it is very clear that a special training in Psychology and Psychiatry would have been indispensible.

All things cannot be covered in undergraduate medical education because of the vast and changing nature of medical science. Invariably, some amount of learning happens on the job when the doctor actually settles down to start work. So some authorities have argued that psychology and psychiatry will be ‘automatically’ learned by doctors when they need it. So we see a good attendance at CME programs of medical associations when the topics are related to psychiatry. But what about clinical skills? CME programes are only lectures and I don’t know how doctors will learn the clinical skills of mental health care.

Unless the MCI mandates that clinical skills have to be learned, the students will not be able to do so during MBBS. After MBBS, even if they want to pick up these skills, who will teach them? Technical knowledge in psychiatry can be picked up in the CMEs but clinical skills have to be learnt during undergraduate clinical training only. So our MCI should include testing of clinical skills in psychiatry and psychology during exams. Then there is a higher probability that students will imbibe these skills. Leaving market forces to create motivation for this learning is not the right approach. I hope the MCI will oblige.