MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
Educational
Reforms & Its Impact -
HEALTH SCIENCE EDUCATION
- Paper Presented By -
Dr.
Dayanand Dongaonkar
Vice-Chancellor
MAHARASHTRA UNIVERSITY OF
HEALTH SCIENCES, NASHIK
Educational
Reforms & Its Impact -
HEALTH SCIENCE
EDUCATION
Dr. Dayanand Dongaonkar,
M.S.
Orth., F.C.P.S., D.Orth
Vice-Chancellor,
Maharashtra
University of Health
Sciences,
Gangapur Raod,
Nashik 400
013.
India is a vast subcontinent with the population of more than 100 crores
with varied socio-economic back ground.
As far as health facilities are concerned, because of variations in Socio-economic factors, there
are variations in health care facilities in the country. Even though we have large number of doctors
from different faculties of medicine, there is serious mal-distribution of
these doctors. There is clear urban and rural division. There is concentration of doctors in urban areas, whereas there is
serious paucity of doctors in rural areas.
Even though in urban areas, there are good number of doctors, standard
varies from place to place and individual to individual, Socio-economic factors
affect the quality of health care, equally important is the quality of health
sciences education.
Slide –1
Historical Background
India has rich traditions of Ayurved since 5,000 years. It has rich
information of promotive and preventive health care. But over the years, it has lost continuity of its research, quality
upgradation and did not keep pace with development of modern science. Modern medicine was introduced in India by
Britishers; the first educational institutes were established in 1st
half of 19th century.
1826 - Medical College, Calcutta
1835 - Medical College, Madras
1843 - Grant Medical college, Mumbai
Even though the modern medicine education was started in India,
there were no organised health care education facilities all over the
country. It took long time for
spreading of this education system.
After independence, there was gradual expansion of this system but
during last 20 years it has mushroomed haphazardly.
As far as modern medicine is concerned, health sciences education is
planned by the Medical Council of India, which was established in 1934. It regulates colleges and its standards
through the Universities in the state but has no definite control on number of
institutions. In addition to modern
Medicine colleges, we have other institutions of health sciences like Ayurved, Homoeopathy,
Dentistry, Unani etc. Across the country, there is variable standard of
education and infrastructure. Even
though, we are all governed by the same Council, the quality of doctors
produced is in a variable spectrum of standards.
Slide - 2
In post independent India, there is
always cry about deteriorating standards of health care education in the
country. The major factors responsible
for are considered to be :-
(a)
Lack of administrative authority.
(b)
Lack of financial authority.
(c)
Lack of policy making authority to the professionals.
Slide – 3
To improve this situation many attempts have been made. The Govt. of
India in 1943, appointed the Health Survey & Development Committee with Sir Joseph Bhore as chairman to survey
the then existing position regarding the health conditions and health
organisation in the country. The
committee, put forward for the first time, comprehensive proposals for the
development of National Programme of health services for the country.
There was no policy consideration on health sciences education by this
committee.
It is observed that since
Independence the Standard of Health Education is going down. As such, on the
lines of University Grants Commission, separate commission for health sciences
education was recommended in 1975 by Shrivastav Committee. In 1983, Ministry of
Public Health & Family Welfare appointed Medical Education Review
Committee. The said Committee strongly recommended establishment of Health
Sciences Universities at State level.
In 1987 "Health Manpower Planning, Production and Management
Committee" was appointed under the Chairmanship of Dr. J. S. Bajaj. This
expert committee also recommended
establishment of Universities for Health Sciences and reiterated that a
separate Commission need to be appointed for Medical & Health Education on
the lines of University Grants Commission and the said commission should lay
emphasis on Quality Education in various faculties of Medicine. Later on,
Ministry of Public Health & Family Welfare appointed a committee under the
Chairmanship of Prof. Rais Ahmed to
study the establishment of Health Sciences Universities. The said committee stressed the need of such Universities and opined that such Universities
should have faculties of Medicine, Dentistry, Ayurved & Unani, Homoeopathy,
Allied Health Science including
Pharmacy.
