Monday, July 27, 2009

Repurcussions of New Education Agenda

The report given by Prof. Yashpal Committee has been taken by the Ministry of HRD on war footing along with the recommendations of the National Knowledge Commission as part of the 100 day agenda of change. It would be wise to go along with the tide and see how it can be leveraged to the strategic advantage of CCH in the shifting sands of educational reforms. The proposed legislation on Special Educational Zones that is under consideration by the Ministry of Commerce and Trade also has to be watched with concern and interest to see what elements of surprise it has in store.

Overall, a situation that is unsettling for the old guard and the Status quoists and a huge vista of opportunity for those who are driving for a positive change

Sunday, July 5, 2009

Curriculum Re-engineering for BHMS Course

Roadmap for Curriculum Re-engineering
 Draft the vision statement for a basic homoeopathic doctor
 Discuss with peer group and finalise the Vision statement of a basic homoeopathic doctor
 Brainstorm for the knowledge, attitude, communication and skills that are expected of the basic homoeopathic doctor
 Arrange these educational components into ‘disciplines’.
 Evolve the weightage for each of the ‘discipline specific’ components
 State the departmental objectives of each of the departments and the interdepartmental objectives for a BHMS course
 Generate the specific instructional objectives for each of the discipline / subject and the instructional objectives for the interdepartmental areas
 Categorise each of these objectives into the four domains of medical education
 Identify the content for achieving each of the instructional objectives
 Suggest the appropriate Teaching / Learning methods and media
 Indicate the feasible evaluation methods to assess the learners for the achievement or otherwise of the intended learning objectives
 Identify a University, which has about three to four homoeopathic institutions imparting BHMS course within a radius of 25 to 30 kilometers to test run the course from the first year onwards.
 Assure academic parity for the students who enroll for the BHMS course of that University
 Impress upon the University academic bodies and the institutions to implement the new curriculum
 Train the teachers of the homoeopathic institutions of that University and the possible external examiners in the principles of educational science and technology
 Conduct the course and the examinations as per the re-engineered curriculum
 Obtain regular feedback and rectify the errors on a priority basis
 Provide transparency for all the stakeholders like students, teachers, administrators and parents in the educational process
 Evaluate the effectiveness of this program as an experiment against the control group of the existing curriculum
 Rectify the loopholes and improve upon the program
 Extend the program across the board
Vision statement of BHMS Course
The purpose of BHMS Course is to evolve a Basic Homeopathic Doctor. The education of Basic Homeopathic Doctor shall be to integrate the principles of homeopathic philosophy with the understanding of basic and applied clinical disciplines, so as to provide sufficient and relevant knowledge, skills and aptitude for the practice of homeopathy in the Community / Hospital Health Care Situations.
Qualities of a Basic Homeopathic Doctor
1. Understanding of the concept of health / disease / healing from the homeopathic view point
2. Understanding of functional aspect of human health as per the basic medical sciences
3. Understanding of disruption of human health dynamics through horizontal integration of the para-clinical disciplines like Pathology and Microbiology with the principles of homeopathy
4. Understanding of diagnostic methods by vertical and horizontal integration of homeopathic principles with clinical disciplines like Practice of Medicine, Surgery, Obstetrics & Gynaecology and their allied specialities
5. Understanding of the outcomes of Homeopathic Pathogenetic Trials’ and their clinical verifications as ‘Data Base’ for prescriptions
6. Understanding the basic pharmaceutical procedures in homeopathy - preparation of medicine, potency scales, dosage forms
7. Understanding of the multidimensional learning of Drug Action
8. Understanding of the various Strategies of Prescription and demonstration of their application in practice
9. Understanding of the legal and ethical issues involved in the medical practice
10. Understanding of the scope and limitations of homeopathy for the doctors’ own patients or community in which they work
11. Competence to practice preventive, promotive, curative and rehabilitative medicine in respect to the priority health issues
12. Understanding of the socio-psychological, cultural, economic and environmental factors affecting health and develop humane attitude towards discharging one’s professional responsibilities
Learning objectives classified into –
1. Anatomy including Embryology
2. Physiology including Biophysics and Biochemistry
3. Homeopathic Pharmaceutics
4. Homeopathic Materia Medica
5. Homeopathic Philosophy including Foundation Course
6. Homeopathic Repertory
7. Pathology including Microbiology and Parasitology
8. Forensic Medicine including Medical Jurisprudence and Toxicology
9. Community Medicine
10. Principles and Practice of Obstetrics and Gynaecology
11. Principles and Practice of Surgery including its allied specialities
12. Principles and Practice of Medicine including its allied specialities
Phases of BHMS Course
Phase I: (12 Months)
No. Subject Teaching Hours
Theory Practical
1 Anatomy including Embryology 200 100
2 Physiology including Biophysics and Biochemistry 200 100
3 Homoeopathic Pharmacology & Pharmaceutics 200 100
4 Principles of homoeopathy 200 -
5 Foundation Course consisting of - Logic, Philosophy, Psychology, Biostatistics * 200 -
* No term end examinations. Assessment in the form of Assignments, Project work, Seminars, etc.

