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Indian Journal of Community Medicine

Producing Quality Doctors: The Dilemma of Internship

Author(s): Dr. Shankar Prinja, Dr. Ramesh Verma

Vol. 31, No. 1 (2006-01 - 2006-03)

Internship is a phase of training wherein a medical 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. A glimpse at the distribution of time spent in different departments reveals that an intern spends maximum time training in Community Medicine. This is an indicator of the vision of Medical Council of India.

With the advent of newer programmes like National Rural Health Mission (NRHM), the role and responsibilities of a Medical Officer has increased tremendously. Through this internship training in Community Medicine we need to instill managerial skills amongst our budding doctors. It is only these effective managers who can run the show of primary health care in our country with the requisite finesse.

The interns should acquire skills to deal effectively with an individual and the community in the context of Primary Health Care. The MCI recommends a residential posting of 3 months for interns at a health centre adopted by the medical college. However many inadequacies/problems plague the internship training. First and foremost is the dilemma of Pre PG examination. There is no uniformity in adherence to the protocol of internship training at various medical colleges. The interns are thus at crossroads whether to follow the rigors of internship or confine themselves to their books and in most instances the latter prevails. Hence, the lack of skill development amongst the current lot. How many in a given year succeed through the entrance examination for PG- approximately 25%? What about the rest?

We thus need stringent implementation of internship training uniformly across the colleges in the country. Since the training in Community Medicine enhances the skills of budding Medical Officers for health care delivery, adherence to its protocol religiously becomes all the more imperative. The interns during this period should be exposed to live situation through participation in implementation and management of ongoing national health programmes; working with the health workers, anganwadi worker and dais; resource generation through panchayats for better sustainability of the system; participation in continuing education programmes of various cadres of health personnel; working with pharmacist and store incharge to understand inventory management and also to work with different stakeholders. These are to name a few. Needs assessment for internship training at local level can be undertaken to develop a training schedule on monthly basis for a continuum of three months.

The interns should be assessed and satisfactory completion of internship training should be determined on the basis of proficiency of knowledge; competency in skills; capacity to work in a team; responsibility, punctuality and initiative; participation in discussion and research aptitude. It is only through such quality doctors with high level of skills; especially managerial, that we can meet the goals and targets enshrined in various policy documents.

Dr. Shankar Prinja , Research Scientist-II,
Hib Probe Project
Deptt. of Community Medicine,
PGIMER, Chandigarh
E-mail: [email protected]

Dr. Ramesh Verma , Lecturer
Deptt. of SPM
PGIMS, Rohtak

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