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REVIEW ARTICLE
Year : 2021  |  Volume : 48  |  Issue : 1  |  Page : 3-6

Implementing foundation course for medical undergraduates in India


1 Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet, Tamil Nadu, India

Date of Submission29-Jan-2021
Date of Acceptance24-Mar-2021
Date of Web Publication5-May-2021

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_11_21

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  Abstract 


The delivery of medical education to the undergraduate medical students and producing a competent medical graduate is a complex task, especially considering the wide range of domains, in which a medical student has to be trained. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of four studies similar to the current study objectives were identified initially and all were selected based on the suitability with the current review objectives. In an effort to make the newly joined students get familiar with the campus environment and the general structure of the academic program, a month-long foundation course has been proposed. The regulatory body emphasized the need to evaluate the foundation course at institutional level so that it can be improved based on the received feedback for the upcoming batches of students. To conclude, the introduction of foundation course as a part of the competency-based medical education for undergraduate students is a welcome step. The foundation course has the potential to offer multiple benefits to the students, and thus it is the need of the hour that a thorough planning goes in the background, and all the available resources and logistics are utilized well for the effective implementation of the course.

Keywords: COVID-19 pandemic, foundation course, India, medical education


How to cite this article:
Shrivastava SR, Shrivastava PS. Implementing foundation course for medical undergraduates in India. J Sci Soc 2021;48:3-6

How to cite this URL:
Shrivastava SR, Shrivastava PS. Implementing foundation course for medical undergraduates in India. J Sci Soc [serial online] 2021 [cited 2021 Jun 17];48:3-6. Available from: https://www.jscisociety.com/text.asp?2021/48/1/3/315446




  Introduction Top


The delivery of medical education to the undergraduate medical students and producing a competent medical graduate is a complex task, especially considering the wide range of domains, in which a medical student has to be trained.[1] The intended training not only exposes medical students to the vast field of medical knowledge and clinical skills but also to the human interactions, interpersonal relationships, professionalism, etc., in heterogeneous settings.[2] In order to accomplish the desired results, a student is expected to be committed, dedicated, demonstrate mental resilience and an inclination toward self-directed and lifelong learning. However, this seems too much from students who join a medical college after completion of their school at a young age, and thus it makes it important to invest some time exclusively to familiarize them to the new environment.[1],[2]


  Methods Top


An extensive search of all materials related to the topic was carried out in the PubMed search engine and Medical Council of India website. Relevant research articles focusing on the foundation course in medical education in Indian settings published in the 2013–2020 period were included in the review. A total of four studies similar to the current study objectives were identified initially and all were selected based on the suitability with the current review objectives and analyzed. Keywords used in the search include foundation course, medical education, and India. The collected information is presented under the following subheadings, namely, orientation programs, overview and scope of foundation course, need of the foundation course, objectives of the foundation course, curricular governance, lessons from the field, evaluation of the foundation course, plan for the 2020 batch of undergraduate students, implications for practice, and implications for research.


  Orientation Programs Top


In an effort to make the newly joined students get familiar with the campus environment and the general structure of the academic program, it is a general practice in all the academic institutions to conduct some or the other kind of orientation programs.[2] The same stands true in medical colleges offering undergraduate program in India, and it is quite essential as students who enroll for the course belong to different geographical, sociocultural, linguistic, medium of instruction, and boards of education. In India, these orientation programs lacked standardization, as it was happening for variable period of time (namely, from 1 day to a week's time) and in terms of topics being covered as a part of the course.[2]


  Foundation Course: Overview and Scope Top


One of the most important events in the timeline of delivery of medical education in India has been the introduction of the competency-based medical education for undergraduate students admitted for the academic year 2019–2020.[1] In fact, a number of curricular innovations have been proposed with an ultimate goal to produce a competent Indian Medical Graduate (IMG) such as initiation of a month-long foundation course, the shift from the teacher-centered to student-centered learning, strengthening of assessment, and introduction of electives. As a matter of fact, the seeds for the five roles (namely, clinician, lifelong learner, leader, communicator, and professional) expected of an IMG are shown during the foundation course.[1]