Central Govt. under the Ministry of
Public Health & Family Welfare accepted the idea of having separate
Commission on Health Science Education and creation of independent Health Science
Universities in July 1993. Govt. of India appointed Prof. Mukherjee committee
in 1995 to review the outcome of health sciences universities of Andhra Pradesh
and Tamil Nadu. Dr. Mukharjee clearly
opined that health sciences universities have contributed to upgrade quality of
education and also suggested the need to enhance education in Allied Health
Sciences. The committee further opined
that the Health Sciences University should be able to devise, syllabi, curricula
and bridge courses to fulfill their needs.
All public Health Training Institutions should be affiliated to the
Health Sciences Universities. Health
Sciences University should also be responsible to direct, supervise & guide
training for Health Services Personnel & ensure quality & effectiveness
of training.
Slide – 4
Health Sciences
Universities were established as follows :-
1) NTR University of Health Sciences,
Vijaywada, AP - 1986
2) MGR Health Sciences University,
Chennai, Tamil Nadu - 1987
3) Rajiv Gandhi University of Health
Sciences, Banglore, Karnataka - 1994
4) Maharashtra University of Health
Sciences, Nashik - 1998
5) Baba Farid University of Health Sciences,
Faridkot, Punjab - 1998
Slide - 5
National scenario of health sciences education
Faculty
wise colleges in the country with admission capacity & with numbers of Registered Drs.
|
|
Medical |
Dental |
Ayurved |
Homoeopathy |
Unani |
Total |
|
No. of coll |
182 |
134 |
198 |
166 |
37 |
717 |
|
Intake capa |
19190 |
8110 |
7000 |
7450 |
-- |
41,750 |
|
Regd. Drs |
5,49,867 |
35,000 |
4,27,504 |
1,94,147 |
16,599 |
12,23,117 |
Slide - 6
STATEWISE NUMBER OF MEDICAL COLLEGES IN THE COUNTRY
|
Name of the State/Union Territories |
No. of
Medical Colleges |
Number of Admissions |
No. of
Registered Drs. |
|
Andhra Pradesh |
16 |
1781 |
43102 |
|
Assam |
03 |
0391 |
14135 |
|
Bihar |
11 |
0700 |
32226 |
|
Chandigharh |
01 |
0050 |
|
|
Delhi |
04 |
0460 |
31694 |
|
Goa |
01 |
0070 |
01916 |
|
Gujarat |
10 |
1145 |
32177 |
|
Haryana |
01 |
0150 |
01065 |
|
Himachal Prdesh |
02 |
0115 |
|
|
Jammu & Kashmir |
04 |
0380 |
06344 |
|
Karnataka |
24 |
3005 |
57307 |
|
Kerala |
07 |
0900 |
26757 |
|
Madhya Pradesh |
07 |
0820 |
18181 |
|
Maharashtra |
35 |
3540 |
66477 |
|
Manipur |
01 |
0100 |
|
|
Orissa |
03 |
0321 |
14009 |
|
Pondicherry |
03 |
0175 |
|
|
Punjab |
06 |
0520 |
31209 |
|
Rajasthan |
06 |
0600 |
20230 |
|
Tamilnadu |
17 |
1850 |
63434 |
|
Uttar Pradesh |
13 |
1212 |
40672 |
|
West Bengal |
07 |
0805 |
48932 |
|
Total |
182 |
19,190 |
5,49,867 |
Slide – 7
Maharashtra
State scenario of health sciences
education
Facultywise colleges in the state of Maharashtra with admission capacity & with numbers of
Registered Drs.
