Upgrading Community Medicine to ‘Community Medicine and Public Health’ is a middle ground in the curriculum
The country has seen the threat of two COVID-19 waves and is staring at a third. While COVID-19 has been presented as a widespread public health disaster, the impact of medical doctors in the health policy response to COVID-19 has been particularly profound. This is symptomatic of our long-standing tendency to confuse medicine with public health, which is pervasive even in the highest policy-making sectors.
In any case, both the scope and outcome of the drug in the overall health of the population are quite limited. COVID-19 implies that this fact leaves libraries and academia, and manifests itself in the form of tangible policy measures that help strengthen public health in the country.
distinctive feature, stop
In the 1950s, a global consensus on the importance of socially-oriented physicians in population health and a concomitant national consensus resulted in the establishment of community medicine as a distinct medical specialty at both the undergraduate and postgraduate levels. Large portions of the community medicine curriculum are devoted to tackling major public health challenges, the plethora of vertical disease control programs that have always inspired national public health discourse. The comprehensive medical curriculum has remained more or less stable since independence.
Likewise, there has been hardly any effort to reform the community medicine curriculum, which primarily provides technical input for technical health programs – one that can also take on larger questions relating to health policy and health systems, And can simultaneously create critical thinking. Lines that differ from clinical therapy.
multidisciplinary science
Some experts have advocated the establishment of public health departments in medical schools prompted by the COVID-19 pandemic. Community medicine, while often equated with public health, fails to embrace many aspects of the multidisciplinary combination of public health competencies. Pair the community medicine curriculum with some of the bastions of socially-oriented public health courses, and the distinction is readily apparent. But supporters of community medicine are not denying this essential distinction – ultimately, community medicine is a medical specialty while public health is a multidisciplinary science. Since public health is a multidisciplinary science, why do we place an emphasis on establishing public health competencies in medicine, and not so much for other allied fields such as engineering or anthropology?
The practical answer is that medical doctors, Actually, is likely to remain the most influential player in public health policy, at least for the foreseeable future. This makes it imperative that physicians imbibe multidisciplinary public health thinking from their early days. Recent medical curriculum reforms in India have emphasized clinical empathy, early clinical performance, and, at least ritualistically, greater community exposure.
example of cuba
However, none of these provide the competencies needed to critically evaluate the landscape of a country’s larger public health and health systems. It is least desirable for a medical course to be immersed in clinical medicine and not develop a broad public health orientation where health policy is largely shaped by doctors. At the postgraduate level, a re-emphasis on multidisciplinary public health principles will be equally important to ensure that we produce not only community medical technocrats but full advocates of health system reform. While health care reform is a complex process with many interacting elements, the role of early medical education in it is often underestimated. Countries like Cuba demonstrate how a medical curriculum linked to public health can strongly influence the entire philosophy of health care provision in a country.
Despite the considerable overlap between them, the non-replacement potential of community medicine and public health cannot be overlooked, at least in the current Indian context. Community medicine will always defend its uniqueness as a fundamental medical specialty for doctors, and public health courses should be open to students from diverse backgrounds.
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looking ahead
The middle ground can be found by upgrading community medicine to ‘community medicine and public health’ at both the undergraduate and postgraduate levels. This would involve improving the community medicine curriculum through incorporating or emphasizing areas of public health that are currently missed or under-emphasized, such as social health, health policy and health systems. Also, the refurbished ‘Community Medicine and Public Health’ departments will require representation from doctors, and experts from areas related to public health.
Dr. Soham D. Bhaduri is a physician, health policy expert, and editor-in-chief of The Indian Practitioner
.