Graduate Medical Regulations
“Indian Medical Graduate” (IMG) possessing requisite
knowledge, skills, attitudes, values and responsiveness, so
that he or she may function appropriately and effectively as a
physician of first contact of the community while being
globally relevant.
Revised Regulations on Graduate Medical Education, “Indian
Medical Graduate”
ROLES
• Clinician - preventive, promotive, curative, palliative and holistic care
with compassion
• Leader and member of the health care team -collect analyze,
synthesize and communicate health data
• Communicator - patients, families, colleagues and community
• Lifelong learner - continuous improvement
• Professional - ethical, responsive and accountable
How it is being learnt now?
My Teacher
Through
Hidden curriculum
The hidden curriculum
The hidden curriculum consists of those things the students
learn through the experience of attending college rather than
the stated educational objectives of such institutions
The declared curriculum The taught curriculum
What is assumed the The curriculum that is
students are learning presented
The learned curriculum
RM Harden. Medical Teacher,23,2001 What students actually learn
Attitude, Ethics and Communication
(AET-COM) Module
• Section I: Extract of goals, roles and universal competencies as
envisaged by IMG document
• Section II: Suggested teaching modules for each professional year ,
resources cases and method to teach
• Section III: List of additional non-core competencies that form a
desirable set of learning
• Section IV: Competency log - in a simulated setting
• progressing in complexity over time
Attitude, Ethics and Communication
(AET-COM) Module
• Section V: Formative elements that are observable by guides and
marked over time.
• Appendix 1: Set of competencies as approved by the Academic
Committee of the Medical Council of India
• Appendix 2: Modified communication skill rating tool adapted from
the Kalamazoo consensus
Learning Modules for Professional Year I
• Number of Modules: 5
• Number of hours: 34
Group Activity
Group 1: Module 1 , AETCOM Booklet Pg. 18
Group 2: Module 2, AETCOM Booklet Pg. 20
Group 3: Module 3, AETCOM Booklet Pg. 22
Group 4: Module 4, AETCOM Booklet Pg. 25
Group 5: Module 5, AETCOM Booklet Pg. 27
Using the booklet on the table, Discuss amongst your group members
the features of respective module – 10 minutes
Each group presents the learning experience of respective module –
(2-3 minutes)
Group Activity
Points to be presented:
• Background
• Competency Addressed
• Types of learning experiences for students
• Content in brief
• Assessment
• Comment on the feasibility of implementation
Doctor – Patient encounter:
Kalamazoo statement 7essential skills
1. Building the doctor patient relationship
2. Opening the discussion
3. Gathering information
4. Understanding the patient’s perspective
5. Sharing information
6. Reaching agreement on problems and plans
7. Provide closure
SPIKES- Six- Step Protocol for Delivering Bad
News
• Step 1: S- Setting Up The Interview
• Step 2: P- Assessing The Patient’s Perception
• Step 3: I- Obtaining The Patient’s Invitation
• Step 4: K- Giving Knowledge And Information To The Patient
• Step 5: E- Addressing The Patient’s Emotions With Empathic
Responses
• Step 6: S- Strategy and Summary
Foundations of Communication skills
• 1.4 : Introduction : principles of communication
• 2.1 : Kalamazoo statement skills : active listening and data gathering
• 3.1 : Dealing with emotions
• 3.3 : Administering informed consent
• 4.1 : Communicating diagnosis, prognosis, therapy options
Attitudes/ perspective taking
• 1.1 : Doctor
• 1.2 : Patient
• 1.3 : Doctor Patient relationship
• 2.4 : Team member
• 2.8 : Family member
• 4.4 : Empathy
Ethics
• 1.5 : Cadaver as our first teacher
• 2.2 : Foundations of bioethics : 4 principles
• 2.3 : Respecting health care as a right of patient
• 3.2 : Disclosing medical error
• 3.4 : Confidentiality
•…
•…
• 4.8 : Dealing with death
• 4.9 : Medical negligence
What
How
Teach By example
Classical approach
Vs
Direct and explicit teaching
What and How to teach?
Attitude- Teaching ?
• Modules
• Role play
• Feed Back
• Project work
• Field trips
• Medical camps
• Voluntary services
• NCC / NSS
• [Link]
Implications
• Experiential learning
• Reflection
• Narration
Assessment in AETCOM
• 75% attendance for eligibility to appear in final
• Internal assessment
o Written : short note , creative writing experience
o OSCE based case scenario/ viva voce
• At least one question in each paper of clinical specialities in university
exam to test knowledge domain
• Skill competencies to be tested during clinical/ practical exam
• Log book
Summing up….
Taste it yourself