|
|
Medical |
Dental |
Ayurved |
Homoeopathy |
Unani |
Allied
H.Sc. |
Total |
|
No. of coll. |
34 +1 |
16 |
50 |
39 |
6 |
29 |
174 +1 |
|
Intake
capa |
3255 |
1100 |
2470 |
2860 |
300 |
690 |
10675 |
|
Regi. Drs |
69,351 |
8,383 |
38,024 |
32,645 |
-- |
-- |
1,48,403 |
Slide – 8
Doctor Population Ratio
|
|
Medical |
Dental |
Ayurved |
Homoeopathy |
Multidisc. (M/Aur/H) |
SRIVASTAV COM.(1975) 1M,1F=5,000 1 : 2500
DGHS (1993) 1 : 3500 |
|
National |
1819 |
28571 |
2339 |
5151 |
854 |
|
|
Maharashtra
|
1442 |
11929 |
2630 |
3063 |
714 |
Slide - 9
Experience in
Maharashtra
Maharashtra University of Health Sciences was
established in June 1998 and all the institutions of health sciences were
affiliated to this University. At present we have five faculties with 174
institutions with an intake capacity of 10,675 every year, of which Medical
& Dental are 4,355.
Medical Colleges must be well administered, so
as to set high standard of education and can adopt innovative programme without
the intervention or control of the University.
This is possible with help of adequate financial inputs, academic
freedom, efficient management, professionalism concern about quality etc. Such institutions can be made autonomous.
Problems in Health Sciences
Education
When
the University came into existence, we
had extensive debate with different sections of society to evolve policies and
priorities at the University. It was
generally observed that we are producing large number of graduates . They are poor in skills. This was mainly
because of poor staff position and infrastructure. Whole teaching programme was examination oriented with poor
professional skills of the students.
There was considerable discontent amongst students because of
malpractices in the examination system.
Slide - 10
The Quality of Health Sciences
Education depends on: -
1.
The quality of Students
2.
The quality of Teachers
3.
Quality of Content and Technique of Education
4.
The quality of Infrastructure
5.
The quality of Management
Slide –11
Objectives of Maharashtra University
of Health Sciences
1.
To have planned growth of Health Sciences
institutions in the state.
2.
To produce good quality graduates both in
professional and social skills.
3.
To upgrade quality of teachers.
4.
To promote research.
5.
To have Public health education for the
community at large.
Slide - 12
Reforms undertaken by MUHS
Slide -13
(a)
Perspective Plan
It was generally felt that we need priority to enhance
quality than quantity, however at the
same time, we have regional imbalances in the State. We have prepared
perspective plan for the State, so that the colleges can be started in
undeveloped, underdeveloped and
unserved areas to bring equity in different regions. For the first time, perspective plan was prepared in 1999 for one
year and subsequently the five year covering the period 2001-2006. This plan was prepared with
extensive debate with Academicians, bureaucrats and politicians. This has given definite direction for
expansion of health sciences education
in the state of Maharashtra and we have reasonably controlled unplanned growth
of health science colleges.
Slide – 14
(b) Academic Policies
With vast
and fast expansion and commercialization of health sciences education, large
spectrum of colleges with varying standards have come up . To improve upon the quality, we have to make
students & teachers to swallow bitter pills of discipline. So, we have introduced:-
1.
Compulsory attendance in the class room & clinics
2.
Introduction of Internal Assessment Programme.
3.
Interactive teaching programme.
4.
Upgradation of syllabi in all
faculties.
5.
Vertical & Horizontal Integration of
Teaching
6.
Common examination pattern for all faculties.
7.
Common entrance test made more Transparent.
8.
Establishment of School of Training & Evaluation.
9. Establishment of School of Research.
Slide – 15
(c) Examination Reforms
With commercialization of education, there
were set malpractices in the examination system of Universities . It was a
quite uphill task to change the
system. But we had to deal this
sensitive area with commitment. Following examination reforms are undertaken:-
1.
Removal of ATKT (Allowed to Keep Terms).
2.
Removal of revaluation system and introduction
of moderation scheme.
3.
Reorganization of grace marks.
4.
