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Tuesday, September 22, 2020

Maharashtra: Medical education goes online, with hiccups and low clinical exposure

With the focus entirely on coronavirus over the last five months, students fear the loss of an entire year as they grapple with online lectures and zero practical exposure.

Written by Tabassum Barnagarwala | Mumbai | Updated: August 26, 2020 9:55:00 am
Mumbai medical students, Mumbai news, Maharashtra news, coronavirus crisis, Medical students, Indian express newsMedical students write their exam at JJ hospital. (CCTV image)

At this time of the year, in the pre-Covid-19 world, undergraduate medical students, second year onwards, would mill about in hospital wards examining patients, taking their history, and crowding around their lecturers at patients’ bedsides. Postgraduates could be found in operation theatres assisting or observing a surgery. With the focus entirely on coronavirus over the last five months, students fear the loss of an entire year as they grapple with online lectures and zero practical exposure.

Akash Rade, a final-year MBBS student in Seth GS Medical College attached with KEM hospital, is at home in Jalgaon since March. Before the pandemic, MBBS students spent three hours in hospital wards daily to diagnose patients and learn about treatment lines from their lecturers. Those practical sessions have stopped.

“The final year is a formative year for us. Our lecturers are not taking online classes because they are busy so we have asked senior resident doctors to take classes,” Rade said.

An overburdened faculty is juggling between treating Covid-19 patients and taking online lectures. With network problems an issue, first-year students in KEM said they receive pre-recorded lectures each day. Teachers try but online interaction is zero.

The Maharashtra Association of Resident Doctors has asked the state government for a waiver in tuition fees in the absence of academic sessions. Earlier this month, MARD representatives met city mayor Kishori Pednekar to discuss the issue.

Rade received the preliminary exam question papers via email. He is expected to mail his answers back. This is the only way for medical colleges to conduct internal exams, with the risk that students might cheat.

Pranav Gaikwad, a first-year student, lives in picturesque Matheran, and says he finds it difficult to study from home. “In hospital, we would have group sessions. We would see patients around us and there was an atmosphere created to get seriously involved in studies. Right now that is difficult to achieve,” he says.

Second-year students face another problem. In a normal year, every second-year student would have been exposed to 20 autopsies. The count of post-mortems has fallen across government hospitals due to the coronavirus risk. Dr Harish Pathak, head of forensic department, KEM hospital, says the few autopsies they do cannot be streamed online for students. “We will have to compromise on the number of post-mortems they see,” he says.

Grant Medical College is yet to start online classes for third-year undergraduates. Dr Preeti Lewis, assistant professor in the gynaecology department, said, “A new curriculum for undergraduates has been introduced last year. Its implementation has also become a problem. Hopefully from September online classes will begin.”

In Lokmanya Tilak Municipal General hospital, Dr Sujata Baveja, head of microbiology, says the pandemic has changed the way medical education is approached. “We are also learning how to teach in this period. Online classes are a new concept for all of us and initial hiccups will be there,” she said.

Undergraduates are getting theoretical knowledge but zero practical exposure. And postgraduates have contrary problems: plenty of exposure to Covid-19 treatment but no time to study their specialisation. Students of general medicine, community medicine and anaesthesia department are getting good exposure as Covid-19 revolves around these specialities, but students of orthopaedics, general surgery, cardio-vascular, neurology and plastic surgery are complaining of lack of hands-on training in their specialty.

Currently operation theatres in medical colleges and hospitals like Nair, KEM and Sion are shut. In KEM hospital, doctors said they have started noticing fungus growing in cardio-vascular department’s OT. “Reopening all this will take time, even we want to resume normal classes and surgeries,” the doctor said.

While students fear they are losing out on education, orthopaedic surgeon Dr Dheeraj Sonavane in Grant Medical College said, “We are telling students this pandemic is a different form of learning.” Dr Hemant Deshmukh, dean in KEM hospital, agrees, “A doctor learns through practical experience as he works. A year lost will not affect in the long run.”

Dr R N Bharmal, director of medical education, BMC, said Maharashtra University of Health Sciences is ensuring lectures for undergraduates. “The challenge is for postgraduate students. We are slowly resuming non-Covid surgical branches. Even pandemic is a learning experience to tackle emergency management, community engagement. Surgical skills can be acquired later on in life,” he said.

The MUHS began theory exams from Tuesday across the state. Exam halls were sanitised and social distancing norms were followed in seating arrangement for students. In some centres, emergency isolation rooms were kept ready.

While government medical colleges are able to offer some exposure, in private hospitals the challenges are higher. Dr Girish Maindarkar, president of College of Physicians and Surgeons, said, “For students to get hands-on training we need patients. And patients are not ready to come to hospital for routine procedures.” In private hospitals, surgical rate has dipped to 10-20 per cent of usual count in five months.

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