Phase II: (18 Months)
No. Subject Teaching Hours
Theory Practical
1 Pathology including Microbiology 200 100
2 Forensic Medicine including Medical Jurisprudence and Toxicology 100 50
3 Homoeopathic Materia Medica 200 100
4 Organon and Homoeopathic Philosophy 200 100
5 Community Medicine * 100 100
6 Obstetrics and Gynaecology * 100 100
7 Principles of Surgery * 150 50
8 Practice of Medicine * 100 50
* University Examinations not to be conducted during this phase

Phase III: (12 Months)
No. Subject Teaching Hours
Theory Practical
1 Community Medicine 100 100
2 Obstetrics and Gynaecology 100 100
3 Principles of Surgery 100 100
4 Practice of Medicine * 100 50
5 Homoeopathic Materia Medica 100 100
6 Organon and Homoeopathic Philosophy 100 100
7 Homoeopathic Repertory * 50 -
* University Examinations not to be conducted during this phase

Phase IV: (12 Months)
No. Subject Teaching Hours
Theory Practical
1 Homoeopathic Materia Medica 200 100
2 Theory of Chronic Diseases and Homoeopathic Philosophy 100 100
3 Homoeopathic Repertory 100 200
4 Practice of Medicine 200 200

Phase V: (12 Months) – Internship
Apart from the hospital / clinic / community based medical service, this shall include seminars, project work, assignment, etc to develop
 Communication skills, Personality development, Managerial skills
Examination Scheme
For every 100 marks of theory paper,
 Practicals – 40 + 10 (internal assessment)
 Viva – 30 + 20 (internal assessment)
Internal assessment shall be calculated as 20% of Continuous Assessment Test score in the Practicals and 40% of the Continuous Assessment Test score in the Theory exams. There shall be at least three Continuous Assessment Tests in each Academic Phase.
Eligibility to appear for Phase 1 exam
 80% attendance in the subject(s) concerned
 Appearance in at least two-thirds of the Continuous Assessment Tests
 Minimum score of 50% in the CAT
 Successful completion of the Project / Assignment for the Foundation Course
* The candidate may not be promoted to the next higher class unless he / she has successfully completed ALL the subjects
Eligibility to appear for further exams
 80% attendance in the subject(s) concerned
 Appearance in at least two-thirds of the Continuous Assessment Tests
 Minimum score of 50% in the CAT
 The candidate may be promoted to the next higher class even if he / she has not successfully completed all the subjects till Phase 4 of the course
 The candidate shall be allowed to carry over the papers till Phase 4. This facility is made to provide continuity for the clinical postings
 However the candidate shall be permitted to appear for Phase 3 exam, only after successfully completing all the Phase 2 papers, and phase 4 exam only after successfully completing all the Phase 3 papers
Examination pattern
 Examinations shall be conducted as Theory, Practical / Clinical and Viva.
 Practical / clinical examinations for the subject Principles of Homoeopathy in Phase 1 of the examinations need not be conducted.
 Theory exam for every 100 marks shall have 2 long essays of 10 marks each, 12 short essays of 5 marks each and 10 short answers of 2 marks each.
 The practical / clinical examinations shall be patterned on Objective Structured Practical / Clinical Examination
 The Viva shall be patterned on Structured Oral Examination

