Now, MBBS students to do course on ethics too

India has recently joined a long list of countries that have included a course in medical ethics as part of undergraduate medical education. The course will start from the first year of the MBBS programme and run until the final year.

The Competency Based Medical Curriculum uploaded on the Medical Council of India (MCI) website underscored the importance of ethical values, responsiveness to the needs of the patient and acquisition of communication skills through dedicated curriculum time for acquiring what it called “Attitude Ethics and Communication (AETCOM) competencies”. In the foreword to the curriculum, the Board of Governors currently running the MCI stated that medical students should be “trained to effectively communicate with patients and their relatives in a manner respectful of the patient's preferences, values, beliefs, confidentiality and privacy”.

Over the past four years, a panel of experts laid the basic framework for the revised MBBS curriculum. A book on AETCOM was prepared by the MCI and training of faculty on this module has been on since 2015. The curriculum set out the expectation from introducing the module stating that along with medical skills a medical graduate ought to be able to appreciate the socio-psychological, cultural, economic and environmental factors affecting health and develop a humane attitude towards patients.

According to the chairperson of the MCI Board of Governors Dr Vinod K Paul, emphasis on attitudes, ethics and communication was missing earlier as students mostly learned these from their peers, seniors and teachers. “By the 1990s, it had become obvious that ethics was important and most countries had introduced it in the medical curriculum. The framework of ethical decision-making is my shield to society when questioned about the decisions I take and doctors need to be taught how to wade through increasingly complex situations. Teaching AETCOM is a formal attempt to bring out the best in students. It will not change everyone, as students come with their own socializing and from different backgrounds. But the majority will benefit from it,” said Dr Paul.

Welcoming the introduction of medical ethics in the curriculum, eminent gastrointestinal surgeon Dr Samiran Nundy said the challenge would be to ensure that it was not restricted to didactic teaching and that it was relevant to India. “The most important thing is for the professors teaching ethics to practise what they preach. Students learn by emulating their teachers and so teachers must be seen doing what is right,” said Dr Nundy.

Dr Arun Gadre of the Alliance of Doctors for Ethical Healthcare, said the introduction of any ethics anywhere is good but felt that without role models in colleges, just teaching the theory of ethics would only make students cynical.