Microbiology education must for MBBS graduates – Know why and know how

Feeling of superiority of most MBBS graduates over other allied science graduates in every medical college is quite visible. Also another type of racism exist among medicos is clinical versus non clinical. The question is not about the feeling superiority of one over the other but how such ego centric act is affecting our health care delivery system adversely.

The mission of Modi regime to reform the most corrupt MCI has started putting the house in order. The most disgusting fact is that the ‘doctor instinct’ in most of the so called MBBS doctors and specialists is missing these days and instead they often exhibit their instincts only around pecuniary benefits. We must squarely blame the present system of medical education for the above catastrophe than anything else.

Our current medical education is predominantly revolving around ‘diagnosis and just knowing the drugs (mostly at brand name level). Many doctors have even reduced their knowledge source to CIMS/MIMS to update the medical knowledge. Most of the medical graduates these days do not have any inquisitiveness or research caliber unfortunately that is how our present medical education is placed. It is a standard practice that most of the medical professionals diagnose various infections diseases strictly based on the clinical features without waiting for the confirmatory diagnosis and would prescribe antibiotics. Finally we blame the patients and accuse self medication for drug resistance.

If our medical system integrates the expertise of medical microbiologists to know about the pathogen, its drug resistance pattern and other biochemical aspects, the big danger of multi drug resistant bugs can be easily prevented. Still time is not too late, the MOHFW must bring a strong policy that the pathogens involved in every infectious disease must be studied and this must form part of clinical establishment bill. Since greater proportion of health care delivery system in India is being done by private practitioners, the pathogen identification and characterization must be made mandatory even in private practice. In the interest of our country, Government must provide basic infrastructure and financial aid for the above.

From the first year onwards till house surgency and as well as in every specialization of higher studies in medicine, microbiology education must be included because whether it is surgeon or cardiologist or dermatologist or ENT specialist, all of them must have fair knowledge of various pathogenic microbes, impact of seasonality on microbial burden, their biology, how they spread, how the underlying pathogens can worsen the medical conditions of the patient and at times how it can be fatal etc.

The current medical service of just treating the patient by prescribing drugs, our country cannot afford to continue because such shortsighted medical culture will certainly prove disastrous consequences. Preventive and research based medical practice is must where the role of medical microbiology is essential.

NITI Ayog while reforming our medical education and re-structuring MCI, the role and importance of Medical Microbiology in our medical education must be augured and all those graduated in Medical Microbiology from premier institutions must be involved. This should not be seen as tokenism but such reform is must for making our country healthy.

The Medical professionals must know a lot about pathogens the same way as the clinical diagnosis and drugs. How many doctors really advise patient, for example the Tuberculosis patient should not sneeze in public, always must cover the face with cloth etc. It may be also possible that many doctors may not even know such details.

The doctors should not see the patients merely as ATM machine to swipe money by way of prescribing drugs of the company that they secretly patronage and mandate variety of tests to receive extra payments for such referrals.

All developed countries like UK, US etc., give more thrust to Medical Microbiology before starting the treatment. Every isolate of the pathogen can tell a lot about the likely health danger of the country. But the big question is have we made our doctors responsible, sensitive and inquisitive through the present style of medical education?

Epidemiology should not be treated as sideline activity and nor the importance of medical microbiology be reduced to need based activity.

Only the microbiologists and scientists from basic science have discovered the several deadly pathogens including HIV, characterized them, defined why it is so deadly etc.

In India, the contribution of doctors (MBBS, MD) towards new drug discovery, new way of diagnosing a disease, development of cost effective treatment, novel means of preventing diseases etc., are absolutely zero.

More often some doctors act as ‘commission agents’ and ‘medical knowledge sellers’ in the busy health care bazaar.

Whom should we blame for the above apocalypse other than the Government and the MCI.

The education system followed for MBBS graduation is largely the imported knowledge which in most occasions does not fit to our context. The laundry list of drugs used for the treatment is whether really required for our country or not demands nation wide debate.

Detailed statistics on what are the pathogens prevalent in various parts of European Union countries, US etc., are clearly known. Similarly many other details about different pathogens are well characterized regularly by those advanced countries.

India being the fastest growing GDP has not even started its baby step in this regard. CDC is collaborating with different nations to understand the epidemiology of different countries.

Most of the medical discoveries in western countries were done by medical professionals. That is largely because the medical professionals in those countries are sufficiently taught about various aspects of science of microbes and other basic sciences besides anatomy, physiology, endocrinology etc.

Microbiology is ever changing because microbes are continuously evolving and showing different traits and adaptability but the human physiology or endocrinology etc., doesn’t change that rapidly. Therefore the most dynamic subject Medical Microbiology must be scaled up several folds in our medical education. The knowledge about medical microbiology should not be done just at introductory level but it must be included in all medical specialties.

It is not about doctors feeling superior over non medicos in medical colleges but the real superiority of the medicos will be in knowing the science and employing it very well than reducing the medical profession just to earn and that too, mostly through emotional terrorism on gullible people.

Union health ministry must reform the medical education keeping in mind the long lasting interest of our nation and should not fall into quick fix solutions.

Both human biology and Microbes’ biology are equally important in our medical education to produce really superior medical professionals so they can also think they are superior to other allied sciences.

Dr S Ranganathan