Restructuring homeopathic postgraduate curriculum

Vision of MD Homeopathy Course
To generate human resources who can align with the objectives of national health programs and improve the contribution of homeopathy as clinicians, researchers and teachers.

Objectives
The postgraduate in homeopathy shall –
o acquire a high degree of proficiency in theoretical and practical aspects of homeopathy
o recognise the need of physical, mental, spiritual and social health concerns of the sick
o be aware of appropriate investigation procedures to diagnose and manage the sick
o adapt scientific disposition while acquiring knowledge and skills relevant to homeopathy
o obtain adequate competency in providing comprehensive health care
o develop communication and interpersonal skills for interacting with the sick and members of health care teams
o develop ethical outlook in relation to clinical practice, research and teaching

Course Structure

MD Part I
It shall be for the duration of one academic year. It shall consist of the following subjects –
o Human Biology – comprising of horizontal integration of anatomy, physiology, biochemistry, psychology and having a homoeopathic orientation.
o Homoeopathic Concept of Disease – comprising of horizontal integration of pathology, microbiology, community medicine with homoeopathic principles and vertical integration of homoeopathic philosophy with clinical subjects like medicine, surgery, obstetrics and gynaecology.
o Research Methodology and Biostatistics – research procedure, research design, sample design, significance of biostatistics in research studies, statistical tests of significance, essence of biomedical ethics, biomedical ethics in relation to homeopathic research, etc.
o History of Medicine – events and personalities who have influenced the course of medical practice with special reference to homoeopathic practice.

Note – Resources for the integrated teaching / learning of the subjects Human Biology and Homoeopathic Concept of Disease have not been developed. Thus, there is a need to co-operatively generate such resources, so that there is objectivity both in teaching and evaluation. Central Council of Homeopathy may constitute a one-man committee to prepare a framework of curriculum for these subjects. Subsequently, subject experts in the constituent disciplines may be invited for a workshop, which can finalise content both for theory and practical teaching.

Activities
o House job with special focus on wards and clinics of the specialty subject to which admission is taken
o Lectures and practicals on Research Methodology and Biostatistics
o Lectures and practicals on Human Biology and Homoeopathic Concept of Disease
o Submission of synopsis to the university within six months of admission to the course
o Seminars, symposia, group discussions, assignments, project, journal reviews and poster presentation on the topics of MD Part I subjects.
o Teaching sessions for the undergraduate students in both classroom and wards for the specialty subject to which admission is taken

MD Part II
It shall be for the duration of two academic years. It shall consist of the speciality subject only. Examination shall be held at the end of two academic years.
Activities
o Lectures and clinical / practicals on Specialty subject
o Seminars, symposia, group discussions, assignments, project, journal reviews and poster presentation on the specialty subject.
o Teaching sessions for the undergraduate students in both classroom and wards for the specialty subject
o Planning and conducting of the research study under the supervision of Guide
o Submission of dissertation to the university six months before Part II examination

Papers for Examination
Examination for History of Medicine shall consist of
o one theory paper of 100 marks on 9th month of academic year
o one project on a topic of history relevant to homeopathy mutually decided by the student and guide for 75 marks
o one poster presentation on a topic of history relevant to homeopathy mutually decided by the student and guide for 25 marks
o one seminar on a topic of history relevant to homeopathy mutually decided by the student and guide for 50 marks