The regulatory body has set the norms about the number of hours (175 h), and the modules (namely, orientation, skills, community orientation, professional development and ethics, improvement of language and computer skills, and sports and extracurricular activities) that need to be covered in the foundation course. Further, the norms pertaining to the attendance (minimum of 75%), and the need to obtain feedback about the course from students have also been specified so that the entire course can be evaluated for remediation and modifications. In order to minimize the stress on the students during this course, it has been envisaged that the performance of the students in the foundation course will not be considered as a part of the internal assessment.[1],[3]


  Need of the Foundation Course Top


The proposed foundation course has to be planned by the medical colleges in the 1st month of the medical training so that they are provided with desired knowledge and skills to make them familiar about their profession and the expectations from them.[2],[3] The broad scope of foundation course not only plays an important role in the accomplishment of the desired attributes but enhances the satisfaction level of students' and ensures continuous quality improvement. It will also act as the strong foundation for learning in the course and also in the professional career. As the emphasis will be more toward small group activities, the students will also be exposed to teamwork and leadership qualities.[2],[3],[4]


  Objectives of the Foundation Course Top


The purpose of the foundation course is to orient the students to all aspects of the medical education (such as scope of medical profession, role of the medical doctor in the well-being of community, the structure of the academic program, academic ambience, role of alternate health systems in the nation, importance of attitude-ethics-communication-professionalism, structure of the health-care delivery system, national health priorities, national policies, patient safety, and basic principles of primary care). The next objective is to support the students to upgrade their linguistic and interpersonal skills, prepare them for better time and stress management, and train them for optimal use of computer and information technology.[1],[4]


  Curricular Governance Top


In each of the medical institution, the course will be run under a faculty coordinator, who is identified by the dean from the first professional year.[1] It is the responsibility of the coordinator to identify the resource person from different specialty, coordinate their training, implement the program based on the available resources and logistics, and finally evaluate the program. The Medical Education Unit (MEU) is responsible for organizing the training session for the resource persons and capacity building.[3],[4] The overall monthly schedule has to be approved by the curriculum committee and should be shared with all the students and resource persons for seamless implementation. The faculty members of the first professional year will have a defining role in the implementation of the 1-month long foundation course.[3]

In order to make the sessions more effective and appealing, the resource persons are encouraged to make their sessions interactive and include different types of activities (namely, lectures, role plays, small group activities, and reflective writing). Each of the sessions has specific learning objectives and the resource person should strictly adhere to the same. The resource persons can be called from outside the institution as well for covering topics such as yoga or to address the need of children.[4],[5] It is extremely important to obtain feedback from both faculty and students and submit the same to the curriculum committee for further evaluation within a stipulated period of time. Moreover, the success of the overall program will depend on the overall planning and cooperation between faculty members.[3],[4],[5]


  Lessons from the Field Top


At Shri Sathya Sai Medical College and Research Institute, a constituent unit of the Sri Balaji Vidyapeeth, Puducherry, the entire team of the Curriculum Committee, MEU, and the faculty members from the first professional year worked for a number of months to develop the schedule of the month-long program for the first batch. At the same time, efforts were taken to synchronize the same with the timetable of foundation course of our constituent college. We were unique in the sense that we exposed students to sessions in music therapy and yoga therapy through trained teachers from outside the institution. In addition, the MEU formulated a checklist for the evaluation of the daily sessions, which was carried out by one member of the MEU on a daily basis. We met all the norms of each of the defined module, and feedback was obtained from students periodically to evaluate the program.


  Evaluation of the Foundation Course Top


The regulatory body emphasized the need to evaluate the foundation course at institutional level so that it can be improved based on the received feedback for the upcoming batches of students.[1] In fact, a questionnaire-based cross-sectional study was done in a medical college in Jammu and Kashmir involving both the students and the resource persons. A total of 63% and 69% students and resource person gave an overall positive feedback to the course, with skill module being identified as the most relevant by almost three-fourth of the 1st-year students.[4] However, from the faculty perspective, the module covering topics on sports and extracurricular activities was identified as the most relevant one in the foundation course.[4]

In another study done in a medical college in Pondicherry, it was reported that the foundation course was well received by the students, while the best part of the course was topics covered under the skill module and activities pertaining to field visits to the community and primary health center.[5] On inquiring about the suggestions for the modification in the program, both students and faculty were of the opinion to reduce the duration of didactic sessions and replace the same with practical and interactive activities. In addition, emphasis was given toward reducing the overall duration of the course and the need to ensure that topics are not repeated.[4],[5]

In terms of addition of topics, it was reported that they can be exposed to recording of vital signs in patients, plan for reading, preparation for exams, approach to balance study and hobbies, and exposure to the frequently used equipment in the field of medicine, can be incorporated.[4],[5] These findings should be given due acknowledgment and an action taken report should be formulated, which can be then discussed and improved on the level of the curriculum committee.


