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 Table of Contents    
LETTER TO EDITOR  
Year : 2021  |  Volume : 46  |  Issue : 3  |  Page : 576-577
 

Graduates of MD Community Medicine to specialize in infectious diseases: A long-term public health prospect


1 Department of Community Medicine, AIIMS, Raipur, Chhattisgarh, India
2 Department of Community Medicine, AIIMS, Jodhpur, Rajasthan, India
3 Department of Community Medicine, GMC, Bhopal, Madhya Pradesh, India

Date of Submission20-Dec-2031
Date of Acceptance21-Apr-2027
Date of Web Publication13-Oct-2021

Correspondence Address:
Dr. Manju Dubey
Department of Community Medicine, AIIMS, Raipur - 492 099, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijcm.IJCM_1058_20

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How to cite this article:
Dubey M, Kumar M M, Choudhary Y, Toppo M. Graduates of MD Community Medicine to specialize in infectious diseases: A long-term public health prospect. Indian J Community Med 2021;46:576-7

How to cite this URL:
Dubey M, Kumar M M, Choudhary Y, Toppo M. Graduates of MD Community Medicine to specialize in infectious diseases: A long-term public health prospect. Indian J Community Med [serial online] 2021 [cited 2021 Nov 27];46:576-7. Available from: https://www.ijcm.org.in/text.asp?2021/46/3/576/328164




Sir,

The Global Burden of Diseases, Injuries, and Risk Factors Study 2019[1] highlights that 25.02% of total deaths in India are attributed to communicable diseases, compounded by increasing population density (resulting in overcrowding), proportion of population in slums (resulting in poor water, sanitation, and hygiene), and poverty. This is against a deficient health-care delivery system, in terms of both infrastructure and Human Resources for Health.[2] The epidemiology of infectious diseases thus demands multisectoral, multipronged interventions to prevent, control, detect, diagnose, and treat infectious diseases.

In the era of emerging and re-emerging infectious diseases, often with pandemic potential necessitating preparedness and prompt investigation of every outbreak, along with antimicrobial resistance and stewardship; changing epidemiology and management of infectious diseases; changing spectrum of infectious disease emergencies - the need for infectious disease specialist is pivotal than ever before.

The super specialty training program in Infectious Diseases is relatively a young branch in India with only fifty individuals specialized as of 2017.[3] Doctorate of Medicine (DM) and Fellow of National Board of Examinations (FNB) in Infectious Diseases are available in India, predominantly through the National Board of Examination (NBE) accredited institutions recognized for running fellowship courses and institutes of national importance (similar to AIIMS). The minimum required/prior entry eligible qualification for DM Infectious Diseases (3-year course) in NBE accredited institutions is MD/DNB (General Medicine) or MD/DNB (Pediatrics) or MD/DNB (Respiratory Medicine) or MD (Tropical Medicine)[4] and MD Medicine/Pediatrics/Microbiology/Tropical Medicine or equivalent recognized degree in institutes of national importance,[5] for FNB Infectious Diseases (2-year course) the prior entry eligible qualification being MD/DNB (General Medicine) or MD (Tropical Medicine).[6]

It is really unfortunate to not have residents completing MD Community Medicine/Preventive and Social Medicine eligible for super specialty training program in Infectious Diseases. The course curriculum, “Guidelines for competency based postgraduate training program for MD in Community Medicine,” from the National Medical Commission (NMC) and of other institutes or universities (such as the AIIMS, The Tamil Nadu Dr. MGR Medical University, and The West Bengal University of Health Sciences) includes communicable diseases, especially those of public health importance, their epidemiology, natural history, burden, influence of social, cultural, and ecological factors on the epidemiology of the disease, prevention and control (including vector control) measures, diagnosis and management (including clinical methods, use of essential laboratory techniques, selection of appropriate treatment regimes, rehabilitation, and follow-up), principles of planning, implementing, and evaluating control measures for the diseases at the community level, disease surveillance, health education, and outbreak investigation. This is in addition to skills related to demography, Reproductive and Child Health, nutrition, health management, sociology, school health, occupational health, water, environmental sanitation, and hygiene, incorporating a comprehensive approach to infectious disease prevention and control.

NMC states that Community Medicine, as a branch of medicine, will inculcate a holistic view of health and medical interventions with the knowledge, skills, competencies in primary, secondary, and tertiary care, control and prevention of outbreaks/epidemics, community diagnosis, health needs assessment, epidemiological assessment, research, and planning evidence-based health policies and programs. This will be done through orientation and/or field postings in Health Sub-Centers, Primary Health Centers under and/or at Rural Health Training Center, and Urban Health Training Center attached to Departments of Community Medicine as per Medical Council of India norm for duration of 1 year. Postings will also be in the teaching hospital for exposure to clinical departments, namely Pediatrics, Obstetrics and Gynecology, and General Medicine, to acquire clinical skills for diagnosis and management of communicable diseases for a minimum period of 1 month.[7] It is high time that Community Medicine departments across the country are well equipped to train postgraduates in lines with spelt out curriculum.

Given the knowledge, skills, and competencies acquired by residents of MD Community Medicine, the state of infectious disease specialists in the country and global/national situation in terms of communicable/infectious diseases, it is the need of the hour to make MD Community Medicine residents eligible for DM/FNB infectious diseases. In addition, Community Medicine is the heart of every health system, and especially in this time of COVID pandemic, the role of this branch has been widely acknowledged. Community Medicine being considered a clinical branch with special emphasis on communicable diseases at one end, but making MD Community Medicine residents not eligible for DM/FNB infectious diseases at the other is not justified. The role of the Indian Association of Preventive and Social Medicine to materialize this is immense; if not, it will be an opportunity lost.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:1204-22.  Back to cited text no. 1
    
2.
Murray CJ, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:1223-49.  Back to cited text no. 2
    
3.
Parry N. Just Fifty Infectious Disease Specialists in India. Health Issues India; 2017. Available from: https://www.healthissuesindia.com/2017/10/24/just-fifty-infectious-disease-specialists-india/. [Last accessed on 2020 Oct 28].  Back to cited text no. 3
    
4.
Information Bulletin-National Eligibility Cum Entrance Test, Admission to DM, MCh and DNB Super Specialty Courses (NEET-SS, 2020). Available from: https://cdn.digialm.com//per/g01/pub/852/EForms/image/ImageDocUpload/654/1112652249523015558621.pdf. [Last accessed on 2020 Oct 28].  Back to cited text no. 4
    
5.
Prospectus for Post-Graduate & Post-Doctoral Course [DM/M.Ch. MD], Jan-2021. AIIMS New Delhi. Available from: https://www.aiimsexams.org/pdf/Prospectus%20DMMCH%20Jan-2021%20-%20 (10.9.2020).pdf. [Last accessed on 2020 Oct 28].  Back to cited text no. 5
    
6.
Information and Application for Fellowship Entrance Test, NBE FET-2019. Available from: https://natboard.edu.in/fellow_ship_nbe/bulletin/FET_2019_Bulletin.pdf. [Lastaccessed on 2020 Oct 28].  Back to cited text no. 6
    
7.
Guidelines for Competency Based Postgraduate Training Program for MD in Community Medicine. National Medical Commission. Available from: https://www.nmc.org.in/wp-content/uploads/2019/09/MD-Community-Medicine.pdf. [Last accessed on 2020 Oct 28].  Back to cited text no. 7
    




 

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