WHERE DO WE STAND - MD COMMUNITY MEDICINE GRADUATES?

During industrial revolution, in the Western part of the world, Community Medicine was divided into Public Health and Family and Community medicine. These developments took place in the early 70s. Reference: http://www.fph.org.uk/uploads/r_origins_of_FPH.pdf We are lagging 50 years behind the Western world. In India, a MD Community Medicine graduate is taught both Family Medicine and Public Health.

A MD Community Medicine Graduate is trained to be,

1.      Public Health Specialist

2.      Primary Care Physician with special emphasis to infectious diseases ( All important infectious diseases prevalent in India), non communicable diseases (obesity, diabetes, hypertension, cardiovascular diseases, cancers, rheumatic heart disease etc), preventive obstetric care, preventive paediatric care,

3.      Programme Manager

4.      Health & Hospital Manager

5.      Epidemiologist

6.      Occupational health specialist

7.      Expert in public health nutrition  

Reference: http://www.iapsmgc.org/pgforum.php?page=mci_guidelines&mid=84

Problem statement:  

India has a great need for family physicians, as we have fewer doctors trained in MD General Medicine.  

India has a great need for specialist training of doctors in the field of Infectious disease, Non-communicable disease, Geriatric medicine, Occupational health. Many Universities in United Kingdom, United States, Saudi Arabia have options for the above mentioned specializations.

It is a sad state that India which is in so much need of doctors trained in the above specialties does not have MCI recognized degrees.  

In India, Family Medicine degree is recognized by MCI, parallel to that is the MPH course which is gaining momentum at present.  

Where do we Community Medicine Graduates trained in both the above disciplines stand?  

Therefore, We have the following 6 requests:

1]      MCI recognized MD Community Medicine (which includes components of Primary health care/ Family Medicine and Public Health) should be recognized as a more specialized degree than a MPH by any other science graduate.

2]      MD Community Medicine should be renamed as Family and Community Medicine. Thousands of universities in the world have Family and Community Medicine as a branch ( Reference links are provided below)  

i.            The University of Arizona Department of Family and Community Medicine. http://www.fcm.arizona.edu/  

ii.            The Department of Family & Community Medicine the University of Maryland Medical Center. http://medschool.umaryland.edu/familymedicine/ 

iii.            The Department of Family & Community Medicine at the University of Toronto, North America. http://www.dfcm.utoronto.ca/  

iv.        The Department of Family & Community Medicine at the University of California, San Francisco. http://fcm.ucsf.edu/  

v.        The Department of Family & Community Medicine at the UC Davis Health System, Sacramento, CA. http://www.ucdmc.ucdavis.edu/famcommed/ vi.        The Department of Family & Community Medicine at the University of Kentucky College of Medicine, UK Medical Center MN 150 - Lexington KY, USA. https://familymedicine.med.uky.edu/  

vii.        The Department of Family & Community Medicine at the Northwestern University, Chicago. http://www.familymedicine.northwestern.edu/  

viii.        The Department of Family & Community Medicine at the MU School of Medicine, University of Missouri Health, Columbia. http://medicine.missouri.edu/family-community-medicine/

3]      A MD Community Medicine graduate should be made eligible to take MCI recognized super specialization courses, which MCI should start as follows:-

a.       DM/Fellowship/PhD - Infectious diseases

b.      DM/Fellowship/PhD - Non communicable diseases

c.       DM/Fellowship/PhD - Public health nutrition

d.      DM/Fellowship/PhD - Epidemiology

e.       DM/Fellowship/PhD - Occupational health

f.        DM/Fellowship/PhD – Health administration

g.      DM/Fellowship/PhD – Biostatistics

i.       DM/Fellowship/PhD – Geriatric Medicine

In USA family medicine physician can do fellowships like – adolescent medicine, geriatric medicine, hospice and palliative medicine, maternal and child health, sports medicine, sleep medicine, emergency medicine, addiction medicine, etc.  Reference- https://nf.aafp.org/Directories/Fellowship/Results

4]      Public Health Cadres should be created at Administrative level and Health Department similar to IAS/IPS/IFS cadres. Competitive exams can be set up for the same.

5]      A MD Community Medicine graduate should get posts above Programme Officers level in MOHFW. At present only MBBS graduate or a person with any degree can get that post without the Public Health specialization.

6]      MCI, State Medical Councils, Ministry and Ethical Committees must have a member with MD Community Medicine degree.