Natl Med J India
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Evaluation of 3-year tuberculosis external quality assessment results of public health laboratories.
Background We aimed to evaluate the 3-year participation status of tuberculosis (TB) laboratories in public health laboratories (PHL) tuberculosis external quality assessment (EQA) and EQA results. Method During 2018-2020, PHLs participated in the EQA programme organized annually by the National Tuberculosis Reference Laboratory (NTRL). Five kinds of EQA samples were sent to the participating laboratories on three parameters, including microscopy, culture and phenotypic first-line drug susceptibility testing and they were asked to perform according to the standard protocol. ⋯ Results A total of 24 PHLs participated in the EQA in 2018; 30 in 2019 and 23 in 2020. In terms of sensitivity, specificity, accuracy and reproducibility in microscopy, respectively, in 2018, 20 of the laboratories were 100%, 4 of them 80%, and in culture 16 of them were 100% and 2 of them 80%; in 2019, 28 of them were 100%, 2 of them 80%, and in culture 11 of them were 100%, 6 of them 80%, 1 of them 60%; in 2020, 20 of them were 100%, 3 of them 80%, and in culture 13 of them were 100% and 3 of them 80%. Conclusion It is beneficial for laboratories working on TB to participate in EQA in terms of evaluating the accuracy and reliability of the method used.
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Background The newly introduced 'Elective programme', a voluntary special study module in the final phase of the undergraduate medical curriculum, offers scope for new immersive, self-directed learning opportunities. We describe a programme of study for learning 'medical sociology' through the innovative use of humanities in medicine. Methods Our elective module, called 'Community Health and Rock Music' (CHaRM), was a 2-week programme, merging the curricular subject of community health with 'rock music' as an exposure to the 'counter-culture' outside of the medical world. ⋯ Additional learning was the exposure to the 'counter-culture of arts'. All 7 student assessments 'met expectation', with 4 of them 'exceeding expectation'. Conclusion An 'elective programme' combining humanities with medicine is potentially an innovative, student-centric and replicable model of learning that impacts the affective domain critical for doctors-in-training.
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Evaluation of a novel method for teaching drawing of histology diagrams to first year MBBS students.
Background The challenge faced by an undergraduate medical student to draw factually correct histology diagrams needs to be addressed by the use of innovative teaching strategies. We introduced a new method to teach drawing of histology diagrams and compared its outcome with two preexisting methods. We obtained feedback from the students and faculty. ⋯ The quality of diagrams produced by methods 2 and 3 were better than those by method 1, and equally so. The ease of drawing and time taken to draw were the best for method 2. Hence, overall, method 2 may be adjudged the best method.
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Historical Article
India's role in the odyssey of medical training in South Africa.
Apartheid had a devastating impact on medical education in South Africa. Until the development of the University of Natal Medical School in 1951, there were minimal opportunities for blacks (collectively Africans, Indians and so-called coloureds) to undertake undergraduate and postgraduate medical training in South Africa. At the height of apartheid (1968-1977), whites who had constituted 17% of the population, accounted for up to 87% of all medical graduates. ⋯ The global isolation of South Africa from the late 1940s further impacted negatively on the medical training for blacks in South Africa. During apartheid, the Government of India provided full scholarships to the marginalized in South Africa to study medicine in India. This initiative, coming at a time when India was grappling with its post-colonial challenges, was a remarkable yet seldom appreciated gesture.
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To compensate for physician shortage, many countries around the world have introduced a cadre of mid-level healthcare providers (MLHPs) into their health systems to shoulder many of the conventional responsibilities of a physician. Besides backing their clinical competence and service quality, evidence and experience on MLHPs also supports their lower turnover and higher rural retention rates. In India, mainstreaming of MLHPs has time and again been met with resistance from organized medicine. ⋯ Aided by global precedents, we broaden the rationale for mainstreaming MLHPs, address some common misunderstandings, and describe the conducive emergent legal and policy landscape. We also explain how a possible reorganization of Indian healthcare, highly likely under expanded publicly financed health insurance and value-based healthcare regimes, can warrant greater health workforce differentiation and an expanded role of MLHPs in mainstream healthcare delivery. We also touch upon important political economy considerations, including the need for navigating organized medical opposition, involving medical stakeholders in the MLHP mainstreaming process, autonomous regulation of MLHP professions, streamlining MLHP competencies, and inclusive health financing systems.