Table 1.
Medical curriculum and psychiatry training of medical students across the world$
| Country (regulatory body) | Undergraduate medical curriculum | Psychiatry training | Strength or Remark |
|---|---|---|---|
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| WHO-region: America | |||
| United States (Accreditation Council for Graduate Medical Education (ACGME))[33,34] | Program name: MD Duration: 4 years Pre-clerkship: 2 years Clerkship: 2 years |
Pre-clerkship: early human development (term 1), behavioral science with a focus on knowledge, communication, professionalism (term 4). Clerkship: 6 weeks in psychiatry, a major subject; Provision of elective clerkship, including in psychiatry. |
Integrative program Emphasis on supervised training Option for electives Teaching in a small group (SG) Summer courses, and research with credits Exposure to diverse settings (CAAMH, community, CL, forensic, old age psychiatry, etc.) Enrichment programs |
| Canada[35](CanMEDs, 2015) framework governs the standard of medical education) | Only graduate-entry program Duration: 4 years; First 2 years (foundations): basic science; Year 1: cognitive sciences; Year 2: chronic disease mgt., incl. mental health; Year 3 and 4: clerkship, incl. electives |
Around 8,000 hours of teaching per year at the MD Program Pre-clerkship: 3 weeks psychiatric rotation Clerkship: 6 weeks. Elective options in psychiatry. Exposure to CAMH, geriatric psychiatry, addiction medicine |
System-based curriculum Provision of joint degree programs; a limited number of interested students can simultaneously enroll in MSc/Ph.D. programs; research opportunities during electives. Case-based learning, multidisciplinary summary lecture, SG teaching |
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| WHO-region: Europe | |||
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| United Kingdom (General Medical Council (GMC))[36,37] | Course duration: 6 years First two years: pre-clinical Year 3-5: clinical posting Year 6: one year of foundation course (internship) |
First two years: medical psychology Year 3–5: 8 weeks clinical attachment in psychiatry Year 6: elective posting (10-week elective, student assistantship) |
Integrated approach Provision of student-selected components (SSCs): opportunity to pursue a subject of interest Classes in SGs Problem-focused learning Opportunity to be exposed to CL and forensic psychiatry, including mental health act, etc. Enrichment programs |
| Spain[38] | Course duration: 6 years, Preclinical: 3 years Clinical: next 3 years |
Second semester: psychological medicine (6 credits) Year 4: psychiatric attachment (6 credits) |
Enrichment program- Innovative Teaching Plan |
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| WHO-region: Mediterranean region | |||
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| Turkey# (National Core Curriculum)[39] | Course duration: 6 years, including one year of internship | Year 5: Lecture in psychiatry Duration: 40 hours of lectures, 10 hours of clinical training 20 days: Psychiatry rotation (3d in CAMH) mandatory exam at the end of the posting Internship: 1 month of clinical attachment. |
Internship in psychiatry is less robust considering a higher students to faculty ratio. Psychiatry receives lesser weightage in entrance exams for postgraduation. |
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| WHO-region: Africa | |||
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| Somaliland#[40] | Course duration: 5 years | Year 5: 20 weeks psychiatry teaching; 16 weeks of bed-side teaching (twice/week). Lecture throughout the psychiatry posting. 2 weeks: Theory lecture in global mental health -Interested students have the opportunity to participate in community outreach Assessment: mid-term- and final exam |
Alumni driven program Hybrid mode of teaching during the COVID-19 pandemic |
| Botswana#[41] | Course duration: 5 years | Regular training, incl. one long-term on-the-job training. Clerkship: 8 weeks rotation; for completion, mandatory passing of exam in psychiatry |
Collaboration with UK and US Problem-based learning Innovation in imparting psychiatric training (high-tech and low-tech tools for learning clinical and theoretical aspects) Limited resources paved way for evidence-based and reality-oriented training (investigation and treatment). |
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| WHO-region: Asia | |||
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| India#[6] | Course duration: 5.5 years, incl. one year of internship. | -First year: Basics of behavioral science -Year 2: clinical posting -Year 3 and 4: lectures in psychiatry -Psychiatry training: 40 hours of theory and 4 weeks of clinical postings. Assessments: Formative and summative -Internship: 2 weeks of psychiatry rotation. |
-Psychiatry is still a subspecialty under general medicine -Integrative teaching has been adopted. -Psychiatry is not a major subject; recently AIIMS, Rishikesh has made this provision. -Variation in training across countries, incl in INIs. |
| Sri Lanka# (Sri Lanka Medical Council)[1] | Course duration: 6 years, incl. one year of internship. |
-8–12 weeks of clinical training and 40–75 hours of lectures Clinical posting: two separate clerkships placed in the 4th and 5th year. Internship: Psychiatry posting isn’t mandatory |
-Psychiatry is one of the major subjects like medicine, surgery, etc. -Considerable homogeneity in training across the country compared to other SEAR countries |
| Bangladesh#[1] | Duration: 6 years incl. one year of internship | 3-weeks of clinical rotation in psychiatry Year 4 and 5: Ward placement in the third phase for clinical classes 20 hours: didactic lecture Internship: no mandatory placement in psychiatry |
-Psychiatry teaching starts late in medical course -Receives less importance during the internship (elective psychiatry posting) |
| China# (Clinical medicine curriculum)[42] | Course duration: 6 years | -Year 3–6: Didactic lecture and clinical attachment -Year 6: 7 weeks clinical clerkship -Exposure to in-patient, out-patient, and community rehabilitation clinics. Exposure to sub-specialties: geriatric, CAMH, SUD, and sub-specialty electives |
Variation across the country Japan# |
| (Japan Accreditation Council for Medical Education (JACME))[43] | Duration: 4–5 years Pre-clinical: 2 years Clinical: 2 years school, and college entry programs (duration: 4 years) |
2 weeks psychiatry clerkship -Psychiatry, one out of six major disciplines |
Emphasis on outcome-based education |
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| WHO-region: Oceania | |||
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| Australia and New Zealand (Australian Medical Council (AMC); Medical Council of New Zealand) e.g.,[44,45] | Duration: 4–6 years Year 1: background knowledge of biomedical science Year 2–3: clinical attachment Year 4: electives or selective pre-vocational training: 2 years |
-Taught throughout the undergraduate course -Year 1: Lectures on mental health -Proposal to increase rotation in psychiatry to 13 weeks (Victoria mental health system, 2021) |
-Emphasis on problem-focused learning and Integrative learning -Assessment: throughout the program, fit for purpose assessment -Culturally relevant training -Interdisciplinary and interprofessional training. -Small group teaching -High-tech simulation facilities |
#Low-and middle-income country, the rest others are HICs. (): mentions the accreditation body/agency; AIIMS: All India Institute of Medical Sciences, INIs: Institute of National Importance; CAMH: Child and adolescent psychiatry, CAAP: Combined accelerated psychiatry program (CAPP), CL: Consultation-liaison, mgt: management, INIs: Onstitute of national importance, SEAR: Aouth-east Asian, region, SG: small group, SUD: Substance use disorders