Evaluation criteria for certification
Evaluation Maximum marks Total marks Minimum marks
Theory exam 100 100 50
Project 75
150
75
Poster presentation 25
Seminar 50

MD Part I

Subject Theory Int. Assessment Viva Total
Max Min Max Min Max Min Max Min
Human Biology 100 50 50 25 50 25 200 100
Homoeopathic Concept of Disease 100 50 50 25 50 25 200 100
Research Methodology & Biostatistics 100 50 50 25 50 25 200 100

Internal Assessment shall be as follows –
Human Biology – 2 theory paper for 100 marks each on 6th and 9th month of academic year.
Homoeopathic Concept of Disease – 2 theory paper for 100 marks each on 6th and 9th month of academic year
Research Methodology and Biostatistics – 2 theory paper for 100 marks each on 6th and 9th month of academic year

MD Part II

Specialty Subject Theory Clin / Pract Viva Total
Max Min Max Min Max Min Max Min
Paper 1 100

200

100

50

100

50

600

300
Paper 2 100
Paper 3 100
Paper 4 100

Dissertation
o Shall be submitted to the university six months before Part II examination
o Two copies shall be submitted to the university along with a CD
o Dissertation shall be valued by two examiners – one internal and one external by persons who are eligible to be guide in that subject
o Approval from both the examiners is necessary for the candidate to appear for Part II exam
o In case one of the examiners does not approve the dissertation, it may be sent to another examiner – external if the external examiner has disapproved and internal if the internal has disapproved the dissertation.
o In case both the examiners have disapproved the dissertation in the first instance or if the third examiner also disapproves the dissertation, it may be returned to the candidate with the remarks of examiners, so that the candidate may resubmit it after making suitable amends within six months.
o The candidate shall be permitted to appear for Part II exam only after the dissertation is approved

Examination
Part I exam shall be conducted after completing one academic year
o To be eligible for part I exam, the candidate shall have
 at least 80% attendance
 successfully completed the log book comprising of 10 cases, 6 seminars and 6 journal reviews to the satisfaction of the Guide
 completed 20 hours of teaching undergraduate classes
 obtained at least 50% in the assessment of History of Medicine
 obtained at least 50% in the internal assessment of Human Biology, Homoeopathic Concept of Disease and Research Methodology & Biostatistics
o To be successful, the candidate shall obtain at least 50% separately in theory and viva in each of the three subjects
o Two examiners – one internal and one external – shall conduct viva, with each awarding marks out of 25. Total of these marks shall decide the result
o In case the candidate in unsuccessful in any of the subject he / she has to appear for the theory and viva of that subject only

Part II exam shall be conducted after completing two academic years
o To be eligible for Part II exam, the candidate shall have
 at least 80% attendance
 successfully completed Part I exam at least two years before Part II exam
 completed the log book comprising of 60 cases – 30 chronic and 30 acute, 12 seminars and 12 journal reviews to the satisfaction of the Guide
 completed 50 hours of teaching undergraduate classes obtained approval of the examiners for dissertation
o To be successful, the candidate shall obtain at least 50% separately in theory, clinical / practical and viva
o Four examiners – two internals and two externals – shall conduct viva. Guide of the candidate shall be one of the internals, Each examiner shall award marks out of 25. Total of these marks shall decide the result.
o Clinical examination shall consist of a chronic case and an acute case. Chronic case shall be evaluated for 70 marks and acute for 30. Evaluation shall be conducted jointly by the examiners, each of who shall award marks out of 70 for chronic and 30 for acute case. Average of these marks shall be calculated for declaring the result.
o In case of Practical examination in Homoeopathic Pharmacy, the examination shall consist of a major procedure and a minor procedure. Major procedure shall be evaluated for 70 marks and the minor for 30. The examiners shall conduct evaluation jointly, each of who shall award marks out of 70 for major and 30 for minor procedure. Average of these marks shall be calculated for declaring the result.
o In case the candidate in unsuccessful in any part of the paper, he / she has to appear for the entire paper consisting of theory, clinical / practical and viva

