NMC releases Guidelines on Professional Responsibilities of Medical Students
New Delhi: The Ethics and Medical Registration Board (EMRB) of the National Medical Commission (NMC) has recently released the guidelines on "Professional Responsibilities of Medical Students" to make medical students understand the grave responsibilities of their chosen profession.
"These guidelines may serve to remind them of their social obligations even during the training period, in the spirit of human service and excellence and help them align with the goals of curriculum for Indian Medical Graduate (IMG). It is expected that these guidelines will be used by Teachers, Medical Education Unit (MEUs) and Institutions to instill a sense of responsibility in Medical Students rather than using them for punitive actions," NMC ethics board mentioned in the guidelines.
Releasing the guidelines in the public domain, NMC EMRB member Dr. Yogender Malik has mentioned that these guidelines will normally be reviewed yearly. The commission has also invited comments in this regard to be sent to ethics@nmc.org.in.
The Apex medical commission has discussed several issues related to the students including responsibilities related to academic growth, responsibilities related to personal growth, responsibilities towards society and national goals, and support framework to ensure optimal functioning and growth of medical students.
Describing the duties of medical students, NMC stated in the guidelines, "The responsibilities of the medical student in India are closely aligned with the goal of the medical curriculum i.e. to "create an "Indian Medical Graduate" (1MG) possessing requisite knowledge, skills, attitudes, values and responsiveness, so that she or he may function appropriately and effectively as a physician of first contact of the community while being globally relevant".
The Commission pointed out that the significance of nurturing a medical student with respect to expectations from a doctor or a medical teacher was deeply realised by physicians of ancient Bharat like Vagbhatta, Charakh and Sushruta.
According to the guidelines, with the goal of developing a competent Indian medical graduate, it needs to be ensured that the life of a medical student is centred on the holistic development of the student encompassing the following broad aspects:
1. Academic growth: in terms of the knowledge and skills required by the student to become an effective healthcare professional.
2. Personal growth (physical, mental, social, and spiritual): in terms of an increased awareness of personal strengths and weaknesses and measures to ensure the building of character and morals that are essential in the practice of medicine. This also entails an awareness of the intrinsic worth and dignity of all people regardless of their gender, ethnicity, language, region, religion, or social standing, among others.
3. Commitment to society and national goals: in terms of understanding the social determinants of disease and the physician's voice and action in promoting societal change for the greater good. This also presumes an understanding of national health care priorities and a commitment to always respond in times of acute national needs.
1. Responsibilities related to academic growth:
1.1 Students are expected to attend teaching-learning sessions diligently, with the awareness that learning does not come from books alone but from the vast experience of teachers and from practical teaching-learning encounters. Students should be aware that adequate attendance is a prerequisite for attaining eligibility to appear in professional examinations.
1.2 Students are expected to develop scientific temperament and strive towards excellence. In this regard, students are expected to commit themselves diligently and continuously to self-directed and enquiry-driven learning so as to lay the foundations of `life-long learning' which are essential to the practice of medicine. Such practices are expected to prepare a student especially in light of the changing disease patterns, and advances in technology and therapies, among others.
1.3 Practical and bed-side learning are an essential component of the learning process and constitute distinct learning methods that cannot be substituted. Each patient encounter is unique and helps the student understand the person behind the patient. Students are expected to attend these regularly and actively participate in them. The acquisition of skills is an active process —students are to ensure that they observe and perform procedures / processes outlined in the curriculum.
1.4 Students are expected to maintain their logbooks, practical records and case record books diligently. Copying, fudging and manipulation of these records are unacceptable and will invite serious penalties as per institutional norms.
1.5 Students are expected to prepare for and undergo certifications for all the competencies listed in the revised curriculum. Wherever required, students may need to undergo remedial training and re-certification.
1.6 Students are expected to be honest and practise integrity during all examinations. Cheating in any form is a form of corruption that not only undermines the purpose of the examinations, but also runs contradictory to what is expected of a medical student.
1.7 Students are expected to be willing to get involved in research during their MBBS course under the guidance of their teachers. They should be familiar with the ICMR guidelines that govern research. A student is expected to be aware that all research including student research must be approved by the Institutional Ethics Committee.
2. Responsibilities Related to Personal Growth:
2.1 Students are expected to take care of themselves and lead healthy life style. They are particularly expected to avoid alcohol, tobacco and other substances of abuse. Students are expected to seek treatment and counselling in case of substance abuse.
2.2 Students are expected to actively participate in mentorship sessions. The medical course inherently carries with it unique pressures and challenges: students may feel out-of-control and unable to live up to their own expectations and those of their peers or families. Students are strongly encouraged to seek professional help in these circumstances. In order to maintain health and well being, students are encouraged to participate in Yoga and meditation sessions organised by the institution.
