The new curriculum introduced in 2019 by the National Medical Commission in the form of Competency-based medical education (CBME) is a milestone change in the medical education system of India. Novel aspects such as teaching Attitude, Ethics and Communication (AETCOM) skills, alignment & integration of systems and sub-systems, early clinical exposure (ECE), and skill-based training are some of the noticeable aspects. Another vital addition to this group is Electives. The elective program has been part of Western universities since many decades. 1
Primer
An elective is defined as a student-centric, self-directed course, generally of brief duration, bent in the curriculum to offer prospects for the learner to reconnoiter and unfold the zones of interest in the health care profession.2 Electives can infold the fields of research, education, laboratory work, community postings, or other specialty-specific clinical courses. Students have a choice of recognizing a topic of their interest, and so it is anticipated to provide a unique learning experience and a greater degree of fulfillment. The college may consider the availability of elective opportunities in various specialties within the institute and may also collaborate with hospitals and healthcare centers in distant locations to offer students a vivid range of experiences.
Designing, Implementation, and Evaluation
For the fruitful application of this endeavor, it is important to know the opinions and concerns of the beneficiaries and facilitators which would enable better-quality learning. The process of deciding on elective postings for MBBS students can vary depending on the policies and procedures of each college and the student's personal interests.
As per the CBME, eight weeks, that is, two months are allotted for elective rotations after completion of the examination at the end of the MBBS Phase III-Part 1 and before the commencement of MBBS Phase III-Part 2. 3
Electives are divided into two blocks (four weeks duration each).
Block-1: Electives from preclinical or paraclinical or other basic sciences (laboratory) or under a research cell.
Block-2: Department of clinical orientation such as specialties, super-specialties, casualty, blood bank, and ICUs.
While designing an elective course, the planners should state the specific learning objectives, the length of the course, the plan of the sessions, the course organizer, resource materials, and any other prerequisites. The name of the coordinating faculty and the number of candidates permitted to join the course after giving due consideration to the available resources should be notified beforehand to the students. Some popular elective postings for medical students in India include:
For Block 1
Pharmacology: Students get exposure to varied facets like therapeutic drug monitoring, adverse drug reaction reporting and prescription audits.
Biochemistry: Students get an insight into understanding the correlation between biochemical parameters and various diseases such as infectious, endocrinal, and metabolic diseases.
Community Medicine: Get trained in carrying out community-based surveys, analyse data using vital statistical tools etc.
For Block 2
Medicine: Students can gain hands-on experience managing common medical conditions such as diabetes, hypertension, and infections by working alongside experienced physicians in this specialty.
Surgery: As medical students, they can observe and assist in surgical procedures in various specialties such as general surgery, neurosurgery, orthopedics etc.
Paediatrics: They can learn how to care for children and infants by observing and assisting in paediatric clinics, neonatal units, and paediatric wards.
Obstetrics and Gynecology: Students can gain experience managing pregnancies, childbirth, and women's health by working alongside obstetricians and gynaecologists.
Psychiatry: They can observe and assist in managing patients with mental health conditions such as depression, anxiety, and schizophrenia.
Emergency Medicine: You can learn how to manage medical emergencies and trauma cases in the emergency department.
The allotment of the Elective posting could be done based on parameters such as student preferences based on career goals one possesses, academic performance, and the institutional feasibility for the same.
To judge the success of the program, the students can be assessed either during the course or toward the end by evaluating the log book and by giving grades. 4 Due considerations must be given to carrying out the assessment to ascertain the effectiveness of the program and if required, modify the course for the future batches of students. 5
Sum-up
Electives are like a gateway for the students to walk into the specialty they have preferred and understand the work pattern, adversities, and positive facets of it. This initiative serves as a pathbreaking step in opting for a future career and so it necessitates good groundwork by departments and faculty to make it a beneficial endeavor.
