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Strengthening Evidence based Reproductive Health Services in Medical Education: Integrating gender and impacting clinical practice

14 May 2018

UNFPA and the Department of Medical Education and Research, Government of Maharashtra organized a workshop on Strengthening Evidence based Reproductive Health Services in Medical Education: Integrating gender and impacting clinical practice on 12th May 2018 at Mumbai. President MCI, Dr. Jayshree Mehta was the Chief Guest for the consultation. Present at the consultation were Directors, Medical Education from 19 States; Vice Chancellor, Maharashtra University of Health Sciences; Secretary MCI; Joint Secretary MCI and Deans from six top medical colleges in Maharashtra were also present.

The workshop aimed to:

  • Share processes and experiences on integrating gender and rights issues in medical curriculum in Maharashtra.
  • Discuss methodologies for strengthening evidence based reproductive health care in medical colleges by building skills of medical students in providing rights based contraceptive services.

As part of the session on integrating gender in medical education, CEHAT, our implementing partner made a presentation of the processes followed under the program and the impact of the implementation research to assess change in gender attitudes of students who had been taught using the gender integrated modules.  Faculties from two Government Medical colleges presented their experiences of transacting gender integrated modules and how this had lead to changes in clinical practices that are gender sensitive and evidence based. The session also had a presentation on review of medical text books from a gender perspective and experience sharing by two students. Director medical education and research summed up the entire process to inform other Directors of the steps that need to be taken for replication of processes. VC of MUHS mentioned that while modules of five disciplines have been approved by the Academic Council, gender integrated modules of all disciplines should be prepared and a comprehensive approval sought.

Dr. Jayshree Mehta, MCI, President appreciated the Maharashtra effort of integrating gender across five disciplines and ensured that MCI curriculum which is being revised would look at  integrating gender and right based practices. She also committed to include sections from the gender integrated modules of Maharashtra as part of the minimum standard requirement of medical curriculum as recommended by MCI.

 

Methodologies to strengthen evidence based, gender sensitive reproductive health care in medical colleges and building skills of medical students in providing rights based contraceptive services was also discussed. A recent study undertaken in three states by PGI with UNFPA support that revealed poor skills of medical students on rights based provision of Family Planning services was presented by PGI. Dr. Kirti Iyengar from UNFPA made a presentation on need for strengthening medical curricula by integrating evidence based RH practices. These presentations formed the basis for a free flowing discussion on what changes can be brought about in the teaching of medical students so that they acquire greater skills for provision of Contraceptive services, respectful maternity and exhibit sensitivity towards the reproductive rights of young people.

Some of the suggestions that emerged included:

- Include issues around rights based family planning and gender in the two month foundation course for medical students – To be done in collaboration with and guidance from MCI.

- Identify opportunities to ensure questions on evidence based family planning are included in exams of undergraduate students/post graduate students.  This can be done by:

  • Including teaching on Family Planning in examinations semesters
  • Including a case on Family Planning in PG exams (This is already being done in some States)
  • Giving marks for family planning posting of Interns
  • Include questions on contraceptive methods/counseling as part of exams at UG level.
  • All medical colleges to be mandated through MCI to establish fully equipped skill Labs /Family Planning Labs with Samples of Contraception, models, SOPS etc.
  • For students to develop skills that are client friendly and right based, MCI should consider integrating competency based training as part of curricula and look at evolving teaching/facilitating methodologies that can help students develop such skills. MCI informed that they are looking at including 2000 skills as part of the revised curriculum and FP skills would form a core component of these. These skills will be transacted from the 2019 batch of medical students.
  • Organize consultations with text book writers to align information to International / National standards and protocols. A suggestion that GME faculty could  be commissioned to write text books that include evidence based practices and are aligned to National and international guidance on the issue.
  • Medical Colleges to be encouraged by MCI to have contraception and evidence based maternal care as a theme of their Annual Conferences and students to get CME points for participating in such seminars.
  • SOPs on various contraceptive methods to be shared with Medial colleges, they are normally shared only with District hospitals. These SOPs to displayed at conspicuous places in medical colleges.
  • There is a concept of integrated teaching in medical colleges and  in order to build skills around contraception, OBGY and community medicine can organize integrated teaching sessions.

The following States in addition to Maharashtra showed interest in piloting the above initiative: Chandigarh, Gujarat, West Bengal, Rajasthan, Uttarakhand and Uttar Pradesh.