2.3 Students are expected to freely interact with all their colleagues without discriminating on the basis of language, caste, gender, region, religion, socio¬economic class, or any other way which may invariably prevent understanding of the rich diversity of students and tend to foster stereotyping and division. Active participation in extra-curricular activities can help overcome such divisions and barriers. An atmosphere of openness to all members of society is critical as they are to deliver services to the whole society in an equitable and sustainable manner in future including services in different regions.
2.4 Students are expected to actively participate in the current modules of the curriculum prescribed by NMC. These are designed to promote an appropriate attitude, ethical conduct and proper communication methods during patient encounters. The students are expected to be aware of patient's autonomy, beneficence, non-maleficence and justice. These elements of medical education are not merely ancillary to the main subjects but essential to ensure anethical doctor-patient relationship and maintain public trust in the health system.
2.5 Students are encouraged to seek positive role models among medical students and teachers whom they can emulate in terms of skills, attitudes and behaviour.
2.6 During their clinical training, medical students are expected to politely introduce and identify themselves as students to the patients before eliciting history and examining patients. They must understand that patients are not a means to an end. Students must be sensitive to the patient's needs and wishes. Students must also be aware that they must maintain the confidentiality of information that they elicit during their clinical patient encounters and at the same time be responsible to inform the treating team about the same to ensure proper management. They must be aware of their limitations, and should avoid giving advice regarding treatment, or doing counselling without due instruction from their teachers.
2.7 Learning at the level of communities is also an essential component of medical education. During the community interactions, students encounter diversity in education, living standards, social support systems, access to basic amenities, health access and environmental conditions etc. Such knowledge and experience is essential if students are to understand the social context when patients come to hospital and to be able to participate in health promotion and disease prevention activities in the community. Hence, whenever possible, students should be willing to participate in health camps/ health awareness campaigns.
2.8 Students must be aware of the ever expanding scope of social media with its usefulness as well as possible professional hazards associated with its indiscriminate use. Hence, medical students are expected not to indiscriminately post on social media regarding patient and patient related information.
2.9 In case of any grievance, students are expected to approach appropriate authorities for its redressal.
3. Responsibilities towards society & national goals:
3.1 Medicine is a social and moral endeavour. So, they are expected to dress modestly and appropriately in all their professional endeavours.
3.2 Students are encouraged to organise regular environmental audits of the campus to identity the problem areas concerning the environment and initiate suitable programmes like tree plantation, reduction of use of single use plastic, judicious use of water etc.
3.3 In keeping with role of a citizen-doctor, students are encouraged to keep abreast of new health laws being discussed in parliament or at the state and to respond, when bills are opened for public views and comments.
3.4 Students are expected to learn the local language so as to effectively communicate with patients during their studies.
3.5 Students are expected to participate in community events related to health education, health promotion and prevention.
3.6 Students are expected to assist in health services in situations like natural calamities, disasters, health emergencies etc. through proper channels and under supervision. Sense of social service and nationalism should be integral part of medical education.
4. Support Framework to ensure optimal functioning and growth of medical students:
4.1 Medical colleges should have atmosphere conducive for the medical students to achieve optimum personal and professional growth. Medical colleges must ensure that adequate and appropriately trained faculties are available for the education of students according to the prescribed NMC standards.
4.2 Medical colleges are required to ensure that students have adequate clinical exposure.
4.3 Medical colleges are required to conduct all examinations and certifications as prescribed by the NMC with integrity and honesty. Cheating must be dealt with strict action. Colleges must not inflate internal assessment marks and students should expect a fair and impartial examination process.
4.4 Medical colleges must ensure that ragging is banned and that strictest action is taken in the event of breaches.
4.5 Medical colleges are required to set up appropriate mentorship programmes, student counselling services and a referral system to take care of students' stress and mental health issues. Students in care must be assured of full confidentiality.
4.6 Regular student feedback should be taken by the college so that remedial action can be taken to improve the teaching-learning process.
4.7 Community health exposure of students should be encouraged even beyond the boundaries of curriculum including encouragement for additional voluntary initiatives by students to get involved in community health services from the beginning under the guidance of doctors. Even voluntary participation by students in health camps/ health awareness campaigns organised by registered medical organisations of repute for a certain number of days in an academicyear may be encouraged. This exercise is of utmost importance for preparing a medical student with "attitudes, values and responsiveness, so that she or he may function appropriately and effectively as a physician of first contact of the community" as desired in the IMG goal.
4.8 Institutes should encourage healthy lifestyle by providing adequate sports & yoga facilities, gymnasium and healthy food options etc. within campus.
4.9 In order to create awareness against tobacco, alcohol and substance abuse, institutes should run or support well designed programmes like 'anti addiction campaigns' in campus and involve students in educating others through `Nasha Mukti Abhiyan' at the campus, hospital or community level.
To view the guidelines, click on the link below:
Also Read: NMC releases Guidelines on Professional Responsibilities of Medical Teachers, details
