Management Skills in Medical Curriculum

Name: Atul Asthana

I feel that doctors' working environment has changed. They no more work asindividual and have to interact much more with experts in other domains.Doctors (and paramedics) now work in an environment where lot other skillsare needed to perform a job.

Management skills need to be developed at veryearly stages and trainees need to know that (unlike what the presentcurriculum suggests), there is life outside the clinic / hospitals.Skills like the ones below are needed to be taught from the inception:

(a) Managing : time, people, equipment, schedules, financials, informationetc.

(b) Legal : handling leaglities etc.

(c) IT and electronics equipment usage.

(d) Handling illiterate patients and their relatives.

(e) Managing media.I therefore think that :

(a) The training should include a lot of exposure to these as structured(part of laid down curriculum) and unstructured (interacting with peopleof other domains).
(b) There should be absolutely compulsory exposure to IT. I'd say that aHospital Management System / HIS / PMS / EMR should be in place and thetrainees need to use it as a regular practice. Please look at open sourceHMS/HIS... like Care2X.
(c) With a country like ours, where healthcare is literally missing even 10kilometers away from a city, we need to collaborate with multiple peopleto provide good healthcare to our people (of which 90% can not affordanything beyond the local doctor, some times, quacks). The trainees shouldbe made part of collaborative efforts like : remote consulting, discussionfora, mailing list etc. where they can learn how to use others' skills tosolve a problem. They should compulsarily spend 6 to 8 weeks in non-urbanareas, live with the people and carry out surveys & research. Community,social and preventive medicine should be taught with lot of practicals andreal exposure.
(d) And, there is a lot of 'healthy' value in Ayurveda, Siddha, Unani,Homeopathy, Yoga etc. These are all healthcare systems unlike the westernmedicinal system (which is taught in MBBS) which only treats symptoms. Thetrainees need to be exposed to such systems too. I know that lot of MBBSdoctors look at all these healthcare systems as quacks. They need to knowand respect these systems.
(e) Lastly, the trainees need to serve in villages in real terms, not forcompleting paper formalities; to understand this country's healthrequirements.And , to revamp the curriculum, I guess, the govt needs to hire amanagement consultant (not from the world class management companies), whocan assess country's healthcare requirements for the next 10 years andmodify this curriculum.Also, govt should look at compulsory skill upgrades after every five years.