Psychiatry training of undergraduates in India is crucial for providing mental health services to public. According to the World Health Organization, India, the second most populated nation in the world, has high morbidity and mortality due to mental health disorders. The prevalence of mental health disorders is nearly 14% as per the National Mental Health Survey 2015–2016. The Global Burden of Diseases Study 1990–2017 highlighted that, in India, one in seven was affected by mental health disorder of varying severity. Burden of mental disorders across the states of India was high with nearly 200 million people affected with mental health disorders, such as depression, anxiety disorders, substance use disorders, schizophrenia, bipolar affective disorders, and other psychiatric disorders. The Indian Psychiatric Society (IPS) has consistently appraised the Government of India and, the then Medical Council of India, the current National Medical Commission (NMC), about the necessity for mandatory psychiatric training of the budding doctors (MBBS students) to address the gap in mental health services. This is because of the limited availability of psychiatrists in India who are 0.292 per l00,000 population, according to the World Health Organization 2016 data with annual addition of another 700 psychiatrists. However, there has been substantial increase in the number of MBBS seats, every year more than 70,000 graduates as doctors from more than 500 medical colleges in India. Although the new competency-based MBBS curriculum enforced from 2019 has increased the duration of exposure for psychiatric training of medical students, it is disappointing that not a single skill in psychiatry is required for licensing and successful completion of MBBS training. The IPS has considered this lacuna as a major setback for mental health services in the Indian scenario. The IPS shall pursue through all means to appraise the Government of India and the NMC about the mandatory incorporation of psychiatric skill evaluation in MBBS training. The IPS held a 2-day deliberation involving experts from all over India and abroad at All India Institute of Medical Sciences, Rishikesh, on undergraduate psychiatry training. The group meticulously reflected upon all aspects of undergraduate psychiatric training, and deliberations were held on opportunities and challenges for psychiatry in the new competency-based MBBS curriculum. The group unanimously reiterated that psychiatric faculty should be trained in competency-based curriculum to maximize the utilization of allotted theory and clinical posting duration for psychiatry in the MBBS curriculum. The possible measures for training the psychiatric teachers were discussed, considering that as crucial in effective implementation of curriculum. Training of psychiatric teachers should happen at state and zonal level in a periodic manner. Within the next 3 years, at least one-third faculty members of psychiatry at Indian medical institutions should be trained in the teaching–learning methodologies that are specific to psychiatry. Guidelines on specific learning objectives for mental health disorders were presented, and teaching–learning methodology for each was discussed. The specific learning objectives and methodology shall be made available at the earliest possible period to the psychiatric faculty and the experts for critical evaluation. The group also considered encouraging faculty and psychiatric departments' involvement in the internship psychiatric training and designing of electives, which can be additional opportunity for undergraduate psychiatry training. Apart from this, foundation course and Attitude, Ethics, and Communication module mentioned in the new MBBS curriculum can also be a window of opportunity to engage the budding doctors positively. For autonomous institutions and deemed institutions, where psychiatry is a mandatory aspect of undergraduate evaluation or can become mandatory in the near future, additional resources and guidelines for the evaluation of MBBS psychiatric skill training were discussed upon and these documents on guidelines shall be made available at the earliest.
The IPS shall also actively engage with psychiatric faculty and regulatory body at various levels so that psychiatric faculty set the questions and evaluate for the allotted marks in Paper II of Medicine as mentioned in the new MBBS curriculum.
The group also discussed the proposed single entrance examination for medical postgraduation, National Exit Examination (NExT) under the NMC that has implications in undergraduate psychiatric training. The IPS shall immediately take measures to ensure that psychiatry is given proportionate and mandatory representation in the proposed NExT or similar examination for postgraduate medical entrance so that budding MBBS doctors do not neglect minimal psychiatric training, irrespective of their desired specialization. The IPS shall hold annual meeting to review the progress of psychiatric training in competency-based MBBS curriculum.