Examiners
Part I examiner shall be selected as follows
 Human Biology from the faculty of Materia Medica, who shall co-ordinate the PG Department of Human Biology
 Homoeopathic Concept of Disease from the faculty of Homoeopathic Philosophy, who shall co-ordinate the PG Department of Homoeopathic Concept of Disease
 Research Methodology and Biostatistics, from the faculty of Repertory, who shall co-ordinate the PG Department of Research Methodology and Biostatistics
o Evaluation and PG Department of History of Medicine shall be co-ordinated by the faculty of Homoeopathic Philosophy
o The examiner so selected shall
 have MD Hom in the relevant subject, i.e., Materia Medica, Homoeopathic Philosophy or Repertory as the case may be
 hold at least the rank of Assistant Professor
 have at least ten years of teaching experience in an institution recognised by Central Council of Homeopathy
 be in the relevant PG Department

Part II examiner shall
 have MD Hom in the specialty subject
 hold at least the rank of Assistant Professor
 have at least ten years of teaching experience in the subject concerned in an institution recognised by Central Council of Homeopathy

Restrucruring homeopathic postgraduate education - an outline

Postgraduate Curriculum for Homeopathy
Course duration – 3 years
Phase I – 18 months
Phase II – 18 months
Phase I Highlights
 Postings in hospital, peripheral OP, Mobile Clinics, Health Camps
 Assignments to integrate National Health programs, Priority Health Problems and Homeopathic Philosophy
 Teaching / Learning situations – Case presentations, Group discussions, Ward rounds, Seminars, Journal club, etc
 Identification of research subject, Synopsis presentation
 Formative evaluation of the assignments, Case presentation, Group discussions, Ward rounds, Seminars, Journal club, etc
 Certifying evaluation for theory paper in Research methodology and Biostatistics for 100 marks and viva for 50 marks.
 Internal assessment of 50 marks for the assignments and case presentations
Phase II Highlights
 Postings in hospital, peripheral OP, Mobile Clinics, Health Camps
 Assignments to integrate National Health programs, Priority Health Problems and Homeopathic Philosophy
 Teaching / Learning situations – Case presentations, Group discussions, Ward rounds, Seminars, Journal club, etc
 Research program and Dissertation
 Certifying examination as follows
• Theory papers : 200 marks
• Clinical exam : 100 marks
• Viva on Dissertation : 100 marks

Need for postgraduate education in homeopathy

Every growing branch of knowledge needs both vertical and horizontal growth. Horizontal growth denotes extensive learning at every level. Vertical growth denotes an in-depth study involving subject specialisation. This vertical growth symbolises the postgraduate education. Homeopathy too as a branch of knowledge has to organise education at postgraduate level.

Postgraduate education in general aims at generating human resources who can be counted as experts in the field, advanced knowledge that could improve significance of the discipline and skills that could enhance practical use of the discipline. Thus the major need for any postgraduate study is awareness that there is a scope for improvement in that discipline. This knowledge improvement could be in the understanding the basics of the discipline or in improving the applicability of the discipline. Such an improvement is brought about by a procedure of enquiry, observation and interpretation, which are collectively called as research. Thus, research is a systematic process based on logical principles, of evolving new knowledge and skills to solve problems or improve the existing problem solving skills. Postgraduate education in homeopathy is a relatively recent phenomenon that is aimed at improving the state and status of homeopathic practice and education. As in any course, the purpose of postgraduate education in homeopathy should aim at elevating the basic and applied knowledge and skills of homeopathy.

Need for postgraduate education in homeopathy is two-fold –

î To advance knowledge and skills for professional performance, and

î To produce human resources who can support academic structure.

