Early exposure to psychiatry & its competencies to medical undergraduates by CBME: how is it a game changer?

–DR.VAIBHAVI.P.S

Volume 12 Issues 10 October, 2022

Ever since our school days, we were taught only about physical health and ways to maintain it. The concept of mental health seemed almost nil at a younger age, and so did awareness about mental health.
In the pre-CBME era, though the 1st year MBBS dealt with the anatomy of the brain and its physiological functions, the translation to various systemic diseases & specialities came in with ease. However, the stress on Psychiatry or mental health illness was certainly lacking.
The medical undergraduates were designed to have clinical psychiatry postings in 2nd MBBS, and the following only exposure would be in final MBBS as theory classes, which would witness hampered attendance by the students for various reasons, leaving the last contact with Psychiatry in internship as minor postings which would many times be missed or unattended.
Psychiatry was seen as a distant branch as the 1st & 2nd -year subjects did not help understand
the symptoms of psychiatric disorders owing to neglect as a minor subject, less time allotted
for postings and attribution of symptoms to external factors alone without due consideration
of biology of the brain function and its manifestations when comprised.
The current CBME curriculum has been carefully designed with clinical postings starting in
II year MBBS, continued clinical sessions complemented by theory classes in III year MBBS
and final year MBBS, yearly internal assessment in III & final year, followed by optional
postings in final year & mandatory postings in internship. This helps the student to have a
continuum and understand Psychiatry in a better way.

This curriculum is also ideal for the undergraduate training period as they are exposed to OPD and IP services early and frequently. It would be an upgrade if the CBME could revise the theory and clinical approach based on brain functioning, which is more relatable and helps link the causation of various
psychiatric disorders and its association to systemic disorders. It would be a bonus if community activities are included as part of psychiatry training as well to help understand
problems in real time.
Certainly, CBME for Psychiatry is a welcome move that helps reduce the stigma against
Psychiatry within the medical fraternity first with positive attitude and widens the horizon for a better & holistic approach of patient care. This curriculum indirectly makes our young
undergraduates’ flag bearers’ in creating mental healthcare awareness in the days to come
among both peers and the public, which is the need of the hour as witnessed by the surge of
mental health issues in the post-COVID times. CBME curriculum is a golden opportunity for
Psychiatric teaching faculty to educate our young brigade the right way and help them
acknowledge that mental illness exist at large and that it is treatable too.
This marks the beginning of the ‘process of change’ where one can expect people to talk about
mental illness more openly, seeking mental health care more voluntarily, which may reflect
in the diagnostic and therapeutics of the population in the days to come.
This way, Psychiatry would get its rightful & long-overdue place in the field of medical
sciences !!

Reference:

1. Sethi S, Kataria D, Srivastava V. Competency-based medical education: Relevance to psychiatry. Indian J Psychiatry. 2021 Mar-Apr;63(2):189-191. doi:10.4103/psychiatry.IndianJPsychiatry_639_20. Epub 2021 Apr 14. PMID: 34194065; PMCID: PMC8214124.
2. Sahadevan S, Kurian N, Mani AM, Kishor MR, Menon V. Implementing competency-based
   medical education curriculum in undergraduate psychiatric training in India: Opportunities
   and challenges. Asia Pac Psychiatry. 2021;13(4):e12491.
3. Gupta S, Menon V. Psychiatry training for medical students: A global perspective and
   implications for India’s competency-based medical education curriculum. Indian J
   Psychiatry. 2022;64(3):240–51.