  Plan for the 2020 Batch of Undergraduate Students Top


Owing to the ongoing pandemic of coronavirus disease 2019, the admission process of the students for the 2020–2021 academic year has been delayed by more than 6 months. The academic course of the 2020 batch of medical undergraduates is starting from February month of 2021, but considering the delay in the start of the course, it has been proposed to not allocate one complete month for the conduction of the foundation course. The medical institutions are given freedom to plan the foundation course, and it is being encouraged to cover the various modules in the afternoon session of Saturdays or by engaging the students in the evening for an hour on a daily basis. However, the feedback about the course has to be obtained as usual, and all efforts should be taken to acclimatize the students to the academic ambience.


  Implications for Practice Top


The introduction of a foundation course at the start of the undergraduation course in a standardized manner was a much-awaited decision as there was an immense need for the same. As the regulatory body has formally introduced and has given lots of emphasis for the successful conduction of the foundation course, it becomes the responsibility of the Dean, Curriculum Committee, Medical Education Team, and the faculty of the first professional years to not only implement the course as per the laid norms but even keep it as interactive and organized as possible so that the students are benefited.[3],[4] The coordination between the entire working team is a must, and the administration should make adequate arrangements for information technology support and other logistics.


  Implication for Research Top


As it is a new initiative, it will have both positive and negative impacts, once the course is being implemented. This calls for the need to carry out research into the different aspects of the foundation course.[1] Each and every medical institution can plan for Kirkpatrick evaluation of the different sessions or the course as a whole, and the students can be made to share their views using both quantitative and qualitative research methods.[5] There is also a need to identify what went well and what needs improvement, and it is essential to obtain the views of both students as well as teachers (as they are the main pillars for the success of the program).[3],[4],[5] It is also essential that the remedial or corrective measures are taken based on the results of the studies, with a solitary intention to benefit the future generation of budding doctors.


  Conclusion Top


The introduction of foundation course as a part of the competency-based medical education for undergraduate students is a welcome step. The foundation course has the potential to offer multiple benefits to the students, and thus it is the need of the hour that a thorough planning goes in the background, and all the available resources and logistics are utilized well for the effective implementation of the course.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Medical Council of India. Foundation Course for the Undergraduate Medical Education Program - 2019. Available from: https://www.nmc.org.in/wp-content/uploads/2020/08/FOUNDATION-COURSE-MBBS-17.07.2019.pdf. [Last accessed on 2021 Jan 29].  Back to cited text no. 1
    
2.
Mittal R, Mahajan R, Mittal N. Foundation programme: A student's perspective. Int J Appl Basic Med Res 2013;3:52-4.  Back to cited text no. 2
    
3.
Dabas A, Verma D, Kumar D, Mishra D. Undergraduate Medical Students' Experience with Foundation Course at a Public Medical College in India. Indian Pediatr 2020;57:261-3.  Back to cited text no. 3
    
4.
Sobti S, Gupta M, Gupta V, Gupta A, Parihar S, Singh V. Assessment of newly introduced foundation course for medical undergraduates: Students' vs. faculty's perspective. J Family Med Prim Care 2020;9:3042-7.  Back to cited text no. 4
  [Full text]  
5.
Velusami D, R Dongre A, N Kagne R. Evaluation of one-month foundation course for the first year undergraduate students at a Medical College in Puducherry, India. J Adv Med Educ Prof 2020;8:165-71.  Back to cited text no. 5
    




 

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  In this article
Abstract
Introduction
Methods
Orientation Programs
Foundation Cours...
Need of the Foun...
Objectives of th...
Curricular Gover...
Lessons from the...
Evaluation of th...
Plan for the 202...
Implications for...
Implication for ...
Conclusion
References

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