Need and modus operandii of research for advancement of professional knowledge and skills is explained under the heading Relevance of research in homeopathy, later in the same chapter. The need to have competent human resources to support academic homeopathic structure has to be objectively discussed to organise the postgraduate education.

Subjects for study in homeopathic undergraduate course can be conveniently classified as –

î Pre-clinical

î Para-clinical

î Clinical

> General clinical

> Applied homeopathic

î Homeopathic.

Pre-clinical subjects include Anatomy, Physiology and Biochemistry. Para-clinical subjects include Pathology, Microbiology, Community Medicine and Forensic Medicine. Clinical subjects include Medicine, Surgery, Obstetrics and Gynaecology. These clinical subjects have a purely clinical component that helps in learning the evolution, presentation, assessment and management of clinical conditions and a parallel homeopathic component for understanding evolution, assessment and management of the same conditions from homeopathic perspective. This point of view is drawn from homeopathic disciplines like its Philosophy and Materia Medica. The purely homeopathic subjects include Homeopathic Pharmacy, Homeopathic Philosophy including Organon of Medicine & theory of Chronic Diseases, Homeopathic Materia Medica and Homeopathic Repertory.

Pre-clinical subjects help the learner to know about normal parameters of health, i.e., how a human body is structured and how does it function. It is advantageous to include Psychology to know how normal human body behaves. Para-clinical subjects help the learner to understand how human body shifts to disease state, what are the possible causes for the shift, how to plan health promotion and disease prevention schedule and what are the legal and ethical implications of homeopathic practice. Such knowledge has to be gained from homeopathic perspective.

Thus, there is a need to develop human resources who can facilitate learning of human health and disease from homeopathic orientation. This is where postgraduate courses for homeopathic teachers in these subjects assume importance. The Homoeopathy Central Council (Minimum Standards of Education) Amendment 2002 makes it mandatory for all homeopathically qualified teachers to have postgraduate qualification i. e. MD (Hom), both for entry level and promotions. Postgraduate courses in homeopathic and some clinical disciplines are now available to supply this requirement. However, teachers in pre- and para-clinical subjects will suffer professionally unless remedial measures are provided for their academic and professional advancement.

One option is to allow any homeopathic postgraduate qualification like MD (Hom) either in Materia Medica, Homeopathic Philosophy, Repertory, Medicine, Paediatrics, Psychiatry or Pharmacy as an accepted qualification to gain entry and promotions for any pre- para-clinical subject. Thus we may have the bizarre instance of MD (Hom) in repertory becoming a teacher in Anatomy; that speaks for the vision of academic planners in homeopathy.

The other option is to include postgraduate programs like MSc (Anatomy), MSc (Physiology), MSc (Biochemistry), MSc (Psychology), MSc (Pathology), MSc (Medical Microbiology), Master of Public Health, etc in The Homoeopathy Central Council (Minimum Standards of Education) Amendment, so that a BHMS graduate can pursue these courses to gain academically relevant knowledge and skills and grow professionally in these departments of homeopathic institute. BHMS qualified person with postgraduate qualification in relevant pre- and para-clinical discipline would be in a better academic state to teach and train homeopathic students in those subjects.

The third option is to design a post graduation program for these subjects in a way that it takes into consideration course content from homeopathic perspective. For example, Pathology is taught not just for histopathological content, but also their pathodynamics from core concepts of homeopathy. Such a curriculum may be structured on the principles of Educational Science and Technology, so that the teachers not only gain mastery over content but also competency in a wide range of curricular components like lesson planning, applying appropriate teaching – learning methods and media, and relevant evaluation techniques to make learning not only more meaningful but also enjoyable.

Postgraduate education in clinical and homeopathic disciplines also needs a review for academic competence. There has to be a dispassionate SWOT analysis of existing courses and openness and willingness to bring about changes if necessary to improve the academic stock of homeopathy.