Theory papers are divided into three sections i.e. MCQs, SAQs and
LAQs.
5.
Each section of theory paper is independently
coded and evaluated by different set of examiners.
6.
Introduction of Central Assessment programme
for theory evaluation.
All these changes had created apprehension
amongst the teachers more than the students in the beginning, which was
adequately taken care by meticulous and well thought training programme of the
teachers. Change of question paper
pattern helped to make the students to get better equipped with Professional
knoledge and for National and International competitions. These reforms have definitely resulted in
improvement of university examination results. All these changes have brought
credibility to examination system and confidence among the students. This has dramatically brought seriousness in
the studies.
Slide – 16
(d) Teachers’ Training Programme
To make educational programme
successful, the key partner in this venture is the Teacher. Considering this fact, we established School
of Training and Evaluation. We conducted very aggressive training programmes
for updating teachers in syllabi patterns, examination reforms, professional
knowledge and communication skills..
During last three years, we conducted 40 workshops and trained over 3000
teachers for this purpose. During
workshop of teachers, we heavily interact with them on different policy matters. We are organising regular workshops for
training of teachers in Research Methodology.
This has definitely changed educational atmosphere and started showing
its impact.
Slide – 17
Interaction with
Students
Beneficiary of the University system are
students, their feedback and confidence
is vital. We regularly organise interaction meetings with students every year.
They have full freedom to discuss their issues with authorities of the
University. This has established
excellent rapport between the students and the University authorities.
Interactions with
Deans/Principals
Heads
of the institutions are the key partners in managing the
academic/administrative show of the University. We have to orient them with the policies of the University and
understand their difficulties, we conduct meetings of Deans/Principals every
six months. We debate on policies and
functional matters. This has helped us
to strengthen ties between affiliated colleges and the University.
Slide
-18
Results
All these reforms, in a
very short period, have produced effects as per our expectations in most of the areas and in certain areas
beyond our expectations. Among the
notable results are..
1.
Sudden change in academic discipline.
2.
Examination results have gradually improved.
3.
Students have acquired better professional skills.
4.
The students are prepared for state, national
and international academic competitions.
5.
The students have become more interactive than
ever before.
Slides : 19-22
Faculty
wise gradual improvement in the results of Internal Assessment
Slides
: 23-31
First
MBBS results of 1998, 1999 & 2000 batches Classwise gradual improvement of 1998 batch.
First BDS results of 1998, 1999 & 2000
batches Classwise gradual improvement
of 1998 batch.
First BAMS results of 1998, 1999 & 2000
batches Classwise gradual improvement
of 1998 batch.
First BHMS results of 1998, 1999 & 2000 batches Classwise gradual improvement of 1998
batch.
Slide - 32
Slide
– 33
Future Plans and
Priorities of the University
1. The credibility of
University depends on the quality of its product i.e. professional capability
of students in terms of their knowledge, skill and social attitude. We will
have to constantly evaluate the product. We are looking forward for a neutral
evaluation agency for this purpose.
2. We have to constantly
upgrade quality of teachers, in terms of professional skills and professional
knowledge. This will be done by
further strengthening of
School of Training.
3. To improve quality of
education, educational research has to be done as an ongoing activity. In
addition, we need clinical research, epidemiological studies to strengthen the
teaching & health care.
Paper
titled ‘EDUCATIONAL REFORMS & ITS
IMPACT - HEALTH SCIENCES EDUCATION’
was presented at the ‘INTERNATIONAL CONFERENCE ON MEDICAL EDUCATION AND
TECHNOLOGY’, to be held between 18, 19 & 20th Jan. 2002 at ‘Dr.
MGR HRD INSTITUTE OF A.P., HYDEABAD’, organized by ‘NTR UNIVERSITY OF HEALTH
SCIENCES, ANDHRA PRADESH’.
After
presentation of the above paper we have received certain responses from the
participants, these are presenting for the readers which themselves speaks well
of the achievements of the university
