Indian proposals to revalidate doctors get mixed reception
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《英国医生杂志》
A proposal by India抯 health minister that doctors should take exams every five years to keep themselves updated on medical advances and reregister to retain their licenses has triggered debate in the medical community.
The health minister, Anbumani Ramadoss, is a medical doctor, and his proposals are in line with recommendations first made by the Indian health ministry five years ago but which were never implemented. The United Kingdom has similar plans to revalidate its doctors. Due to take effect next month, these were postponed after the Shipman inquiry recommendations (BMJ 2005;330:271).
The fresh proposals in India prompted swift criticisms from medical associations there last week. But some doctors said a move to reregister doctors in India was "long overdue."
A statement from the Indian Medical Association said that it favoured voluntary programmes of continuing medical education instead and that the idea of a qualifying exam for doctors to reregister has "no logic." The association said that although the process of updating knowledge has no boundaries, an examination would require a syllabus and course material. Without well defined course material, exams to test doctors would be "impractical," it said.
"We need to improve the quality of continuing medical education rather than force doctors into taking examinations," said Dr Krishan Aggarwal, president of the Delhi Medical Association. Continuing medical education in India is not subject to standards, and it is not known whether doctors attending such programmes benefit from them.
Doctors say it will take time for the medical community to get used to the idea of
repeat registrations. "It抯 human nature. We can抰 expect doctors who are used to a particular system to embrace something like this in a hurry," said Dr Arun Agarwal, dean at the Maulana Azad Medical College in New Delhi and president of the Delhi Medical Council.
The Delhi Medical Council, which has 28 000 doctors on its registers, was the first medical body in India to make it mandatory for doctors to reapply for registration every five years. By July this year 3800 doctors will have applied for their second registrations. But the process requires no more than a declaration that the doctor has participated in 100 hours of continuing medical education.
Doctors in academic institutions have emphasised the need for structured continuing medical education that leads to credits. They say that India could borrow from Western countries, where each programme ends in tests for doctors to earn credits.
"But the first move should be to make continuing medical education mandatory," said Dr Sanjiv Lewin, associate professor of paediatrics at St John抯 Medical College in Bangalore. "Today, a doctor who抯 got a degree and registration doesn抰 have to pick up a book or a journal ever again."(New Delhi Ganapati Mudur)
The health minister, Anbumani Ramadoss, is a medical doctor, and his proposals are in line with recommendations first made by the Indian health ministry five years ago but which were never implemented. The United Kingdom has similar plans to revalidate its doctors. Due to take effect next month, these were postponed after the Shipman inquiry recommendations (BMJ 2005;330:271).
The fresh proposals in India prompted swift criticisms from medical associations there last week. But some doctors said a move to reregister doctors in India was "long overdue."
A statement from the Indian Medical Association said that it favoured voluntary programmes of continuing medical education instead and that the idea of a qualifying exam for doctors to reregister has "no logic." The association said that although the process of updating knowledge has no boundaries, an examination would require a syllabus and course material. Without well defined course material, exams to test doctors would be "impractical," it said.
"We need to improve the quality of continuing medical education rather than force doctors into taking examinations," said Dr Krishan Aggarwal, president of the Delhi Medical Association. Continuing medical education in India is not subject to standards, and it is not known whether doctors attending such programmes benefit from them.
Doctors say it will take time for the medical community to get used to the idea of
repeat registrations. "It抯 human nature. We can抰 expect doctors who are used to a particular system to embrace something like this in a hurry," said Dr Arun Agarwal, dean at the Maulana Azad Medical College in New Delhi and president of the Delhi Medical Council.
The Delhi Medical Council, which has 28 000 doctors on its registers, was the first medical body in India to make it mandatory for doctors to reapply for registration every five years. By July this year 3800 doctors will have applied for their second registrations. But the process requires no more than a declaration that the doctor has participated in 100 hours of continuing medical education.
Doctors in academic institutions have emphasised the need for structured continuing medical education that leads to credits. They say that India could borrow from Western countries, where each programme ends in tests for doctors to earn credits.
"But the first move should be to make continuing medical education mandatory," said Dr Sanjiv Lewin, associate professor of paediatrics at St John抯 Medical College in Bangalore. "Today, a doctor who抯 got a degree and registration doesn抰 have to pick up a book or a journal ever again."(New Delhi Ganapati Mudur)