Sunday, June 08, 2014

D.N.B. in surgery and surgical specialities Is it a failure in India?


Diplomate in National Board (DNB) conducted by National Board of Examinations is considered to be equivalent to post graduate degree in the concerned medical speciality.  This program was initially started with a noble intention of providing post graduate training to a large number of students utilizing facilities available in the public and private sector hospitals.  Now students have started asking whether it is really worthwhile pursuing this stream of education particularly in surgery and surgical specialities.  At present DNB program is available in 54 specialities.

What ails the program?

1. There is no structured teaching program to train post graduate students as these courses are held in Non PG teaching Institutions.  Medical colleges with structured Post graduate program cannot conduct DNB courses.

2. Private institutions cannot give surgical chances to these students as they need to keep their finances in mind.

3. The DNB students are just treated as cheap labor by the training institutions

4. There is virtually no mentoring of the students in most of the Institutions

It should be stressed that surgery cannot be learnt from text books or from watching videos.  A trainee acquires surgical skill only by repeated practice.  Surgical training is virtually non existent for these students in private DNB training institutions.

What are the Pluses of structured university guided Post graduate training program?

1. Training is objective and module based

2. Teaching schedule is structured

3. In Government Institutions clinical material are available in plenty.

4. Student teacher ratio are scrupulously maintained because of constant MCI vigilance

5. Professors spend lot of time with post graduate students mentoring them because they are paid for the job.

At present the drop out rate among DNB students is rather high (more than 60%).  We should understand that the present day students spend a lot of time and resources preparing for a career, hence they have every right to  be disappointed.

The way out:

National Board should stress on the importance of practical training.  It should keep a constant vigil on the quality of education imparted.  It should clearly evolve  compulsory skill sets a student is supposed to posses after completion of the course.

Every DNB training centre should be accredited to the near by Post graduate training Medical Colleges so that students can attend lecture classes conducted in these institutions.

DNB training centers should have free teaching beds.  Currently even though they submit that they have free beds at the time of accreditation it is not so.

Let us at least now be impassionate, wake up to the reality and take corrective measures lest the program with meet its eventual end.